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NUR516 > Thyroid Medications > Flashcards

Thyroid Medications Flashcards

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1
Q

What is the largest endocrine gland?

A

Thyroid

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2
Q

What 3 hormones are produced from the thyroid?

A

1) Thyroxine (T4; converts to T3)
2) Triiodothyronine (T3)
3) Calcitonin

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3
Q

What two hormones produced by the thyroid are needed for metabolism?

A

T4 & T3

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4
Q

What other part of the body plays a role in regulation of thyroid

A

Hypothalamus that secretes a thyrotropin-releasing hormone (TRH)

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5
Q

What does TRH stimulate?

A

The pituitary gland to produce a thyroid-stimulating hormone (TSH) that in turn stimulates the thyroid to produce the thyroid hormones

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6
Q

The body requires ____ to make thyroid hormones in the thyroid gland

A

iodine

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7
Q

Iodine is a component of what 2 thyroid hormones?

A

T3 & T4 → that regulate metabolism, growth, & development

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8
Q

Define euthyroid

A

Normal thyroid gland function

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9
Q

Define goiter

A

Visible enlargement of the thyroid gland

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10
Q

Define Graves Disease

A

Antibody mediated autoimmune disease resulting in hyperthyroidism

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11
Q

Define Hashimoto’s Thyroiditis

A

Autoimmune disease often resulting in hypothyroidism

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12
Q

Thyroid hormone functions:

Stimulates ____ ____ & _____ _____ of cells

A

Metabolic activity; oxygen consumption

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13
Q

Thyroid hormone functions:

Produces ____ & ____

A

Heat & thermogenesis

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14
Q

Thyroid hormone functions:

Stimulates ______, ____, & ____ metabolism

A

Carbohydrate, fat & protein metabolism

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15
Q

Thyroid hormone functions:

Increases what 2 things

A

1) rate of glucose absorption
2) erythropoiesis

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16
Q

Thyroid hormone functions:

Plays a role in regulating ___

A

Mood

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17
Q

Thyroid hormone functions:

What 3 things do thyroid hormones work with to promote growth?

A

1) Growth hormone
2) insulin
3) sex steroids

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18
Q

Thyroid hormones are required for what 2 things?

A

1) normal respiratory response to hypoxia
2) hypercapnia respiratory drive

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19
Q

Thyroid hormones are critical for fetal ____ & ____ development

A

Fetal neural & skeletal development

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20
Q

What is secretion of T3 & T4 controlled by?

