Thyroid Drugs

Front 1

Propylthiouracil- MOA, Dosage (specifically maintenance?), Class, Kinetics, Use

Back 1

MOA- block synth of TH, inhibits peripheral conversion of T4 to T3
Dosage- lower maintenance dose due to thyroid concentration
Class: thionamides
Kinetics-- protein bound
Use: hyperthyroidism, methimazole is preferred agent though

Front 2

Methimazole- MOA, Class, Dose (Maintenance), Kinetics, Use

Back 2

MOA: blocks synth of TH, inhibits peripheral conversion of T4 to T3
Dose- lower maintanace dose b/c concentrates in thyroid
Kinetics- not protein bound BUT MAY CROSS PLACENTA and will cross into breast milk
Use: preferred agent for hyperthyroidism
Class: thionamides

Front 3

How long are pts usually given thionamides?
What kind of monitoring is necessary for pts w/ thionamides?

Back 3

- for 1-2 yrs, until euthyroid state is achieved
- FT4/TSH/CBC (agranulocytosis), LFTs

Front 4

Thionamides- AE

Back 4

- cross sensitivity b.w drugs, maculopap rash, arthralgia, agranulocytosis(educate pts to look for flu like sx), heptatoxicity

Front 5

I 131- MOA, AE, Use

Back 5

MOA: initial disruption of hormone synthesis, then destruction of follicles surrounding thyroid areas
AE: mild thyroid pain, dysphagia, transient thinning of hair, HYPOTHYROIDISM if completely wipes out thyroid
CI: PREGNANCY
Use: hyperthyroidism- preferred in elderly pts or those who failed thiomide tx. Stop thiomide tx 3 days before radioactive iodine tx.

Front 6

Thyroidectomy- AE, Use

Back 6

Use- TOC fo rcarcinoma, compression goiter, CI to thiamides/RAE
AE: hypoparathyroidism, recurrence if not total, hemorrhage, nerve damage

Front 7

Propranolol, CCB (diltiazem)- Use, MOA

Back 7

MOA: decrease palpitations, anxiety, temor, heat intolerance
Use: used for sx while waiting for classic tx to work, DISCONTINUE when tachy stops

Front 8

Iodine- MOA, Use, AE

Back 8

MOA: at high doses, stop thyroid from incorporaing I into hormones-- inhibit hormone production and relesae
AE: rash, drug fever, rhinitis,
Iodis,: metallic taste, burning mouth/throat, head cold
Use: short term sx use-- prepare pt for surgery, decrease vascularity in cancer, and promote euthyroid state, thyroid storm

Front 9

Li- MOA,AE, Use

Back 9

Use: is last resort for hyperthyroidism b/c of narrow theraputic window
AE: thirst tremor, GI effects, CNS

Front 10

Corticosteroids- MOA, Use

Back 10

UseL graves opthalmopathy and thyroid storm

Front 11

Levothroxine sodium- PK, Use

Back 11

PK: slower onset of action than T3, T1/2 -7 days-- steady state in 5-6 wks
Use: monotherapy is DOC for most indications requiring thyroid hormone replacement

Front 12

Liothyronine sodium- PK, AE, Use

Back 12

PK: blood levels fluctuate after each dose-- erratic levels throughout the day
AE: higher incidence of AE than levothyroxine

Front 13

Liotrix- Use

Back 13

Use: myxedema coma

Front 14

TH analog tx- dosing, elderly dosing?

Back 14

dosing- start low and go slow, dose reductions for elderly

Front 15

Dessicated thyroid-Use

Back 15

- only used w. pts who have been onit for yrs, not used for new pts