thyroid drugs

Question 1

most thyroid hormone is in which form?

Answer 1

T4

Question 2

what is the predominant for of thyroid hormone in the blood?

Answer 2

thyroxine binding globulin (TBG)

Question 3

in the absence of thyroid hormone, is gene txn repressed or upregulated?

Answer 3

txn is repressed

Question 4

what is the active ligand of thyroid hormone?

Answer 4

T3

Question 5

where does conversion of T4–>T3 occur?

Answer 5

for activation of active form of hormone to occur, must be deiodinated intracellularly

Question 6

high concentrations of what regulate thyroid hormone synthesis?

Answer 6

1. T3 & T4

2. high concentrations of iodine

Question 7

high concentrations of iodine _____thyroid synthesis, low concentrations of iodine _______thyroid synthesis

Answer 7

high concentrations of iodine inhibit thyroid synthesis, low concentrations of iodine promote thyroid synthesis

Question 8

thyroid hormones ______beta receptors, _____alpha receptors

Answer 8

increase beta receptors,

decrease alpha receptors

Question 9

thyroid effect on GI?

Answer 9

increase secretions and motility

Question 10

does thyroid stimulation or repression result in prevention of accumulation of glycosaminoglycans in interstitial space (prevents edema)

Answer 10

thyroid upregulation

Question 11

heat intolerance is assc’d with hyper or hypo thyroidism?

Answer 11

hyperthyroidism

Question 12

skeletal muscle catabolism is assc’d with hyper or hypo thyroidism?

Answer 12

hyperthyroidism

Question 13

myxedema is assc’d with hyper or hypo thyroidism?

Answer 13

hypothyroidism

Question 14

how can respiratory occur in hyperthyroidism?

Answer 14

high RR + muscle catabolism

Question 15

what is the thyroid hormone replacemnt tx of choice?

Answer 15

levothyroxine (T4)

Question 16

AE: restlessness, insomnia, accelerated bone maturation

Answer 16

AE of administration of thyroid preparations to children

Question 17

AE: nervousness, heat intolerance, palpitations, tachycardia, weight loss

Answer 17

AE of administration of thyroid preparations to adults

Question 18

AE: A fib, osteoporosis

Answer 18

AE of administration of thyroid preparations to elderly

Question 19

which thyroid preparation has a short half life, but is more potent?

Answer 19

liothyronine (T3)

Question 20

low TSH, high T3 & T4

Answer 20

Grave’s disease

Question 21

which drug has a black box warning for causing fatal hepatitis?

Answer 21

Propylthiouracil (PTU)

Question 22

if you have to use a thioamide on a pregnant lady, which is the better choice? why?

Answer 22

PTU

more is bound to plasma proteins–>less likely to cross placental barrier

Question 23

which thioamide to use in the case of thyroid storm?

Answer 23

PTU

has faster absorption than methimazole

Question 24

AE: Metallic taste, sore gums/teeth, “like you have a cold” with HA, sneezing, cough; skin lesions; hypersensitivity, angioedema, laryngeal edema;

Answer 24

Lugol’s Solution/ Potassium Iodide

Question 25

which drug inhib proteolysis of Tgb ?

Answer 25

Lugol's Solution/ Potassium Iodide

Question 26

the most common AE of hypothyroidism is assc'd with?

Answer 26

radioactive iodine

Question 27

what antithyroid agent is assc'd with aplastic anemia

Answer 27

perchlorate

Question 28

what are the key drugs that are used for cardioprotection with thyroid storm?

Answer 28

propranolol, diltiazem, barbituates, bile acid sequestrants

Question 29

what can you use to control tachycardia in asthmatic?

Answer 29

Diltiazem (CCB)