Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
tx for primary/secondary/tertiary hypothyroidism
|
thyroid hormone replacement
|
|
|
synthetic thyroid hormone
|
levothyroxine (T4)
liothyronine (T3) |
|
|
synthetic TH clinical use
|
hypothyroidism
TSH suppression (cancer) nontoxic goiter (levothyroxine) |
|
|
tx of thyrotoxicosis
|
beta blocker
propylthiouracil or methimazole surgery (with euthyroid) |
|
|
MOA of thioamide drugs
|
inhibits thyroid peroxidase
propylthiouracil also inhibits peripheral deiodination |
|
|
MOA for iodide salts
|
inhibit synthesis/release of TH
|
|
|
MOA of radioactive iodine
|
destroys tissue
|
|
|
thioamides
|
methimazole
propylthioruracil |
|
|
enzyme that catalyzes conversion of iodide, H2O2m and TG to form MIT and DIT
|
thyroid peroxidase
|
|
|
clinical use of thioamides
|
control thyrotoxicosis while waiting for remission of Graves
control thyrotoxicosis while waiting for surgery thyroid storm |
|
|
causes embryopathy (usually 1st trimester)
|
methimazole
|
|
|
causes hepatotoxicity and liver failure
|
propylthiouracil
|
|
|
iodide agents
|
iodide salt (KI)
131 I- |
|
|
difference b/w using iodide salt and radioactive iodine to tx hyperthyroidism
|
salts: effect is reversible
131 I-: effect is permanent |
|
|
clinical use of radioactive iodine
|
destroy thyroid tissue
|
|
|
absolute contraindications for radioactive iodine
|
pregnancy, lactation
noncompliance with radiation regulations |
|
|
clinical use of iodide salts
|
thyroid storm
|
|
|
tx of thyroid storm
|
beta blocker
propylthiouracil or methimazole iodide salts (SSKI Lugols) - given 1 hour after thioamide |
|
|
why use levothyroxine (T4) in euthyroid pt. with non-toxic goiter
|
negative feedback decreases TSH
|
|
|
why is T4 better than T3 in hormone replacement
|
T4 has a longer half life
|
|
|
when would you use T3 in hormone replacement
|
emergency (myxedema coma)
|
|
|
b-blocker helps treat what sx of Graves disease
|
heart rate
tremor HTN |
|
|
weight loss
bulging eyes tremors |
graves disease
|
|
|
enzyme that converts T4 to T3 in peripheral tissue
|
thyroid hormone deiodinase
|
|
|
how quickly will methimazole cause a Graves pt to become euthyroid
|
weeks - wait until stored hormone is gone
|
|
|
thioamide agent that is faster at causing euthyroid in graves
|
methimazole
|
|
|
first line tx for hyperthyroidism
|
methimazole
|
|
|
hyperthyroidism tx during pregnancy
|
1st - propylthiouracil
2nd and 3rd - methimazole |
|
|
MOA of iodine salt in hyperthyroidism
|
inhibits TH synthesis and release (wolff-chaikoff effect)
|
|
|
MOA of 131 I- in hyperthyrodism
|
destruction of thyroid gland
|
|
|
major side effect of radioactive iodine
|
hypothyroidism - destroys thyroid
|
|
|
MOA of iodine salt in the preoperative pt.
|
makes surgery easier
|
|
|
iodine salts should be used before or after radioactive iodine
|
only after; salts will compete and release radioactive throughout blood
|
|
|
why are iodide salts given hr before thioamide in thyroid storm
|
iodide will block uptake of thioamide
|
