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thyroid disord
thyroid disorder, hyperthyroidism and hypothyroidism, meds
| Question | Answer |
|---|---|
| follicular cells produce | T3 and T4 |
| parathyroid gland regulate | serum calcium |
| parafollicular cells produce and secrete | thyrocalcitonin or calcitonin |
| must have these in diet to produce three thyroid hormones | dietary protein and iodine |
| these are left behind after thyroid surgery | parathyroid glands |
| parathyroid hormones regulate these | calcium and phosphorus by way of kidneys, bones, and intestinal tract |
| high vascularity and rich blood supply poses this high risk post-op problem for thyroid | bleeding, cannot be seen overtly |
| decreases calcium tells the PTH to do what | increase and tell the bones to give up calciium (resorption) |
| thyroid hormone fxn | fetal dev., controls metabolic activity, promotes pituitary secretions of GH and gonadotropins, protein, CHO, and fat metabolism |
| thyroid effects on cardiac system | chronotropic (timing of HR) and inotropic (force of contractions) |
| patients with increased HR, afib, and aflutters have this test done | thyroid testng |
| thyroid hormones affects insulin this way... | antagonist |
| thyroid replacement | levothyroxine (Synthroid) |
| PTU or Tapazole | blocks thyroid hormone synthesis in hyperthyroid! |
| weight lloss, increased appetite, irritability, goiter, bruits over thyroid | hyperthyroidism |
| contraindicated in pregnancy | iodine containing meds |
| inhibits the release of thyroid hormone | iodine containing meds |
| SSKI | saturate solution of potasssium iodide |
| tapazole | methimazole |
| PTU | propythiouracil |
| to prevent further synthesis and release of thyroid hormones | propythiouracil (PTU) |
| block sympathetic nervous system effects | propanolol (Inderal) |
| IV fluids | to prevent adequate hydration and prevent vascular collapse d/t excessive sweating or increased excretion by kidneys! |
| sodium iodide | one hour after PTU as prescribed |
| may cause agranulocytosis | anti-thyroid meds such as Tapazole or PTU |
| pharm interventions for thyroid storm | PTU, methimazole, sodium iodide solution, propranolol, glucocorticoids |
| normal TSH levels | 2-10mU/L |
| normal T4 total | 4-12ug/dL |
| normal T4 free | 0.8-1.5ng/Dl |
| normal T3 | 80-180ng/dl |
| thionamides | PTU and Tapazole, blocks new hormone synthesis in HYPERTHYROIDISM |
| thionamides | maintenance doses continued for one year or longer |
| liver and bone marrow toxicity | thionamides |
| Interferes with the synthesis of thyroid hormone and inhibits the conversion of T$ to the more active T3; tx of Graves and thyrotoxic crisis | PTU |
| usseful in trx mild cases of hyperthyroidism, inhibit the production of thyroid hormones by antagonizing the ability of thyotropin to sstimulate thyroid secretion | iodides |
| RAadioactive Iodine (I 131) | never use on pregnant women!!!! one dose can ablate thyroid tissue = perm decrease in thyroid activity to euthyroid state. Most common form of Grave trx |
| n/c use a straw b/c of discoloration of teeth | I 131 |
| graves disease | most common form of hyperthyroidism; caused by an autoimmune defect that creates antibodies that stimulate the overproduction of thyroid hormones; exophthalmos is feature characteristic |
| thyrotoxicosis | the state produced by excessive quantities of endogenous or exogenous thyroid hormone. s/s rapid pulse, diarrhea, fever, loss of weight, and extreme restlessness; come and death may occur. |
| iodides | inhibits thyroid hormone release, inhibits thyroid hormone bipsymthesis, and decreases the size and vascularity of the gland eg LUGOLS and SSKI |
| PTU and methimazole | blocks the biosynthesis not the release of thyroid hormone |
| Synthroid (levothyroxine) effect... | lowers TSH |
| can be the result of Synthroid OD, uncontrolled DM, or stopping meds | Thyroid Storm |
| `I131 therapy can cause this extreme rxn the other way | hypothyroidism |
| iodine or tyrosine deficient | hypothyroidism |
| using glucocorticoids, lithium, iodine, goitrogens in overdose | can cause HYPOTHYROIDISM |
| Synthroid | replacement T3 and T4 |
| start with low dose of Synthroid to watch for.... | increased HR and other tachy s/s esp in pt with cardiac problems |
| do not give if HR >100 | Synthroid |
| trx includes IV Synthroid, IV fluids, IV glucose, corticosteroids, thyroxine trx promptly | Myxedema Coma |
| older pt start at 25, younger clients can start at 50-100 | synthroid |
| decreases effects of beta blockers | Synthroid |
| increases the effect of Coumadin | Synthroid |
| Clients with Synthroid and Coumadin monitor for | risk of bleeding |
| PTU | inhibits the formation of new thyroid hormone, thus gradually returning metabolism to normal |
| agranulocytosis with s/s infection in oropharynx from | thionamides, PTU |
| DOC for pregnant women with graves | PTU |
| antithyroid med that is contraindicated for pregnent or brestfeeding women | methimazole |
Created by:
hong204
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