Thyroid Hormone Treatments Overview
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Questions and Answers

What is the mechanism of action of thyroid hormone replacement?

  • Regulate absorption of calcium and phosphate from small intestine, mineral reabsorption in bone, reabsorption of phosphate from renal tubes
  • Increase the metabolic rate of body tissues, increasing oxygen consumption, respiration, heart rate, growth and maturation, and metabolism of fat, carbohydrates, and protein (correct)
  • Prevent formation of thyroid hormone within the thyroid cells, lowering the serum level; also partially inhibit conversion of T4 to T3
  • Destroys thyroid producing cells

What is the primary therapeutic use of antithyroid agents?

  • Hyperthyroidism (Graves) (Thioamides) (correct)
  • Treatment of myxedema coma
  • Suppression of TSH in the treatment/prevention of goiters
  • Hypothyroidism

What are the potential adverse effects of thyroid hormone replacement treatment?

  • Few if any when the correct dose is used.
  • Skin reactions, loss of hair
  • Symptoms of hyperthyroidism (anxiety, GI upset, sweating, weight loss, heat intolerance) if the dose is too high
  • Less predictable effects: cardiac, CNS, difficulty swallowing
  • All of the above (correct)

What is the mechanism of action of radioactive iodine (RAI)?

<p>Destroys thyroid producing cells (C)</p> Signup and view all the answers

What is the primary drug used for thyroid hormone replacement?

<p>Levothyroxine (Synthroid)</p> Signup and view all the answers

What are two commonly used antithyroid agents?

<p>Propylthiouracil (PTU) and methimazole (Tapazole)</p> Signup and view all the answers

Antithyroid agents are generally used to treat hypothyroidism.

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

What are the main potential adverse effects of antithyroid agents?

<p>Agranulocytosis, gastrointestinal upset, and rash</p> Signup and view all the answers

Thyroid hormone replacement therapy is typically prescribed for hyperthyroidism.

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

What is the most common adverse effect of bisphosphonates?

<p>Abdominal pain, constipation, musculoskeletal pain, nausea, diarrhea (D)</p> Signup and view all the answers

Calcitonin salmon is a type of bisphosphonate used for Paget's disease.

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

Match the following medications with their primary therapeutic uses:

<p>Levothyroxine = Hypothyroidism Propylthiouracil = Hyperthyroidism Alendronate = Paget's disease Calcitonin salmon = Hypercalcemia Radioactive iodine = Thyroid cancer</p> Signup and view all the answers

Which of the following is NOT a therapeutic use of thyroid hormone replacement?

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

What is the mechanism of action for synthetic thyroxine (T4, T3, or both)?

<p>Increase the metabolic rate of the body and increase oxygen consumption (E)</p> Signup and view all the answers

Thyroid hormone replacement can cause skin reactions and loss of hair.

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

What are two examples of antithyroid agents?

<p>Propylthiouracil (PTU) and methimazole (Tapazole)</p> Signup and view all the answers

Which of the following is NOT a potential adverse effect of antithyroid agents?

<p>Increased risk of hyperthyroidism (E)</p> Signup and view all the answers

What is the mechanism of action for radioactive iodine (RAI) in treating thyroid cancer?

<p>It destroys thyroid-producing cells (B)</p> Signup and view all the answers

A common side effect of using antihypercalcemic agents for Paget's disease is an increased risk of femoral shaft fractures.

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

What is the primary mechanism of action for Calcitonin?

<p>Decrease bone resorption (E)</p> Signup and view all the answers

What are three main functions that calcium is involved in?

<p>Calcium is involved in bone health, blood clotting, and heart function.</p> Signup and view all the answers

Which of the following is NOT a potential side effect of using bisphosphonates to treat Paget's disease?

<p>Decreased bone pain (A)</p> Signup and view all the answers

What is the primary purpose of synthetic vitamin D analogs?

<p>Regulate absorption of calcium and phosphate (C)</p> Signup and view all the answers

Patients with liver or renal dysfunction may experience a decreased level of drugs and/or toxic effects with synthetic vitamin D analogs.

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

Flashcards

Thyroid Hormone Replacement

Used to treat hypothyroidism, a condition where the thyroid gland doesn't produce enough hormones.

Hypothyroidism

A condition where the thyroid gland doesn't produce sufficient hormones.

