Thyroid meds

Question 1

Take home message from class: Hypothryroidism

Answer 1

No problem! Here, take this pill.

Question 2

Take home message from class: Hyperthyroidism

Answer 2

Shit show! Tape the endocrinologist’s phone number to your door and hide under your desk until the patient goes away.

Question 3

Synthroid: class

Answer 3

Thyroid agent (T4)

Question 4

Synthroid: MOA

Answer 4

T4 replacement

Question 5

Synthroid: indication

Answer 5

Hypothyroidism, thyroid cancer

Question 6

Synthroid: side effects

Answer 6

Decreased bone density

Question 7

Synthroid: contraindication

Answer 7

AMI, uncontrolled adrenal insufficiency

Question 8

Synthroid: Dx-Dx

Answer 8

Amiodarone (contains a lot of iodine)

High dose BBs (decrease T4 –> T3 conversion)

Question 9

How long do you need to wait to see if any Synthroid dose change has worked?

Answer 9

6-8 weeks.

Question 10

Liothyronine: class

Answer 10

Thyroid agent (T3)

Question 11

Liothyronine: MOA

Answer 11

T3 replacement

Question 12

Liothyronine: indication

Answer 12

Hypothyroidism refractory to T4 replacement

Question 13

Liothyronine: side effect

Answer 13

Dysrhythmias, HOTN

Question 14

Liothyronine: contraindication

Answer 14

AMI, uncontrolled adrenal insufficiency

Question 15

Liothyronine: Dx-Dx

Answer 15

Anorexic drugs, DM drugs, tricyclics

Question 16

Liothyronine has a short t1/2

Answer 16

Requires BID-TID dosing

Question 17

Radioactive iodine: class

Answer 17

Anti-thyroid agent

Question 18

Radioactive iodine: MOA

Answer 18

Thyroid cell death in 6-8 weeks

Question 19

Radioactive iodine: indication

Answer 19

Thyroid ablation without surgery

Question 20

Radioactive iodine: side effects

Answer 20

Exacerbation of buggy-outty eyes; painful thyroiditis

Question 21

Radioactive iodine: contraindications

Answer 21

Pregnancy, nursing

Question 22

What are we expecting to occur with radioactive iodine

Answer 22

Hypothyroidism

Question 23

Methimazole: class

Answer 23

Anti-thyroid agent

Question 24

Methimazole: MOA

Answer 24

Blocks oxidation of iodine, preventing T4/T3 synthesis. Does not affect circulating T4/T3.

Question 25

Methimazole: indication

Answer 25

Hyperthyroidism

Question 26

Methimazole: side effects

Answer 26

Decr WBC, aplastic anemia, nephrotic syndrome

Question 27

Methimazole: contraindication

Answer 27

Bone marrow suppression

Question 28

Prednisone: class

Answer 28

Glucocorticoid

Question 29

Prednisone: MOA

Answer 29

Suppresses adrenal function in high doses; decr WBC migration; alters protein synthesis.

Question 30

Prednisone: indication

Answer 30

Oh lots...it's good for what ails you if you need your immune system suppressed.

Question 31

Prednisone: side effects

Answer 31

HPA-axis suppression, psych disturbances, osteoporosis, fluid retention, muscle weakness.

Question 32

Prednisone: contraindication

Answer 32

Systemic fungal infection; concomitant use with vaccines

Question 33

Prednisone is a prodrug. What is the active drug?

Answer 33

Prednisolone.

Question 34

What is another glucocorticoid that is 7-10x more potent than Prednisone?

Answer 34

Dexamethasone

Question 35

______mg of Dexamethasone = _______mg of Prednisone.

Answer 35

0. 75 | 5. 0

Question 36

Fludrocortisone: class

Answer 36

Mineralcotricoid

Question 37

Fludricortisone: MOA

Answer 37

Promotes distal renal tubule absorption of Na+ and secretion of K+.

Question 38

Fludricortisone: indication

Answer 38

Addison's disease; refractory orthostatic HOTN

Question 39

Fludrocortisone: side effects

Answer 39

CHF, hyperglycemia, muscle weakness, may inhibit HPA-axis.