Podcast
Questions and Answers
What is a primary use of Proylthiouracil (PTU)?
What is a primary use of Proylthiouracil (PTU)?
Which side effect must be monitored when a patient is on Methimazole?
Which side effect must be monitored when a patient is on Methimazole?
Which of the following is a characteristic symptom of a thyroid storm?
Which of the following is a characteristic symptom of a thyroid storm?
What is the recommended timing for taking Levothyroxine?
What is the recommended timing for taking Levothyroxine?
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What laboratory tests should be monitored for a patient on Hydrocortisone?
What laboratory tests should be monitored for a patient on Hydrocortisone?
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When administering Octreotide, which condition is it primarily used to treat?
When administering Octreotide, which condition is it primarily used to treat?
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What is the consequence of abrupt discontinuation of corticosteroids?
What is the consequence of abrupt discontinuation of corticosteroids?
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What does a TSH level indicate in patients with hypothyroidism?
What does a TSH level indicate in patients with hypothyroidism?
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What is the primary risk associated with long-term use of corticosteroids?
What is the primary risk associated with long-term use of corticosteroids?
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What is the role of iodine in thyroid hormone synthesis?
What is the role of iodine in thyroid hormone synthesis?
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Study Notes
PROPYLTHIOURACIL (PTU)
- Used for Graves' disease (pre-surgery)
- Monitor for hypothyroidism (too much can cause hypo)
- Liver function tests (ALT/AST) are needed
- Assess if TSH and T4 levels are good to determine effectiveness
METHIMAZOLE
- Used for hyperthyroidism (Graves' disease)
- Side effects include hepatotoxicity
- Agranulocytosis (infection symptoms, fever, palpitation)
- Monitor Complete Blood Count (CBC), Thyroid Stimulating Hormone (TSH), liver function tests (LFT)
LUGOL'S SOLUTION (NON-RADIOACTIVE)
- Used to shrink the thyroid before surgery
- Treatment for thyroid storm (high fever, agitation, restlessness)
RADIOACTIVE POTASSIUM IODINE (I-131)
- Used to suppress thyroid activity
- Avoid use
LEVOTHYROXINE
- Used for hypothyroidism
- Take in the morning
- Do not take for weight loss (contraindicated)
- Side effects of too much include increased heart rate and hot flashes
HYDROCORTISONE
- Used for Addison's disease, inflammation, asthma, allergies, and COPD
- Take as prescribed, not when symptoms present
- Side effects include hypertension
COSYNTROPIN
- Treats adrenocortical insufficiency
- Similar to ACTH, used to diagnose insufficiency
- Addison's disease is a common cause if stopping corticosteroid without tapering
OCTEOTIDE
- Used for acromegaly (too much growth hormone)
KETOCONAZOLE
- Antifungal used to decrease steroid levels
CUSHING'S DISEASE
- Causes elevated blood pressure
- Related to DM (diabetes mellitus) medications
A1C
- Measures glucose over 6-12 weeks
-
6.5% indicates diabetes mellitus (DM)
- DM patients want <7%
DESMOPRESSIN
- Hormone regulating water balance
- Used in treating diabetes insipidus
- Intramuscular (IM) route for glucagon use should not be administered except for severe hypoglycemia when no intravenous access is available
INSULINS BY ONSET
- Rapid-acting insulins (Aspart, Lispro)
- Short/Regular insulin
- Intermediate-acting insulin (NPH)
- Long-acting insulin (Glargine)
NPH (ISOPHANE) INSULIN
- Long-acting insulin; Lantus and Levemir are other long-acting insulins
- Cannot be mixed with other insulins
GLUCAGON
- Treats hypoglycemia
- Produced by the pancreas
METFORMIN
- First-line medication for type 2 diabetes
- Decreases glucose production in the liver
- Decreases B12 and folic acid absorption
- Side effects include GI upset, poor appetite, metallic taste
- Drug interactions with garlic and ginseng might cause hypoglycemia.
DAPAGLIFLOZIN (FARXIGA)
- Used for type 2 diabetes
- Not associated with hypoglycemia
- Contraindicated in chronic kidney disease (CKD)
- Could be used for weight loss
EPOTIN ALPHA
- Increases red blood cell production
- Used in treating anemia, cancer, sickle cell disease
TAMOXIFEN
- Breast cancer treatment.
- Blocks estrogen receptors
- Side effect: increased risk of uterine cancer.
METHOTREXATE
- Cancer treatment.
- Severe myelosuppression when combined with NSAID's
- Hepatotoxicity, ulcerative stomatitis, diarrhea, hemorrhagic enteritis, and pneumocystis pneumonia can be severe adverse effects.
- Pulmonary toxicity, Stevens-Johnson syndrome and malignant lymphomas are other potential symptoms
DOXORUBICIN
- Chemotherapy medication for various cancers
- Cardiotoxicity is a potential. Damage to the heart muscle can occur 4-5 months after treatment ends.
VINCRISTINE
- Chemotherapy medication
- Numbness and tingling affect extremities, may cause difficulty concentrating
THYROID STORM
- Severe hyperthyroidism
- High fever, tachycardia, agitation, restlessness
ADDISON'S DISEASE
- Autoimmune disease
- Low cortisol levels
- Requires high doses of hydrocortisone
HASIMOTO'S DISEASE
- Autoimmune disease that causes hypothyroidism
LEVOTHYROXINE (MICROGRAMS, NOT MG)
- Used for hypothyroidism
- Dosage is in micrograms (mcg) not milligrams (mg).
1:1 RATIO
- Low-grade fever, stress intolerance
- Associated with Addison's disease
- High doses of hydrocortisone are required
COLONY STIMULATING FACTORS
- Stimulates white blood cell production
- Used in cancer patients
- Can cause tingling in hands and feet
FILGASTRIM
- Increases neutrophil production
- Used in cancer patients
RADIOACTIVE IODINE (I-131)
- Used to suppress thyroid activity
- Given in the hospital, frequently requires NPO.
INSULIN: GLUCAGON
- Glucose homeostasis in the body (regulation)
HYPOGLYCEMIA
- Low blood sugar
- Symptoms: cool, clammy skin; fatigue; diaphoresis
BIGUANIDE
- Used for type 2 diabetes
- Metformin is included in this group
DESMOPRESSIN
- Synthetic vasopressin (antidiuretic hormone)
- Treats diabetes insipidus
- Can be used for nighttime wetting (nocturia); hemophilia
COSYNTROPIN
- Treats adrenal insufficiency
DAPAGLIFLOZIN (FARXIGA)
- Given for hypothyroidism; NPO.
- Must be taken for life
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Description
This quiz covers various medications used in managing thyroid conditions, including Propylthiouracil, Methimazole, and Levothyroxine. It highlights their uses, side effects, monitoring requirements, and specific patient considerations. Test your understanding of these critical treatments and their implications in patient care.
