Review Flashcards
most important labs in thyroid
free t4 and TSH
hyperthyroidism labs
low TSH
high T4
hypothyroidism labs
low T4
high TSH
compounds that have iodine
Amiodarone, lithium
hyperthyroidism treatment
thioamides: methimazole and propylthiouracil
methimazole dosing
free t4 1-1.5 ULN 5-10 mg
1.5-2 ULN 10-20 mg
2+ ULN 30-40 mg
thioamides adverse effects
GI, rash, agranulocytosis (fever,flu, immune), hepatitis
what to use in hyperthyroid patients with HR over 90
beta blockers
(prefer metoprolol and atenolol)
hypothyroidism drugs
levothyroxine, liothyronine, armour thyroid
black box warning levothyroxine
weight loss
counseling for levothyroxine
60 mins before breakfast or 4 hours after dinner
empty stomach
uncomplicated adult levothyroxine dosing
1.6 mcg/kg/day
elderly thyroid dose
start 25-50 mcg / day
cvd thyroid dose
12.5-25 mcg/ day
pregnant pts thyroid dose
45% increase in dose
drug interactions
levothyroxine
antacids, bile acid, calcium, warfarin
GERD alarm sx
dysphasia
odynophagia
bleeding
weight loss
when to refer GERD
alarm sx or no PPI relief after 14 days
side effects of calcium
constipation
side effects magnesium
diarrhea