Test 5 Thyroid and Parathyroid Shi Flashcards
(24 cards)
Thyroid hormones for hypothyroidism
Levothyroxine
Levothyroid
Synthetic salt of T4
Desiccated thyroid
Liothyronine: Synthetic salt of T3
Therapeutic action of hypothyroidism drugs
Increase metabolic rate of body tissues
Increase oxygen consumption
Respiration
Heart rate
Growth and maturation
Metabolism of fat, carbs, protein
Indication of hypothyroidism drugs
Replacement therapy
Treatment of myxedema coma
Suppression of TSH in the treatment/ oprevention of goiters
Management of thyroid cancer
Contraindications/ cautions of thyroid hormone drugs
Acute thyrotoxicosis
Acute MI
Lactation
Hypoadrenal conditions such as Addison’s disease
Dosing for older adults
Adverse effects of thyroid hormones
Skin reactions, loss of hair
Symptoms of hyperthyroidism if dose is too high
Less predictable effects: cardiac, CNS, difficulty swallowing
Drug interactions of thyroid hormones
Catecholamines
Insulin, digoxin
Oral anticoagulants
What drugs treat hyperthyroidism (Antithyroid agents)?
Methimazole (Tapazole)
Strong iodine solutions
Thiomides
Therapeutic action of hyperthyroid agents
Thioamines: Prevent formation of thyroid hormone with the thyroid cells, lowering the seru, level ; also partially inhibit conversion of T4 to T3
Iodine solutions: Highly doses block thyroid function
Contraindications of Antithyroid agents
PTU not for use in children except in rare circumstances
Lactation
Adverse effects of antithyroid agents
Thioamides: Effects of thyroid suppression ; GI
Iodine solutions: Hypothyroidism , iodism, staining of teeth ; skin rash ; goiter
Drug interactions of antithyroid agents
Thioamides (PTU): Oral anticoags, theopylline, metoprolol, propranolol, digitalis
Iodine solutions: Anticoags, theophylline, digoxin, metoprolol, propranolol ; foods high in iodine
Methimazole facts
Is used to help control hyperthyroidism and thyroid storm (thyrotoxicosis)
Especially used prior to surgery or radioactive iodine treatment
What to watch out for
* Peripheral neuropathy
* Fever, rash, pruritis
* GI upset
* Dizziness
What are the antihypocalcemic agents?
Teriparatide: Increases bone mass in postmenopausal pt’s woth primary hypogonadal osteoperosis who are at high risk for fractures
Parathyroid hormone (Natpara): Controls calcium levels in pt’s with hypoparathyroidism
Synthetic vitamin D analog: Calcitirol: Used for hypocalcemia
Parathyroid hormone related peptide: Abaloparatide: Used to treat patients with high risk of fracture due to osteoperosis
Calcitriol: Used in pt’s w chronic renal dialysis ; is a vitamin D compound
Therapeutic actions of antihypocalcemic agents
Vitamin D compounds: Regulate absorption of calcium and phosphate from small intestine , mineral reabsorption in bone, reabsorption of phosphate from renal tubes
Teriparatide: Stimulates new bone formation
Parathyroid hormone: Acts as replacement for missing PTH
Abaloparatide: Acts to incrase bone mineral content to stregnthen bone
Contraindications/ cautions of antihypocalcemic agents
Preg
Renal stones
Lactation
Higher osteosarcoma risk
Adverse effects of antihypocalcemic agents
GI
CNS
Patients with liver or renal dysfunction may experience increased level of druf an/ or toxic effects
Hypercalcemia
Drug interactions of hypocalcemic agents
Magensium containing antacids
CHolestyramine or mineral oil
Digoxin
Calcitriol
Regulates absorption of calcium and phosphate from the small intestine, mineral resorption in bone, and reabsorption of phosphate from renal tubules. increasing the serum calcium level
Adverse effects: Dry mouth, constipation, muscle pain, bone pain, metallic taste
What are the Antihypercalcemic agents?
Biphosphonates:
Calcitonins : Calcitonin salmon
Therapeutic actions of antihypercalcemic agents
Biphosphonates: Act to slow or block bone resorption
Treats pagets and postmenopausal osteoperosis
Calcitonins: Balance effects of PTH, Inhibit bone resorption, lower serum calcium levels in children and pt’s with pagets, increase excretion of phosphate, calcium, and sodium from kidney
Contraindications of antihypercalcemic agents
Biphosphonates: Hypocalcemia, preg/ lact
Calcitonins: Lact , allergy to salmon or fish products
Adverse effects of antihypercalcemic agents
Biphosphonates: Abdominal pain, constipation, musculoskeletal pain, ND
Increase in bone pain with pagets
Esophageal ulceration
Long term: Increase risk of femoral shaft fractures
Osteonecrosis of the jaw
Calcitonins: FLushing of the face and sskin, rash, urinary frequency, local inflammation
Intranasal: Dryness and irritation of nose
Calcitonin Salmon
Decreases tubular reabsorption of NA and CA
Increases reabsorption of Ca from GI tract
Nasal spray can also cause back pain, nose bleeds, headaches
