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9 Cards in this Set
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- Back
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Levothyroxine
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Thyroid Hormone T4
oral or inject Indic: *hypothyroid *cretinism(*higher doses required in children) *TSH suppression therapy in Thyroid CA or nontoxic goiter *wks to obtain steady-state monitor serum T4 and TSH *decrease absorption: cholestyramine Iron Ca++ AlOH Soy products * ^ biliary secrecetion/CL- w?inducer of CYP450- rifampicin,phenytoin, carbamazapine, OC *increase effect of warfarin, TCA, and amiodarone SE: same of Hyperthyroid cond. Narrow therapeutic window |
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Liothyronine
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thyroid hormone T3
oral or inject Indic: rapid onset and shorter dura of action- mxedemic coma or prep for 131-I Tx of CA SE: Same as hyperthyroid cond- heat intol, agitation *more potent- cardiac arrhythmias |
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Liotrix
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Mixture of T3 and T4
oral Indic:*hypothyroid *cretinism *TSH supress for Thyroid CA or nontoxic goiter *decrease absorption: cholestyramine Iron Ca++ AlOH Soy products * ^ biliary secrecetion/CL- induce CYP450- rifampicin,phenytoin, carbamazapine, OC *increase effect of warfarin, TCA, and amiodarone SE: same of Hyperthyroid cond. |
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Propylthiouracil (PTU)
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Thioureylene
MoA: *inhib iodination of tyrosine resides *inhib coupling of iodotyrosine residues on thyroglobulin *inhib peri conversion T4>T3 *short plasma t1/2 Indic:*hyperthyroid *control hyperT4 in Graves with awaiting effects of irradiation *thyroid surgery prep SE: agranuocytosis(dose indep) rash, urtucaria PREFERRED in PREG and NURSING-restricted placental transfer and excretion in milk, minimize dose and monitor periodically |
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Methimazole
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Thiourylene
MoA: *inhib iodination of tyrosine residues *inhib coupling of iodotyrosine residues on thyroglobulin Indic:*hyperthyroid *control hyperT4 in Graves with awaiting effects of irradiation *thyroid surgery prep SE: agranuocytosis-dose dep rash, urtucaria Can be used in Preg pt, not nursing pt |
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Iodide (Iodopen)
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MoA: high [iodide]-inhib I` uptake, iodonation and coupling, and release of thyroid hormone
oral, inject, IV Indic:*pre-op Tx for hyperthyroid state-decreases vasc, size, and fragility of hyperplastic gland *hyperthyroid storm NOT prior to 131-I tx, makes it ineffective SE: hypersensitivity to IV dosing angioedema Effects wane over time, iodide block, must use in conjunction with other drugs |
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131-Iodide
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MoA: concentrates in thyroid gland- beta and gamma radiation kill cells in imme vicinity
Indic:ablation tx for hyperthyroid Interacts with high does iodide SE: overTx-hypothyroid CONTRA-absolutely in preg adjunc with B-blockers while awaiting effects |
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beta-adrenergic recep blockers
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Propranolol (non-cardio specific)
MoA: counteract the increased number of B-recep in the heart caused by T3- block and decrease HR, contractility, and arrhythmias Indic: thyroid strom adjuvant to 131-I acute Tx of hyperthyroid state DO NOT change thyrois hormone levels, change clinical manifestations |
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thryoid strom
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life-threatening thyroid hormone-induced hypermetabolic state (thyrotoxicosis)
Heat intol diaphoresis fever (105-106) ^HR high output HF cardiac arrhythmias delirium, seizures, coma diarrhea, nausea, jaundse, abdopain Causes: infec, surgery, 131-I, preg, anti cholinergics, over palpation of thyroid 3-5x more common in females TX- antipyretics iv hydrocortisone-block conversion and immunosuppresion PTU high does iodide |
