Thyroid Management

Question 1

levothyroxine moa

Answer 1

mimics endogenous t4

Question 2

levothyroxine healthy adults dose

Answer 2

1.6 mcg/kg/d

Question 3

levothy 50-60 yrs, no cardiac dose

Answer 3

50 mcg daily

Question 4

levothy w cvd

Answer 4

12.5-25 mcg/d, titrate up

Question 5

levothy titration

Answer 5

25mcg/day increments

Question 6

levothy AE

Answer 6

• cardiac abnormalities
• fracture
• signs hyperthyroidism

Question 7

levothy administration

Answer 7

EMPTY STOMACH

• 30-60mins before bf / 4hrs after dinner
• calcium / iron supplements / antacid -> at least 2 h apart

Question 7

levothy monitoring

Answer 7

4-8 weeks (TSH)

Question 8

target TSH

Answer 8

0.4 to 4 mIU/L

Question 9

thionamides (carbimazole, PTU) moa

Answer 9

inhibits iodination and synthesis of thyroid hormones

Question 10

ptu dosing

Answer 10

PO 50-150mg TDS

Question 11

thioamides ptu euthyroid dosing

Answer 11

PO 50mg BD / TDS

Question 12

thioamides carbimazole dosing

Answer 12

PO 15-60mg in 2-3 doses

Question 13

thioamides carbimazole euthyroid

Answer 13

PO 5-15mg OD

Question 14

thioamides AE

Answer 14

hepatotoxicity (esp PTU)
rash (SJS)
low WBC

Question 15

thioamides monitoring

Answer 15

4-6 months