Thyroid Hormone Replacement Therapy
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Questions and Answers

What is the primary therapeutic use of thyroid hormone replacement?

  • Cancer treatment
  • Diabetes management
  • Hypothyroidism (correct)
  • Hyperthyroidism

Which of the following best describes the mechanism of action of thyroid hormone replacement?

  • Inhibiting thyroid function
  • Reducing oxygen consumption
  • Slowing down metabolic processes
  • Increasing metabolic rate of body tissues (correct)

What is a potential adverse effect of thyroid hormone replacement when the dose is too high?

  • Bradycardia
  • Lethargy
  • Weight gain
  • Symptoms of hyperthyroidism (correct)

What is the initial approach to dosing for thyroid hormone replacement therapy?

<p>Begin with a low dose and increase slowly (B)</p> Signup and view all the answers

Which blood levels should be checked annually during thyroid hormone replacement therapy?

<p>Thyroid function tests (C)</p> Signup and view all the answers

Which of the following could be a less predictable effect of thyroid hormone replacement?

<p>Arrhythmias (A)</p> Signup and view all the answers

In which severe condition is thyroid hormone replacement also used as treatment?

<p>Myxedema coma (C)</p> Signup and view all the answers

What could occur during the first month of treatment with thyroid hormone replacement in children?

<p>Increased hair loss (B)</p> Signup and view all the answers

What is the primary effect of Antithyroid Agents like Propylthiouracil (PTU) and Methimazole?

<p>Inhibit the formation of thyroid hormones (D)</p> Signup and view all the answers

Which side effect is associated with Propylthiouracil (PTU)?

<p>Severe liver toxicity (C)</p> Signup and view all the answers

What condition may arise from an increase in the dose of parathyroid hormone?

<p>Hypercalcemia (B)</p> Signup and view all the answers

What is a possible result of interruption of treatment with certain medications?

<p>Severe hypocalcemia (B)</p> Signup and view all the answers

What should a patient taking Methimazole be routinely monitored for?

<p>Bone marrow function (B)</p> Signup and view all the answers

Which of the following describes a common gastrointestinal side effect of PTU?

<p>Nausea and vomiting (C)</p> Signup and view all the answers

Which of the following side effects is most commonly associated with bisphosphonates?

<p>Esophageal ulceration (B)</p> Signup and view all the answers

Which Antithyroid Agent is less likely to cause gastrointestinal and liver toxicity?

<p>Methimazole (Tapazole) (A)</p> Signup and view all the answers

Which medication is classified as a bisphosphonate?

<p>Risedronate (D)</p> Signup and view all the answers

What is the primary action of antihypercalcemic agents in the treatment of Paget's disease?

<p>Block bone resorption (D)</p> Signup and view all the answers

What effect does Methimazole have on the nervous system?

<p>Causes paresthesia and neuritis (C)</p> Signup and view all the answers

Which mechanism describes the action of Antithyroid Agents in treating hyperthyroidism?

<p>Prevent the conversion of T4 to T3 (C)</p> Signup and view all the answers

What common adverse effect might patients with Paget's disease experience when treated with bisphosphonates?

<p>Increased bone pain (D)</p> Signup and view all the answers

What symptom is NOT typically associated with hypothyroidism after treatment with Antithyroid Agents?

<p>Increased energy levels (B)</p> Signup and view all the answers

Which of the following conditions may lead to increased levels of drugs and toxic effects?

<p>Liver dysfunction (A)</p> Signup and view all the answers

What symptom is not typically associated with the side effects of bisphosphonates?

<p>Fatigue (D)</p> Signup and view all the answers

What is a common side effect of Potassium iodide?

<p>Nausea (B), Metallic taste (C)</p> Signup and view all the answers

What condition is associated with hypothyroidism following the administration of radioactive iodine?

<p>Destruction of thyroid producing cells (B)</p> Signup and view all the answers

Which of the following symptoms is NOT commonly associated with synthetic Vitamin D analogs?

<p>Impaired vision (D)</p> Signup and view all the answers

During a thyroid storm, which hormonal response is primarily inhibited?

<p>Thyroid hormone release (A)</p> Signup and view all the answers

What is a potential adverse effect of Calcitriol?

<p>Constipation (A)</p> Signup and view all the answers

In a patient experiencing epigastric distress, which treatment may lead to a skin rash?

<p>Potassium iodide administration (D)</p> Signup and view all the answers

Which condition is characterized by symptoms such as weakness and headache after taking synthetic vitamin D analogs?

<p>Hypocalcemia (A)</p> Signup and view all the answers

What is the primary function of Radioactive Iodine (RAI) treatment?

<p>Destroy thyroid producing cells (A)</p> Signup and view all the answers

What should a patient do to decrease the risk of adverse effects after taking medication?

