22 Questions
What is the drug treatment option for hyperthyroidism?
Thioamides
What is the mechanism of action of anti-thyroid drugs (thioamides)?
Blocks the synthesis of thyroid (T3/T4) hormones
Which anti-thyroid drug takes longer to lower thyroid hormone levels but is preferred in the first trimester of pregnancy?
Propylthiouracil
What are the two drugs used in the treatment of hyperthyroidism?
Propylthiouracil and Methimazole
What is the preferred anti-thyroid drug for a thyroid storm?
Propylthiouracil
What is the black box warning for Propylthiouracil?
Hepatotoxicity
What is the first-line anti-thyroid drug with a quicker onset of lowering thyroid hormones and is safe in the 2nd and 3rd trimester of pregnancy?
Methimazole
What adjunct medication should be considered for patients with hyperthyroidism?
Beta-blockers and Corticosteroids
What permanent hyperthyroid treatment leads to hypothyroidism
Surgery
Radioactive iodine can be given as a capsule or solution to caused local tissue damage of the thyroid. It is safe in pregnancy.
False
Beta-blockers are recommended for all hyperthyroidism patients AT DIAGNOSIS (esp if heart is above 100)
True
What is the starting dose of levothyroxine for hypothyroidism in a patient with coronary artery disease (CAD)?
25 mcg/day
Which medication should be avoided or separated by at least 4 hours from levothyroxine due to its impact on absorption?
Calcium, iron, or bile acid supplements
What patient education should you give for starting levothyroxine
Take on empty stomach before meal or at bedtime
Levothyroxine is a narrow index drug and needs to remain consistent brand name/generic wise for the patient.
True
Does this drug increase or decrease thyroid hormone?
antacids and multivitamins = decrease carbmazepine / SSRI = decrease estrogen = decrease warfarin = increase
You should gradually titrate Levothyroxine up by ___ to ___ mcg every 4-6 weeks based on TSH and clinical response until at goal.
12 to 25
Levothyroxine is the thyroid hormone replacement drug of choice.
True
What hypothyroidism treatment was traditionally used to alleviate symptoms associated with thyroid cancer, but is less commonly used today due to dose flutuations?
Liothyronine
What hypothyroid drug is made from animal thyroid hormones and therefore has more allergies and dietary restrictions?
Armour Thyroid / NP thyroid
Order of improvement when treating hypothyroidism
T4 = 1st - weeks TSH = 2nd - month Symptoms = 3rd - few months :) = :)
What is the drug of choice for treating hypothyroidism in pregnancy?
Levothyroxine
Study Notes
Hyperthyroidism Treatment
- Thioamides (anti-thyroid drugs) are the drug treatment option for hyperthyroidism.
- They block the synthesis of thyroid (T3/T4) hormones.
Mechanism of Action of Anti-Thyroid Drugs
- Anti-thyroid drugs (thioamides) block the synthesis of thyroid (T3/T4) hormones.
Anti-Thyroid Drugs for Hyperthyroidism
- Two drugs used in the treatment of hyperthyroidism are Propylthiouracil and Methimazole.
Propylthiouracil
- Takes longer to lower thyroid hormone levels, but is preferred in the first trimester of pregnancy.
- Is the preferred anti-thyroid drug for thyroid storm.
- Has a black box warning for Hepatotoxicity.
Methimazole
- Is the first-line anti-thyroid drug with a quicker onset of lowering thyroid hormones.
- Is safe in the 2nd and 3rd trimester of pregnancy.
Hypothyroidism Treatment
- Levothyroxine is the preferred drug of choice for hypothyroidism.
- The starting dose of Levothyroxine for hypothyroidism is 100 mcg/day for a young and healthy patient.
- For a patient with CAD, the starting dose is 25 mcg/day regardless of age.
Patient Education for Levothyroxine
- Take Levothyroxine on an empty stomach 30-60 minutes before a meal or at bedtime.
Drug Interactions
- Warfarin is known to increase thyroid hormone levels.
- Patients should wait 4 hours to take Levothyroxine after taking a calcium, iron, or bile acid supplement.
Test your knowledge on drug treatment for hyperthyroidism with this quiz. Learn about the different drug options available and their mechanisms of action. Perfect for medical students and healthcare professionals.
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