Week 10 Notes Flashcards
What is the preferred treatment for hypothyroidism?
Synthetic levothyroxine
Synthetic levothyroxine is preferred over natural pork-derived thyroid hormone.
How does synthetic levothyroxine function in the body?
Acts like the body’s thyroid hormone
It increases metabolic rate and oxygen consumption in tissues.
What are the physiological effects of thyroid hormone?
Increases temperature, heart rate, respiratory rate
Also enhances protein and fat metabolism.
What adverse effects can occur from excessive levothyroxine administration?
Hyperthyroidism symptoms, increased heart rate, cardiac dysrhythmia
Can also lead to gastrointestinal issues like vomiting or diarrhea.
What can excessive thyroid hormone lead to in the myocardium?
Chest pain, exacerbation of angina, acute coronary syndrome
Due to increased oxygen consumption and insufficient blood flow.
What are the potential consequences of too much thyroid hormone?
Excessive weight loss, abnormal menstruation, heat intolerance
Can also cause bone loss leading to osteoporosis or osteopenia.
What is the recommended approach for patients with cardiovascular disease when prescribing levothyroxine?
Start with a lower dose and titrate up
Especially important for older adults.
What should be monitored in patients with existing bone density issues when prescribing levothyroxine?
Keep TSH in the upper limits of normal
Prevents further bone loss.
How can thyroid hormone affect patients with diabetes insipidus or adrenal insufficiency?
Worsening symptoms, potential adrenal crisis
Requires careful clinical monitoring.
What unique considerations are there for hypothyroidism during pregnancy?
Pregnant patients may require higher doses of levothyroxine
Important to treat hypothyroidism in pregnancy.
What inappropriate uses of levothyroxine have been noted?
Weight loss, infertility, depression relief
Not appropriate without demonstrated hypothyroidism.
What are the antithyroid drugs used for hyperthyroidism?
Propylthiouracil (PTU) and methimazole
These prevent synthesis of thyroid hormone.
What is a significant adverse effect associated with antithyroid drugs?
Agranulocytosis
Can also cause aplastic anemia and hepatitis.
What should be done if agranulocytosis occurs in a patient taking antithyroid drugs?
Immediately discontinue the drug
Monitor for signs of infection.
What is the preferred antithyroid medication for children?
Methimazole
Important to monitor heart rate and symptoms of thyroid dysfunction.
What should patients taking antithyroid drugs avoid?
Iodine-containing foods
Reducing iodine intake is crucial during treatment.
What are the pancreatic enzyme replacements used for?
To aid digestion in patients with exocrine enzyme deficiency
Helps patients absorb nutrients effectively.
What is the best way to diagnose hypertension?
Correctly measuring blood pressure over time.
In emergency situations, when might you treat hypertension immediately?
If the patient has markedly elevated blood pressure and evidence of end organ damage.
Why is it important to measure blood pressure correctly?
To ensure accurate readings and proper diagnosis.
What should be considered when treating a patient with hypertension?
Individual patient circumstances and comorbid conditions.
How does age influence hypertension treatment?
Older adults may require less aggressive blood pressure reduction.
What is a potential risk of orthostatic hypertension?
It can cause syncope and falls, especially in older adults.
What lifestyle modifications are important for hypertension management?
- Maintaining a lean body weight
- Regular strength training and aerobic exercise
- Proper diet that lowers blood pressure