A

TSH from the anterior pituitary

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21
Q

TSH control rate of thyroid hormone release via a _____ feedback mechanism

A

Negative

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22
Q

What determines the release of TSH

A

Levels of thyroid hormones in the blood

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23
Q

What do excess hormones lead to

A

inhibition of TSH

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24
Q

What do low hormones lead to

A

Increase production of TSH

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25
How is the hypothalamus connected to TSH?
Hypothalamus releases thyrotropin releasing hormone (TRH) which stimulates the pituitary to release TSH
26
Normal thyroid levels
TSH (0.4 to 4.5)
27
What does it mean if thyroid levels are less than 0.4
Hyperthyroidism/ overactive thyroid
28
What does it mean if thyroid levels are above 4.5
Hypothyroid/ underactive thyroid
29
Normal range of T4 levels
4-11
30
Normal range of T3 levels
80-180
31
list 10 symptoms of HYPOthyroidism
1) fatigue 2) depression 3) dry skin 4) constipation 5) bradycardia 6) altered menstrual cycles 7) weight gain 8) changes in hair 9) **cold intolerance** 10) cardiac enlargement if prolonged
32
What is hypothyroidism?
decrease in hormone production
33
Hypothyroidism can be ____ or ____
A primary problem or autoimmune (Hashimoto's thyroiditis)
34
What is known as severe hypothyroidism?
Myxedema
35
List 2 medications used to treat hypothyroidism
1) levothyroxine 2) Armour thyroid (desiccated)
36
List 3 medications used to treat hyperthyroidism
1) Methimazole 2) Propylthiouracil (PTU) 3) Iodine solutions
37
Levothyroxine can also be called _____, _____
Synthroid Levoxyl
38
Levothyroxine is a synthetic form of ____
T4
39
4 things to remember with use of levothyroxine
1) good bioavailability & reliability 2) Half life of 6-7 days 3) highly protein bound 4) should be taken on empty stomach 30 min before breakfast
40
What is the goal of using levothyroxine
Restore the TSH and T4 back to normal
41
Side effects of levothyroxine
Usually similar to hyperthyroidism if dose is too high
42
Desiccated thyroid medication is also known as
Armour thyroid
43
What does dessicated thyroid come from?
Thyroid extract that comes from animal thyroid glands that have been dried & powdered
44
Desiccated thyroid contains what 2 hormones
T3 & T4
45
What does bioavailability look like in desiccated thyroid
variable bioavailability
46
Side effects of desiccated thyroid **Hint: 3**
1) change in appetite 2) chest pain 3) diarrhea
47
Nursing considerations when using hypothyroidism medications **Hint: 6**
1) doses individualized based on TSH results 2) avoid giving Ca containing meds, antacids, or iron supplements at same time 3) assess HR prior to giving (Consult if tachycardic) 4) it's a life long med 5) TSH should be checked regularly until dose stabilizes 6) safe in pregnancy
48
When should TSH levels start being checked after starting a hypothyroid med?
Levels checked 6-8 weeks after starting & after dose changes -then annually -may need to check LFTs & WBCs
49
What is hyperthyroidism?
Increased in circulating T3 & T4 which comes from overactive thyroid or excessive thyroid hormone production **Can be mild or lead to death if not treated**
50
Hyperthyroidism is assoicated with what autoimmune disease?
Graves disease → caused by hyperfunctioning of thyroid gland
51
Why is it important to evaluate/ monitor patient's with HYPERthyroidism a little more?
They are at increased risk of thyroid cancer
52
What is Tepezza used to treat?
thyroid eye diseases
53
List 10 Sx of hyperthyroidism
1) Anxiety 2) Restlessness 3) Diaphoresis 4) N/V/D 5) Tachycardia (check for A fib) 6) Weight loss 7) Heat intolerance 8) exophthalmos 9) Changes in menstrual cycle 10) Insomnia
54
What does Tx of hyperthyroidism depend on & what is it directed at?
**Dependent on underlying cause** Directed at: 1) decreasing thyroid hyperactivity 2) preventing complications
55
Tx of hyperthyroidism can be single or combo therapy consisting of? **Hint: 3**
1) Anti-thyroid agents 2) radioactive iodine 3) surgery
56
What does Tx of hyperthyroidism often result in?
Recurrent hyperthyroidism or permanent hyperthyroidism
57
How do thioamides work to TX hyperthyroidism?
1) lower levels by inhibiting formation of thyroid hormones in the cells 2) inhibit conversion of T4 to T3
58
What two lab tests must be obtained prior to starting thioamides?
CBC & liver profile
59
How should thioamides be taken?
On an empty stomach 30 minutes before eating
60
When do we usually see thioamides effectiveness?
Can take several weeks to see effect
61
What thioamide drug is the drug of choice unless pregnant?
Methimazole
62
How many times of day is Methimazole administered?
Once a day
63
What do side effects of Methimazole come from? & what are they?
**Thyroid suppression** Less GI side effects Can cause BM suppression
64
What thioamide drug converts T4 to T3
Propylthiouracil (PTU)
65
How should PTU be administered to pregnant women?
Can be used during the 1st trimester of pregnancy then should be stopped
66
PTU has several drug interactions so its important to monitor what labs?
LFTs → increase risk of liver injury CBC → leukopenia
67
List two types of Iodine drugs used to Tx hyperthyroidism
1) Lugol's solution 2) I-131
68
Which iodine drug is for short term use?
Lugol's solution
69
What does Lugol's solution inhibit?
Release of T3 & T4
70
Lugol's Solution can cause ____. List 4 Sx associated
**Ionism** 1) metallic taste 2) stomatitis 3) sore throat 4) hypersensitivity
71
What type of iodine is radioactive?
I-131
72
What is I-131 typically used for?
Thyroid cancer, Thyrotoxicosis, or special cases
73
list 3 important points to note when using I-131
1) increase fluid intake 2) contraindicated during pregnancy 3) radiation precautions
74
What is the adjuvant therapy used for hyperthyroidism?
Beta blockers
75
List 2 beta blockers used to control Sx of hyperthyroidism
1) Propanolol 2) Atenolol
76
When would we use beta blockers to Tx hyperthyroidism?
In older adults when HR is > 90 or may have HX of arrhythmias, HTN, or chest pain
77
What meds are mainly used to control Sx while waiting for meds to take effects?
Beta blockers

NUR516 (36 decks)

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