Thyroid & Parathyroid Agents Flashcards

1
Q

What are the actions of the thyroid gland?

A
  • Produces two thyroid hormones using iodine found in the diet (T3 & T4)
  • Removes iodine from the blood, concentrates it, and prepares to for attachment to tyrosine, an amino acid
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2
Q

What are the functions of the thyroid hormone?

A

Regulate the rate of metabolism
Affect heat production and body temperature
Affect oxygen consumption, cardiac output, blood volume
Affect enzyme system activity
Affect metabolism of carbs, fats, and proteins
Regulate growth and development

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3
Q

What are the two types of thyroid dysfunction?

A

Hypothyroidism

Hyperthyroidism

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4
Q

Hypothyroidism is the under-activity of the thyroid

A

True

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5
Q

Hyperthyroidism is the overactivity of the thyroid

A

True

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6
Q

Low thyroid function causes high TSH

A

True

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7
Q

What is the normal range of TSH

A

.5-4.5

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8
Q

High thyroid function causes low TSH

A

True

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9
Q

Low TSH represents hyperthyroidism

A

True

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10
Q

What are the causes of hypothyroidism

A

Absence of the thyroid gland
Lack of sufficient iodine in diet to produce needed levels of thyroid hormone
Lack of sufficient functioning thyroid tissue due to tumor or autoimmune disorders
Lack of TRH related to a tumor or disorder of the hypothalamus

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11
Q

What are the replacement hormone products for treating hypothyroidism

A
Levothyroxine (synthroid) 
Thyroid Desiccated (Armour Thyroid) prepared from from dried animal thyroid glands and contain both T3 & T4
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12
Q

Indication of thyroid hormone

A

Replacement therapy in hypothyroidism; pituitary TSH suppression in the treatment of euthyroid gaiters, management of thyroid cancer; thyrotoxicosis in conjunction with other therapy; myxedema coma

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13
Q

Pharmacokinetics of thyroid hormone

A

Absorbed in GI tract and bound to serum proteins
Elimination is in bile
Does not cross the placenta

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14
Q

Contraindications for thyroid hormone

A

Known allergy
Thyrotoxicosis (too much thyroid hormone)
Acute MI

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15
Q

Caution when using thyroid hormone

A

Lactation

Hypoadrenal conditions such as Addison’s

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16
Q

Thyroid hormone exposed to children through lactation can cause growth and development problems

A

True

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17
Q

Adverse effects of thyroid hormone

A

Skin reactions
Symptoms of hyperthyroidism
Cardiac stimulation
CNS effects

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18
Q

Drug-Drug interactions with thyroid hormone

A

Cholestyramine
Oral anticoagulants
Digitalis
Theophylline

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19
Q

Levothyroxine is the prototype for thyroid hormone

A

True

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20
Q

What causes hyperthyroidism

A

Graves’ disease

21
Q

Signs and symptoms of hyperthyroidism

A

Increased body temperature Flushing
Tachycardia Intolerance to heat
Think skin. Amenorrhea
Palpitations Weight loss
Hypertension Goiter

22
Q

What are the actions of antithyroid agents

A

Thioamides prevent the formation of thyroid hormone within the thyroid cells, lowering the serum level of thyroid hormone
Partially inhibits the conversion of T4 to T3

23
Q

Indications with antithyroid agents

A

Hyperthyroidism

24
Q

Pharmacokinetics of antithyroid agents

A

Well absorbed from GI tract and then concentrated in the thyroid gland
Some excretion can be detected in urine

25
Q

Contraindications of antithyroid agents

A

Known allergy

Pregnancy

26
Q

Cautions with antithyroid agents

A

Lactation

27
Q

Adverse effects of antithyroid agents

A

Thyroid suppression

28
Q

Drug-drug interactions with antithyroid agents

A
Oral anticoagulants 
Theophylline 
Metoprolol
Propranolol
Digitalis
29
Q

Propylthiouracil is the prototype for antithyroid agents

A

True

30
Q

Propylthiouracil is used for the treatment of hypothyroidism

A

True

31
Q

The thyroid gland uses iodine to produce the thyroid hormones

A

True

32
Q

What is hypoparathyroidism

A

The absence of parathormone

Most likely to occurs with the accidental removal of the parathyroid glands during thyroid surgery

33
Q

What is hyperparathyroidism

A

The excessive production of parathormone

Can occurs as a result of parathyroid tumor or certain genetic disorders

34
Q

What are antihypocalcemic agents

A

Agents used for stimulation of osteoclasts or bone cells to release calcium from the bone
Increased intestinal absorption of calcium
Increased calcium resorption from the kidneys
Stimulation of cells in the kidney to produce calcitriol

35
Q

Indications for antihypocalcemic agents

A

Management of hypocalcemia in patients undergoing chronic renal dialysis
Treatment of hypoparathyroidism

36
Q

Pharmacokinetics of antihypocalcemic agents

A

Absorbed from GI tract and widely distributed throughout the body
Stored in liver, fat, muscle, skin, and bones
Metabolized in the liver, excreted in the urine

37
Q

Contraindications of antihypocalcemic agents

A

Allergy to vitamin D
Hypercalcemia
Vitamin D toxicity
Pregnancy

38
Q

Caution with antihypocalcemic agents

A

History of renal stones

39
Q

Adverse effects of antihypocalcemic agents

A

GI effects

CNS effects

40
Q

Drug-drug interactions with antihypocalcemic agents

A

Magnesium containing antacids

Cholestyramine or mineral oil

41
Q

Prototype for antihypocalcemic agents

A

Calcitriol

42
Q

Antihypercalcemic agents are used to

A

Treat PTH excess or hypercalcemia

Act on the serum levels of calcium and do not suppress the parathyroid gland or PTH

43
Q

What are the antihypercalcemic agents

A

Bisphosphonates

Calcitonins

44
Q

Alendronate (fosamax), ibandronate (Boniva), risedronate (actonel) are all bisphosphonates

A

True

45
Q

Bisphosphonates should be taken in the AM with a full glass of water, 30 minutes prior to food and drink
Must remain upright for at least 30 minutes after

A

True

46
Q

Alendronate is the prototype for antihypercalcemic agents-bisphosphonates

A

True

47
Q

What is alendronate used to treat

A

Osteoporosis

48
Q

Prototype for antihypercalcemic agents - calcitonins

A

Calcitonin salmon