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7 Cards in this Set
- Front
- Back
Hyopthyroid
-D.O.C. -pharmacokinetics |
Levothyroxine (T4)
-long half-life -stable -potent -inexpensive -free of antigenicity |
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Levothyroxine dosing
-normal maintenance dose -parameters and titrations |
-NMD: 100-150ug/d
-Young patients w/o history of long standing symptoms or patients > 45 with no cardiac symptoms Start: 50ug/d Titrate: up 25-50 ug as required -Elderly patients of patients with a history of cardiace symptoms Start: 12.5-25ug/d Titrate: ip 12.5-25ug as tolderate |
|
Levothyroxine
-drug interactions (6) |
All decrease concentration of levothyroxine
1. Resin binders -Cholestyramine, Colestipol 2. Aluminum containing compounds - Al-hydroxide, Sucralfate 3. Enzyme inducers: Phenytoin, Phenobarb, Rifampin, Carbamazepine 4. Raoloxifene, Estrogen 5. Setraline 6. Omeprazole |
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Levothyroxine - patient counseling
-when and how to take it |
Take at the same time of day, preferably in the AM, ALWAYS on an empty stomach
Do not take with Iron or Calcium containing products |
|
Hyperthyroid
-D.O.C. (2) -MOA |
1. Propylthiouracil (PTU)
2. Methimazole (MMI) MOA: inhibits thyroid peroxidase, inhibits coupling of iodotyrosines, inhibits peripheral conversion of T4 --> T3 |
|
Propylthiouracil and Methimazole
-adverse effects (6) -which effects are signs to stop the medication -which effects contraindicate switching medications |
1. Maculopapular rash
2. GI intolerance 3. Arthralgias & Lupus-like syndrome 4. Benign Transient Leukopenia 5. Hepatotoxicity -don't switch agents 6. Agranulocytosis - STOP agent - don't switch agents |
|
Hyperthyroid
-D.O.C. for toxic nodules, thionamide failure, elderly, cardiac disease or poor surgical candidate -pre-treatment/adjunctive therapy |
Radioactive Iodine
-pretreat with beta-blockers and thionamides in selected patients -post-treat with thionamides, beta-blockers or iodides |