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Thyroid Flashcards

(36 cards)

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1
Q

What is produced from the thyroid gland and are the some of the things that it helps affect?

A
  • Produces Thyroid Hormone
  • Helps regulate; metabolism, cardiac/nervious system functions, body temp, muscle strength, weight.

Thyoid gland is the ONLY organ that ABSORBS Iodine

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2
Q

What are the 2 types of thyroid disorder?

A
  • HYPERthyroidism : overactive thyroid
  • HYPOthyroidism: underactive thyroid
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3
Q

What are the 2 thyroid hormones that are made from the Thyroid Gland?

A
  • Triiodothronine (T3)
  • Throxine (T4)

T4 gets coverted into T3
T3 is more potent BUT has shorter half life

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4
Q

What the is hormone that is released that helps with the regulation of the 2 thyroid hormones?

A
  • Thyroid Stimulating Hormone
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5
Q

What is the negative feedback loop in relation to the Thyroid Hormones?

A
  • Hypothalamus makes TRH activiating the Pituitary
  • The Pituitary makes TSH activiating the Thyroid
  • The Thyroid makes T3 and T4

When high amounts of T3/4, then the Hypothalamus/Pituitary stops making their respectable things and vice versa

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6
Q

What is HYPOthyroidism?

A
  • Low levels of T4 (& T3) with High Levels of TSH
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7
Q

What are some of the signs and symptoms of HYPOthyroidism?

A
  • Cold
  • Dry Skin
  • Fatigue
  • Muscle Cramps
  • Depression
  • Constipation
  • Weight Gain
  • Goiter

The oppisite of HYPERThroidism

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8
Q

What is the most common cause of HYPOthyroidism?

What is it???

A
  • Hashimoto’s Disease: autoimmune disease where antibodies attack the thyroid gland
  • Some drugs can cause HYPO too (different card)
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9
Q

What are some of the Drugs that can cause HYPOthyroidism?

Remember ITALC

A
  • Interferons
  • Tyrosine Kinase Inhibitors
  • Amiodarone
  • Lithium
  • Carbamazepine

Other are: Oxcarbazepine, Eslicabazepine, Phenytion

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10
Q

What are the 2 lab results that help make the diagnosis of HYPOthyroidism?

A
  • Low free T4 (normal is 0.9 - 2.3)
  • High TSH (normal is 03. - 3)
  • Low Iodine (thyroid is using it up)
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11
Q

How long should the TSH and symptoms be monitored for in someone that has HYPOthyroidism?

A
  • Every 4 - 6 weeks
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12
Q

What are the main treatment options for someone that has HYPOthyroidism?

And what is the difference between them

A
  • Levothyroxine (Synthroid, Levoxyl, Unithroid) [T4]
  • Liothyronine (Cytomel) [T3]
  • Armour Thyroid (Thyroid Desiccated) [T3 + T4]
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13
Q

What is the intial dose we should use for someone that is going to be taking Levothyroxine for their HYPOthyroidism?

A
  • 1.6 mg/kg/day
  • If known CAD: start with 12.5-25 mcg
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14
Q

What are the warnings for some one taking Levothyroxine, Liothyronine, Armour Thyroid for their HYPOthyroidism?

A
  • Decrease dose if the patient has any cardiovascular disease or bone mineral density issues
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15
Q

What are the side effects for some one taking Levothyroxine, Liothyronine, Armour Thyroid for their HYPOthyroidism?

A
  • “HYPERthyroidism” like: increased HR, palpitations, sweating, weight loss, arrhythmias
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16
Q

What is important to know about taking Levothyroxine PO for someone with HYPOthyroidism?

Study These Flashcards
A
  • Taken with water at the same time everyday and at least 60 minutes before breakfast or AT bedtime
17
Q

What is important to know about taking Levothyroxine IV for someone with HYPOthyroidism?

Study These Flashcards
A
  • IV to PO: 0.75:1
18
Q

What are the tablet colors for Levothyroxine?

