Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

From Flashcardlet > pharma 4.1B thyroid and anti-thyroid drugs > Flashcards

pharma 4.1B thyroid and anti-thyroid drugs Flashcards

0
Q

Hyper thyroidism

A

Loss of wolff-chaikoff block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Wolff-chalkoff block

A

Large doses of iodine inhibit iodide organification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

80%

A

Oral bioavailability of L-thyroxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

95%

A

oral bioavailability of T3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Synthetic levothyroxine

A

DOC for thyroid replacement and suppression therapy

Half life: 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Liothyronine T3

A

3-4x more potent than T4 Levothyroxine
Half life: 24hours
Not recommended for Routine Replacement Therapy
High risk of cardiotoxicity (only short-term suppression of TSH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Liotrix

A

T4 thyroxine + T3 liothyronine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Thioamides

A

PTU
Methimazole
Carbimazole
Thiocarbamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

PTU

A

Peak: 1 hour
Bioavailability: 50-80%
Excreted by kidney as INACTIVE glucuronide w/in 24hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Methimazole

A

10x more potent than PTU
Completely absorbed
Slower excretion than PTU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thioamides

A

Prevent hormone synthesis
(Inhibit thyroid peroxidase catalyzed rxns, block iodine organification, block iodotyrosine coupling, inhibit peripheral T4 deiodination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3-4 weeks

A

Stores of T4 are depleted after how long?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Methimazole

A

Toxicity: altered sense of taste and smell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Maculopapular pruritic rash

A

Most common adverse effect of thioamide toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

PTU

A

Toxicity: hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Methimazole

A

Toxicity: cholestatic jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Agranulocytosis

A

Most dangerous complication of thioamide toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Anion inhibitors

A

Block uptake of iodide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Potassium per chlorate

A

Major clinical use: iodide-induced hyperthyroidism
(Amiodarone-induced hyperthyroidism)
Rarely used: aplastic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Iodides

A

Inhibit organification
Major action: Inhibit hormone release through inhibition of thyroglobulin proteolysis
Induce hyperthyroidism (Jod-Basedow Phenomenon) or precipitate hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Iodide

A

Tx: thyroid storm

For preoperative preparation for surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Iodism

Acneiform rash

A

Iodide toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

5 days

A

Half life of radioactive iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Propanolol

A

For improvement of hyperthyroid symptoms
Inhibits peripheral conversion of T4

May reduce T3 level if greater than 160mg/d

Inhibits peripheral conversion of T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Levothyroxine

A

Infants: high T4 req
Adults: 1.7mcg/kg/d
Elderly >65: less T4 req

Empty stomach
7 days half life

6-8 weeks: steady state in blood stream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Children: insomnia, acc bone maturation and growth
Adults: inc nervousness, heat intolerance, palpitation, tachycardia, unexplained weight loss
Elderly (chronic): atrial fib, acc osteoporosis

A

Levothyroxine toxicities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Myxedema coma

A

End state of untreated hypothyroidism

Give IV only!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Hypothyroidism

A

Anovulatory cycles
Infertility
Contributes to early development of fetal brain during pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Thyroid hormone therapy

A

Considered if TSH is greater than 10 mIU/L in subclinical hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Levothyroxine

A

Given in drug or amiodarone-induced hypothyroidism

30
Q

Grave’s disease

Diffuse toxic goiter

A

Most common form of hyperthyroidism

31
Q

Antithyroid drug therapy

A

Primary management for grave’s dse indicated for young patients, small glands, and mild disease

32
Q

Methimazole

A

Preferred for pregnant women? Methimazole or PTU?

33
Q

PTU

A

Inhibits conversion of T4 to T3

Faster decrease in activated thyroid hormone level

34
Q

Block replace

A

Levothyroxine of 50-100mcg

35
Q

Titration regimen

A

Superior remission
Cant be used in pregnancy
Not a sensitive index of treatment response

36
Q

Thyroidectomy

A

Tx of choice for very large glands or miltinodular goiters

37
Q

Radioactive iodine

A

Preferred Tx for patients over 21 y/o
With heart dse
With severe thyrotoxicosis
For elderly patients

