Thyroid Disorders Flashcards
(21 cards)
what are the hyperthyroidism characteristics
high T3/T4
low TSH
symptoms of hyperthyroidism
hyperactivity
anxiety and irritation
insomnia and tiredness
goitre
heat sensitivity
weight loss
diarrhoea
polyurea
palpitations
increased metabolism and activity
What is 1st line treatment for hyperthyroidism
carbimazole
what are the MHRA warnings for carbimazole
- congenital malformations - advise on contraception
- acute pancreatitis - immediately STOP
- bone marrow suppression - report and stop if signs
what is 2nd line treatment for hyperthyroidism
propylthiouracil
What is a contraindication of propylthiouracil
C/I in liver disorder - jaundice, dark urine, nausea
what is used for symptomatic relief in hyperthyroidism
beta blockers
What is 1st line for graves disease
radioactive iodine
what is plan if iodine/surgery unsuitable in graves disease
carbimazole given as block and replace with levothyroxine for 12-18 months
what is 1st line for hyperthyroidism in pregnancy
propylthiouracil 1st semester
used if trying to get pregnant in next 6 months
what is precaution after radioactive iodine treatment
women avoid pregnancy for 6 months
men avoid for 4 months
what are the characteristics of hypothyroidism
low T3/T4
high TSH
what are the symptoms of hypothyroidism
tiredness
weight gain
depression
constipation
intolerance to cold
dry skin
menstrual irregularities
decreased metabolism and activity
what is 1st line for hypothyroidism
levothyroxine
what to monitor for levothyroxine
TSH every 3 months until stable
yearly thereafterwh
what are the administration instructions for levothyroxine
take in the morning
at least 30 mins before breakfast or caffeinated drinks
what is the MHRA warning for levothyroxine
new guidance that small proportion of patients can feel symptoms if alternating between brands
what is 2nd line for hypothyroidism
liothyronine
What is the interaction that needs a 4 hr gap
antacids, calcium aluminium + magnesium
reduces absorption of levo
what is the interaction that needs a 2 hr gap
ferrous sulphate
reduces absorption of levo
What are other interactions with levothyroxine
CYP450 enzyme inducers and inhibitors
levo can cause hyperglycaemia so counteracts antidiabetic drugs
orlistat can reduce levothyroxine absorption