Remember: Orangutans Will Vomit On You Right Before They Become Large, Proud Giants

Study These Flashcards
A
  • Orange = 25 mcg
  • White = 50 mcg
  • Violet = 75 mcg
  • Olive - 88 mcg
  • Yellow = 100 mcg
  • Rose = 112 mcg
  • Brown = 125 mcg
  • Turquoise = 137 mcg
  • Blue = 150 mcg
  • Lilac = 175 mcg
  • Pink = 200 mcg
  • Green = 300 mcg
19
Q

What are some of the important drug interactions for those that are taking a HYPOthyroidism medication?

Study These Flashcards
A
  • DECREASE Levothyroxine absorption: Antacids (Fe, Ca, AL, Mg), Cholestyramine, Sevelamer, Sucralfate (separate by 4 hours)
  • SSRIs and Estrogen can decrease TSH levels
  • Beta-Blockers, Amino, PTU can decrease T4 to T3 conversion
20
Q

What are some of the key counseling points for HYPOthyroid medications?

Levothyroxine

Study These Flashcards
A
  • Drug interactions are due to binding
  • Take with water and 60 minutes before meals OR right before bed
  • Pill Color
  • Pregnant?
  • Blood Work regularly (TSH and T4 level x 4-8 weeks)
21
Q

What is HYPERthyroidism?

Study These Flashcards
A
  • When the thyroid is overactive
  • High T4 & Low TSH

The oppisite of HYPO

22
Q

What are the signs and symptoms of HYPERthyroidism?

Study These Flashcards
A
  • Hot
  • Weight Loss
  • Agitation
  • Palpitations and Tachycardia
  • Thinning hair
  • Protruding Eyes
  • Diarrhea

The oppisite fo HYPO

23
Q

What is the most common cause of HYPERthyroidism?

Study These Flashcards
A
  • Graves disease: autoimmune disease where the antibodies stimulate the thyroid to make too much T4
24
Q

What are some of the drugs that could cause HYPERthyroidism?

Study These Flashcards
A
  • Iodine
  • Amiodarone
  • Interferons
25
What are some of the **treatment options** for **HYPER**thyroidism? ## Footnote -
- Propylthiouracil (Thionamides) - Methimazole (Thionamides) - Radioactive Iodine (RAI-131) - Surgery
26
What is one thing that you can giev someone taking a **HYPER**thyroidism medication to help control their symptoms?
- Beta-Blockers [helps with palpitations, tremors, tachycardia]
27
How longs does it take when taking an **anti-thyroid medication** before you start seeing controlled symptoms?
- 1 - 3 months of treatmentat **high doses** - Once controlled = reduce the dose
28
What is the **boxed warnings** for **PTU** in **HYPER**thyroidism?
- Severe liver injury - PTU: preferred in the 1st trimester of Pregnancy
29
What are the **warnings** for the **HYPER**thyroidism medications?
- Hepatoxicity, Bone Marrow Suppression [agranulocytosis], DILE ## Footnote In Lupus deck but **DILE** causes Lupus symptoms: **muscle pain, butterfly face rash, weight loss**
30
What are the **side effects** for the **HYPER**thyroidism medications?
- **GI Upset**, headache, rash, constipation, loss of taste
31
What are some **important notes** about the **HYPER**thyroidism medications?
- Methimazole is **DOC** - PTU is best for **Thyroid Storm** - PTU is best in **1st trimester** BUT Methimazole is best in **2nd and 3rd trimesters**
32
What is the importance of **Potassium Iodine** for the use of after exposure to radiation?
- Helps block the accumulation of Radioactive iodine = preventing thyroid cancers
33
What is **Thyroid Storm**
- Life threatening emergency by a decompenstaed **HYPER**thyroidism cause by infection, trauma, surgery, radioactive iodine, or stopping anti-thyroid medications
34
What are the **signs and symptoms** of **Thyroid Storms**
- Fever - Tachycardia - Tachypenia - Dehydration - Sweating - Delirium - Coma
35
What is the **Drug Treatment** for **Thyroid Storm**? ## Footnote -
- **PTU** is preferred [500 - 1000 mg LD] - Inorganic Iodine (**SSKI** or **Lugol's Solution**) - Beta Blockers (**Propranolol**) [40 - 80 mg q6h] - Steroids (**Dexamethasone**) [2 - 4 mg q6h]
36
What is the **MOA** of the **Thionamides (Hyperthyroid Meds)**?
- **Inhibits the synthesis** of thyroid hormones = inhibition of **Peripheral conversion** of T4 to T3
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