<p>Stay upright for at least 30 minutes after taking the medication (A)</p> Signup and view all the answers

What is a potential risk of long-term use of certain medications?

<p>Osteonecrosis of the jaw (B)</p> Signup and view all the answers

What is the primary route of administration for calcitonin used to treat Paget's disease?

<p>Subcutaneous injection (D)</p> Signup and view all the answers

What side effect is associated with the intranasal route of calcitonin administration?

<p>Nasal dryness and irritation (A)</p> Signup and view all the answers

What is the critical condition defined as having more than 5 minutes of continuous seizures?

<p>Status epilepticus (D)</p> Signup and view all the answers

Which medication requires monitoring of liver enzyme levels?

<p>Dilantin (A)</p> Signup and view all the answers

What is a common side effect of calcitonin during its administration?

<p>Hypocalcemia (A)</p> Signup and view all the answers

Which of the following should not be given with a beta blocker?

<p>Ergot (D)</p> Signup and view all the answers

Flashcards

Thyroid Hormone Replacement

Synthetic forms of thyroid hormones (like T4) used to treat hypothyroidism, accelerating the body's metabolic rate.

Hypothyroidism

A condition where the thyroid gland doesn't produce enough hormones, slowing down metabolism.

Mechanism of Action

Thyroid hormones increase the metabolic rate of body tissues, impacting oxygen consumption, respiration, heart rate, and growth & maturation.

Thyroid Hormone Adverse Effects (correct dosage)

Relatively few if the correct dose is used; may include skin reactions, hair loss, diarrhea, and nausea/vomiting (especially in initial treatment, children).

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Levothyroxine (Synthroid)

A common synthetic thyroid hormone used to treat hypothyroidism.

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Myxedema Coma

Severe, life-threatening hypothyroidism.

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Hyperthyroidism Symptoms (overdosing)

Symptoms of excessive thyroid hormone - anxiety, tremors, weight loss, palpitations, rapid heartbeat; may occur with incorrect dosage.

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Thyroid Function Tests

Blood tests to monitor thyroid hormone levels, used for accurate dosing and to catch issues early.

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Antithyroid Agents

Drugs that prevent the thyroid from making thyroid hormone.

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Propylthiouracil (PTU)

An antithyroid agent that lowers thyroid hormones.

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Methimazole (Tapazole)

An antithyroid agent.

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Thyroid Hormone Suppression

Lowering the level of thyroid hormone in the blood.

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Side Effects of PTU

Nausea, vomiting, GI complaints and potential liver toxicity.

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Side Effects of Methimazole

Bone marrow suppression, paresthesia, neuritis, vertigo, and drowsiness.

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Difficulty Swallowing

Side effect of certain drugs that requires taking with water.

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Antihypercalcemic Agents (-ates)

Drugs used to treat excessive calcium levels (hypercalcemia).

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Paget's Disease

A condition causing excessive bone calcium.

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Bisphosphonates

A class of antihypercalcemic agents that slow bone resorption.

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Bone Resorption

Breakdown of calcium-containing bone.

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Hypercalcemia

High levels of calcium in the blood.

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Side effects of ates (example)

Common issues like abdominal pain and constipation.

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Liver/Kidney Impact

Liver or kidney problems can increase drug effects or toxicity.

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Hypocalcemia

Low blood calcium levels, a risk from stopping treatment.

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Thyroid Cancer Diagnostic Test

Low doses of radioactive iodine (RAI) are used to evaluate thyroid function (dx and eval).

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Hypothyroidism Treatment

Replacement therapy for low thyroid hormone production. Thyroid hormone produced by thyroid cells and released into the blood for use.

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Thyrotoxic Crisis

A serious complication of hyperthyroidism, characterized by high levels of thyroid hormones and symptoms like skin rashes.

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Pre-Thyroidectomy Treatment

Potassium Iodide (KI) is used to suppress thyroid hormone production before surgery to prevent thyroid storm.

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Synthetic Vitamin D Analog Side Effects

GI effects (metallic taste, nausea, dry mouth, constipation, anorexia); CNS effects (weakness, headache, somnolence, irritability).

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Synthetic Vitamin D Analog Function

Assists in calcium and phosphate absorption/reabsorption from small intestine and bone (promoting mineral balance) and kidneys.

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Iodine Toxicity Signs

Characterized by iodism symptoms: metallic taste, burning mouth, sore teeth, diarrhea.

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Hypocalcemia Symptoms

Low levels of calcium in the blood potentially affecting various bodily functions and causing a range of symptoms.

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Reducing Calcitonin risk

Decreasing risk of potential side effects from calcitonin by taking the medication with water and staying upright for at least 30 minutes after.

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Long-term Calcitonin risk

Prolonged use of calcitonin may increase the chance of femur bone breaks and a specific jawbone condition.

