thyroid meds

Question 1

levothyroxine

Answer 1

hypo (TSH elevated)
take in the morning
start 25-50mcg

elderly takes lower 12.5mcg (b/c affects heart)
takes 4-6 weeks to reach therapeutic
long term use increase risk for osteop

Question 2

hyperthyriod

First line
second line
3rd line

Answer 2

1st line: radioactive iodine
2nd line: thrydioectomy
3rd meds: PTU
-beta-blocker help sympotms not a cure

Question 3

propylthiouracil (PTU)
side effects?
what do we monitor and why =?

Answer 3

decrease neutrophils and causes agraulocytosis–> stop med and monitor a CBC for several months post
- take is several times a day

-hepatitis can happen so monitor LFTs

Question 4

Tapazole (methimazole)

Answer 4

easier option (no lab draws and once daily)
more effect

Question 5

how do we treat preg hyperthyroid?

Answer 5

P before T
1st tri start PTU
2nd start Tapazole

Question 6

subclinical TSH abnormal but T3 and T4 normal? What do we do?

Answer 6

watch by draw labs q6-12 months and then start meds