Myxedema Coma

A severe form of hypothyroidism requiring immediate treatment.

Levothyroxine

A synthetic thyroid hormone used to treat hypothyroidism.

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Mechanism of Action (Thyroid)

Increasing metabolic rate via oxygen consumption, respiration, and more.

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Antithyroid Agents

Medications used to treat hyperthyroidism (overactive thyroid).

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Hyperthyroidism

A condition where the thyroid gland is overactive, producing too much hormone.

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Graves' Disease

An autoimmune disorder leading to hyperthyroidism.

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Propylthiouracil (PTU)

An antithyroid medication to lower the blood levels of thyroid hormones.

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Methimazole

An anti-thyroid drug used to lower the blood levels of thyroid hormones.

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Radioactive Iodine (RAI)

A treatment for thyroid cancer by destroying thyroid cells.

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Thyrotoxic Crisis/Storm

A severe, life-threatening complication of hyperthyroidism.

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Potassium Iodide

Medication to treat thyroid storm or prior to surgery.

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Parathyroid Hormone

Regulates calcium and phosphate levels in the body.

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Calcitriol

Vitamin D analog for calcium regulation.

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Hypercalcemia

High levels of calcium in the blood.

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Bisphosphonates

Medications slowing bone resorption, often for osteoporosis.

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Alendronate

Example of a bisphosphonate used to treat osteoporosis.

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Paget's Disease

A condition of abnormal bone remodeling, leading to weak, painful bones.

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Calcitonin

A hormone that lowers blood calcium levels.

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What is the classification of levothyroxine?

It's a thyroid hormone replacement drug.

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What is the therapeutic use of levothyroxine?

It's used to treat hypothyroidism, a condition where the thyroid doesn't produce enough hormones.

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What is the mechanism of action of levothyroxine?

It acts as a synthetic form of thyroxine (T4), increasing the body's metabolic rate.

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What is the most common adverse effect of levothyroxine?

Few side effects when the dose is correct, but skin reactions and hair loss are possible.

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What is the main function of antithyroid agents?

They block the thyroid gland from producing hormones, treating hyperthyroidism.

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What are the two main classes of antithyroid agents?

Thioamides, such as propylthiouracil (PTU) and methimazole, and radioactive iodine.

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What are some common adverse effects of antithyroid agents?

Effects of thyroid suppression like weight gain, lethargy, and depression. Also GI upset and agranulocytosis.

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What is the mechanism of action of propylthiouracil (PTU)?

It prevents the formation of thyroid hormone within the thyroid gland.

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What is the mechanism of action of radioactive iodine (RAI)?

It destroys the thyroid gland cells that produce hormones.

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What is a rare but severe side effect of antithyroid agents?

Agranulocytosis (low white blood cells) can occur.

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What is the therapeutic use of potassium iodide?

Used to treat thyrotoxic crisis (thyroid storm) and to shrink the thyroid gland before surgery.

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What is the mechanism of action of potassium iodide?

It inhibits thyroid hormone production and release by high levels of iodide.

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What is the classification of calcitriol?

It's a synthetic vitamin D analog.

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What is the therapeutic use of calcitriol?

It's used to treat hypocalcemia, a condition of low calcium in the blood.

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What is the mechanism of action of calcitriol?

It increases the absorption of calcium and phosphate from the intestines, boosting blood calcium levels.

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What are some potential adverse effects of calcitriol?

GI effects, CNS effects, and toxicity in patients with liver or kidney dysfunction.

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What is the classification of bisphosphonates?

They are antihypercalcemic agents that slow bone resorption.

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What is the therapeutic use of bisphosphonates?

Used for conditions like Paget's disease and osteoporosis.

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What is the mechanism of action of bisphosphonates?

They slow down the breakdown of bone by inhibiting osteoclast activity.

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What are common adverse effects of bisphosphonates?

GI issues like abdominal pain and constipation, musculoskeletal pain.

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What are some rare but serious adverse effects of bisphosphonates?

Osteonecrosis of the jaw (jawbone poking through the gum) and femoral shaft fractures.

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What is the classification of calcitonin?

It's a hormone that lowers blood calcium levels.

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What is the therapeutic use of calcitonin?

Used to treat hypercalcemia, osteoporosis, and Paget's disease.

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What is the mechanism of action of calcitonin?

It inhibits bone resorption and reduces calcium release from bones.

