1
Q
what treatments are available for hypOthyroidism?
A
Levothyroxine (T4)
Liothyronine (T3)
Dessicated thyroid (T4/T3)
2
Q
What are symptoms of excess?
A
irritability inc. HR, contractility, HTN, palpitations diarrhea dec. bone mineral density hair loss inc. sweating weight loss/ heat intolerance
3
Q
what are symptoms of deficit?
A
depression, lethargy dec. HR, HF, hypotension, shock constipation mm pain, weakness and fatigue brittle hair or nails, dry skin weight gain cold intolerance
4
Q
Compare the onset of levothyroxine vs. liothyronine
A
levothyroxine = 3-5 days liothyronine = 4 hours
5
Q
what are treatments for hypERthyroidism?
A
PTU
Methimazole
Potassium iodide
6
Q
what’s the MOA of potassium iodide (high dose I-)?
A
“Wolff-Chaikoff effect”: inhibition of
NIS, TPO, hormone release
7
Q
what is the MOA of methimazole?
A
inhibits thyroid peroxidase
8
Q
what is the MOA of propylthiouracil (PTU)?
A
inhibits TPO and 5’ deiodinase conversion of T4 to T3
9
Q
Compare protein binding in methimazole vs PTU
A
methimazole = none! (excreted in breast milk and crosses placenta) PTU = 60-80% (less excreted in milk)
10
Q
Compare dosing of methimazole vs. PTU
A
methimazole: daily
PTU: q8hrs