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Calcitonin's action

Calcitonin controls calcium levels, counteracts effects of another hormone that affects bones (Parathyroid Hormone), preventing bone loss; It lessens the activity of bone breakdown/resorption.

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Calcitonin delivery methods

Calcitonin is delivered to the body by subcutaneous injection or intranasal route.

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Calcitonin side effects

Calcitonin side effects include flushing, skin rash, nausea, vomiting, frequent urination, local inflammation around injection site, and nasal dryness/irritation.

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Hypocalcemia warning

Dosage of calcitonin administered to ensure appropriate calcium levels; watch for potentially low calcium levels.

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Dilantin monitoring

Monitoring liver enzymes, blood components, and blood pressure, and assessing skin when taking Dilantin.

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Status Epilepticus

Repeated or prolonged seizures (lasting more than 5 mins) or multiple seizures in a short period.

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Study Notes

Thyroid Hormone Replacement

  • Therapeutic Uses: Treating hypothyroidism (including myxedema coma and thyrotoxicosis), and for suppressing TSH in the treatment/prevention of goiters. Know the differences in blood levels to other kinds of hypothyroidism.
  • Mechanism of Action: Synthetic forms of thyroxine (T4, T3, or both) increase the metabolic rate of body tissues which speeds up oxygen consumption, respiration, heart rate, maturation, and metabolism of fat, carbohydrates, and protein.
  • Adverse Effects: Few adverse effects if the correct dose is used. Annual thyroid function tests are required. Potential skin reactions, hair loss, diarrhea (especially in children), nausea/vomiting (n/v) are possible, especially in the initial treatment period. Symptoms of hyperthyroidism (anxiety, tremors, weight loss, palpitations, tachycardia, chest pain, sweating) may occur if the dose is too high. Cardiac issues like arrhythmias and high blood pressure (HTN) and central nervous system issues like anxiety, sleeplessness, headaches, can also occur.
  • Drug Exemplars: Levothyroxine (Synthroid) is a common example.

Antithyroid Agents

  • Therapeutic Uses: Treating hyperthyroidism (Graves' disease).
  • Mechanism of Action: Prevents the formation of thyroid hormone in thyroid cells, lowering the serum levels. This action is partially achieved by preventing iodine use by the thyroid.
  • Adverse Effects: Potential for skin reactions, hair loss, especially in the first month of treatment in children, and diarrhea. Symptoms of hyperthyroidism (anxiety, tremors, loss of weight, palpitations, irregular heart beat, chest pain, sweating) are possible if the dose is too high. Other potential effects include: cardiac (arrhythmias, high blood pressure), central nervous system (anxiety, sleeplessness, headache), or difficulty swallowing (take with a full glass of water).
  • Drug Exemplars: Propylthiouracil (PTU), Methimazole (Tapazole).
  • Hypothyroidism: A condition where the thyroid gland does not produce enough thyroid hormones.
  • Hyperthyroidism: A condition where the thyroid gland produces too much thyroid hormone.
  • Thyroid Cancer, Low Doses: Used for diagnosis and evaluation of thyroid function.
  • Thyrotoxic Crisis/Storm: A severe form of hyperthyroidism.
  • Pre-Thyroidectomy: Measures taken prior to thyroid surgery.
  • Hypocalcemia: Low levels of calcium in the blood.
  • Hypercalcemia: High levels of calcium in the blood.

Other Medications

  • Bisphosphonates (Alendronate): Used to treat osteoporosis and Paget's disease. May cause esophageal ulceration, so instructions include taking with water and staying upright after taking for 30 minutes to prevent complications. Long term use increases the risk of femoral shaft fractures.
  • Calcitonin: Treats Paget's disease and postmenopausal osteoporosis. (Administered via injection; intranasal administration possible.)
  • Radioactive Iodine (RAI): Used for thyroid conditions.
  • Potassium Iodide: Used as a medication (e.g., Losat, Thyrosafe, Thyroshield). -Potential adverse effects include metallic taste, nausea/vomiting, dry mouth, constipation, and loss of appetite (anorexia). Other potential central nervous system (CNS) effects include weakness, headaches, sleepiness (somnolence), and irritability.
  • Calcitriol: Affects calcium and phosphate levels in the body. Possible side effects include metallic taste, gastrointestinal (GI) distress, dry mouth and other digestive issues.
  • Dilantin: Used for treating seizures and status epilepticus (seizures that last more than 5 minutes, or multiple seizures). The safety profile required monitoring of liver enzymes, blood cell composition, blood pressure, and skin.

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Description

This quiz covers the therapeutic uses, mechanism of action, and adverse effects of thyroid hormone replacement. Understand how synthetic thyroxine impacts metabolism and the necessary precautions for dosage. It's crucial for healthcare professionals to recognize the signs of both effective treatment and potential overdose.

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