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What are common adverse effects of calcitonin?

Flushing, skin rash, nausea, vomiting, and nasal dryness if intranasal route used.

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What is one common adverse effect of bisphosphonates?

Esophageal ulceration, a sore in the esophagus, can occur.

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What are some key differences between thyroid and parathyroid hormones?

Thyroid hormones are produced by the thyroid gland and affect metabolism. Parathyroid hormone is produced by the parathyroid glands and regulates calcium levels.

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What effect does levothyroxine have on TSH levels?

Levothyroxine suppresses TSH (thyroid-stimulating hormone) production by the pituitary gland.

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What happens to the thyroid gland when treated with radioactive iodine?

The thyroid gland gets smaller over time as the radioactive iodine destroys thyroid cells.

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Study Notes

Thyroid

  • Classification & Therapeutic Uses:

    • Thyroid Hormone Replacement: Treats hypothyroidism, including myxedema coma. Suppresses TSH to prevent/treat goiters (enlarged thyroid).
    • Antithyroid Agents: Used to treat hyperthyroidism (Graves' disease). Reduce thyroid hormone production.

  • Mechanism of Action:

    • Thyroid Hormone Replacement: Synthetic forms of thyroxine (T4, T3, or both) increase body metabolic rate, oxygen consumption, respiration, heart rate, growth, and maturation. Metabolism of fats, carbohydrates, and proteins also increases.
    • Antithyroid Agents: Prevent thyroid hormone formation within the thyroid cells. Partially inhibit the conversion of T4 to T3.

  • Adverse Effects:

    • Thyroid Hormone Replacement: Few adverse effects at correct dosages. Potential skin reactions, hair loss, and increased hyperthyroid symptoms (anxiety, GI upset, sweating, weight loss, heat intolerance) at high doses. Also less predictable effects like cardiac issues, CNS problems, and swallowing problems.
    • Antithyroid Agents: Agranulocytosis (low white blood cells), GI upset, and rash at high doses. May lead to hypothyroidism (cold intolerance, weight gain, bradycardia, lethargy, and depression) if the dose is too high. Hepatotoxicity (liver damage) is a concern. Monitor CBC levels and liver function is very important.

  • Drug Examples:

    • Thyroid Hormone Replacement: Levothyroxine (Synthroid).
    • Antithyroid Agents: Propylthiouracil (PTU) and Methimazole (Tapazole).

Thyroid Cancer

  • Mechanism: Destroys thyroid-producing cells.

Parathyroid

  • Mechanism: Regulates calcium and phosphate absorption from the small intestine. Includes mineral reabsorption in bone and phosphate reabsorption from renal tubes.

  • Use: Regulates calcium homeostasis.

  • Adverse Effects:

    • Gl Effects: nausea, vomiting, diarrhea and general GI distress.
    • CNS Effects: nervous system disturbance, altered mental status.
    • Patients with liver or renal dysfunction: Toxic effects from elevated drug levels and potential increased toxicity of drugs.
    • Hypercalcemia: Increased calcium levels.

  • Treatment:

    • Interruption of Treatment: Can cause severe hypocalcemia requiring careful monitoring. Calcium has 3 key functions: bones, blood-clotting factors, and heartbeat.

  • Other Effects:

    • Hypothyroidism: Iodism (metallic taste), tooth staining, skin rash, goiter formation

Antihypercalcemic Agents

  • Mechanism of Action: Acts to slow or block bone resorption, preventing further bone damage.
  • Therapeutic Uses: Treatment for Paget's disease.
  • Adverse Effects:
    • Common: Abdominal pain, constipation, musculoskeletal pain, nausea, diarrhea, potentially increased bone pain associated with Paget's disease, esophageal ulceration.
    • Long-Term: Increased risk of femoral shaft fractures, osteonecrosis of the jaw (jawbone damage).
    • Other: Flushing of face and hands, skin rash, nausea and vomiting, urinary frequency, local inflammation at the site of injection. Intranasal route: nasal dryness and irritation. Many side effects reduce over time.

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Thyroid and Parathyroid PDF

Description

This quiz covers the classifications and therapeutic uses of thyroid hormone treatments, including both hormone replacement and antithyroid agents. It also explores their mechanisms of action and potential adverse effects. Test your knowledge on these crucial aspects of thyroid therapy.

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