38
Q

Hypothyroidism

A

Occurs in 80% of patients taking radioactive iodine

39
Q

Pregnancy and breast feeding

A

ABSOLUTE CONTRAINDICATIONS to radioactive iodine

Can conceive safely after 6months

40
Q 
Beta blockers (propanolol)
Diltiazem
A

Adjuncts to thyroid therapy

41
Q

Adjuncts to antithyroid therapy during acute phase thyrotoxicosis

A

Beta blocker, diltiazem, barbiturate, bile acid sequestrants

42
Q

Bile acid sequestrantsn(cholestyramine)

A

Rapidly lowers T4 levels

Inc fetal excretion of T4

43
Q

Toxic goiter

A

FT4 elevated or normal

FT3 or T3 markedly elevated

44
Q

Single toxic adenoma

A

Surgical incision or radioiodine therapy

45
Q

Toxic multinodular goiter

A

Tx is methimazole or PTU

Subtotal thyroidectomy

46
Q

Subacute thyroiditis

Give supportive therapy

A

Acute phase of viral infection of thyroid gland
Destruction of thyroid parenchyma
Transient release of stored thyroid hormones
Occurs in Hashimoto’s thyroiditis
SPONTANEOUSLY RESOLVING HYPERTHYROIDISM

47
Q

Thyroid storm

A

Thyrotoxic crisis

48
Q

Thyroid storm

PROPANOLOL

A

IV

Control severe CV manifestations

49
Q

Thyroid storm

DILTIAZEM

A

Alternative to propanolol
Severe heart failure or asthma
Oral
IV for asthmatic patients only

50
Q

Thyroid storm
KISS
SATURATED SOL’N OF POTASSIUM IODIDE

A

Oral

Retards release of thyroid hormones from gland

51
Q

Thyroid storm

PTU

A

Rectal
Blocks hormone synthesis
Retention enema

52
Q

Thyroid storm

HYDROCORTISONE

A

Protect Patient against shock
Block conversion of T4 to T3
IV

53
Q

Thyroid storm

SUPPORTIVE THERAPY

A

Control fever

Heart failure

54
Q

Thyroid storm

PLASMAPHARESIS or PERITONEAL DIALYSIS

A

Lower levels of circulating thyroxine

55
Q

Total thyroidectomy

131iodine ablation+oral prednisone

A

Tx for opthalmopathy

56
Q

Opthalmopathy

A

Elevate head
Artificial tears (prevent corneal drying)
Smoking cessation
Severe acute inflamm rxn

57
Q

Irradiation of posterior orbit

Using well collimated high energy xray therapy

A

If steroid therapy fails or is contraindicated

58
Q

Dermopathy

A

Pretibial myxedema

59
Q

Topical corticosteroid with occlusive dressing

A

Tx for dermopathy or pretibial myxedema

60
Q

PTU

A

Tx for thyrotoxicosis on first trimester

61
Q

Subtotal thyroidectomy

A

Tx for thyrotoxicosis on mid trimester

62
Q

Thyroid supplement

A

Tx for thyrotoxicosis after delivery

63
Q

Methimazole

A

Risk of fetal scalp defects

64
Q

PTU
Lugols sol’n
Propanolol
Oral prednisone

A

Tx for neonatal grave’s dse

65
Q

Subclinical hyperthyroidism

A

Low TSH with normal thyroid hormones
Cardiac toxicity (a-fib)
Treat if TSH is less than 0.1 mIU/L

66
Q

Type I - iodine-induced (multinodular goiter)

Type II- inflammatpry thyroiditis (leakage of thyroid hormone into circulation)

A

2types of amiodarone-induced thyrotoxicosis (AAT)

67
Q

Thioamides - type I

Glucocorticoids - Type II

A

Tx for type I and type II Amiodarone-induced thyrotoxicosis (AAT)

68
Q

Nontoxic goiter

A

TSH stimulation from inadequate thyroid hormone synthesis
Most common cause is iodide deficiency (Tx give iodide)
Hashimoto’s thyroiditis

69
Q

Thyroxine therapy

A

Tx for hashimoto’s and dyshormonogenesis

70
Q

FNAB

A

Primary diagnostic test for thyroid neoplasms

71
Q

Total thyroidectomy
Postop radioiodine therapy
Lifetime levothyroxine

A

3 Txs for thyroid carcinoma

72
Q

Rise in serum thyroglobulin
Postive 131iodine scan when TSH is elevated
Admin of recombinant human TSH (thyrogen) (IM)

A

Positive tumor criteria for thyroid

From Flashcardlet (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions