Pathophysiology and Pharmacology Book PDF

25/10/2024, 12:55 Pathophysiology and Pharmacology Book | Moodle Pathophysiology and Pharmacology Book 3. Endocrine Disorders relating to the Thyroid gland...

25/10/2024, 12:55 Pathophysiology and Pharmacology Book | Moodle Pathophysiology and Pharmacology Book 3. Endocrine Disorders relating to the Thyroid gland 3.1. Hypothyroidism Hypothyroidism When we are talking about hypothyroidism there are several causative factors - ranging from an autoimmune disorder (Hashimoto's disease ) or primary or thyroidal hypothyroidism which is dysfunction of the thyroid gland itself. Central hypothyroidism is failure of the pituitary gland, hypothalamus or both. Hashimoto's disease is a condition in which the immune system damages the thyroid, reducing its ability to produce thyroid hormones Signs and Symptoms https://gracevillephysio.com.au/blog/physio/physiotherapy-nutrition-hypothyroidism/ The person with hypothyroidism may suffer from extreme fatigue, hair loss, fragile and brittle nails and dry nails are common; numbness and tingling of the fingers may occur. The person's voice may become husky and the patient may complain of being hoarse. Females can have menstrual disturbances such as menorrhagia or amenorrhoea and may experience a loss of libido. In severe cases the person will have a lowered body temperature and pulse rate. The person may begin to gain weight without eating additional food and the skin can become thickened. Hair becomes thin and falls out and face becomes expressionless and often viewed as masklike. the person often complains of being cold even in a warm environment. As the disease progresses though processes slow, speech becomes slow and the tongue enlarges, hands and feet increase in size and deafness may occur. The person may also complain of constipation. Advanced hypothyroidism may produce personality and cognitive changes that are characteristic of dementia. Inadequate ventilation and sleep apnoea may occur in severe cases. Other complications such as pleural effusion and respiratory muscle weakness may also occur. https://gracevillephysio.com.au/blog/physio/physiotherapy-nutrition-hypothyroidism/ Progression The lack of TH causes a decrease in the metabolic rate Outcomes https://moodle.federation.edu.au/mod/book/tool/print/index.php?id=7654087&chapterid=2165050 1/3 25/10/2024, 12:55 Pathophysiology and Pharmacology Book | Moodle Consider the connection of some of the symptoms below to the effect of too little TH (explain WHY these symptoms occur) Cold intolerance Bradycardia Weight Gain Depression Fatigue The symptoms above look like the exact opposite of Graves disease....... Column Treatment Replacement of natural L-thyroxine with a synthetic form called L-thyroxine Levothyroxine Regardless of the aetiology for the condition of hypothyroidism, replacement therapy is required and simple with thyroxine (Levothyroxine). This drug comes in oral preparations and is safe, stable, and cheap. The elderly patient initiated on this medication are usually more sensitive to, and experience more adverse reactions, so start low (dose) and go slow (titration). When evaluating and adjusting dosages, clinical response is more important than blood hormone levels, so educating your patient about the side effects and relief of hypothyroidism symptoms is key. General action:thyroid hormone medication characterised by slow onset of action, long duration of action and a half life of 6 to 7 days General use: used in thyroid hormone deficiency(hypothyroidism) and TSH responsive throid tumors General side effects: usually associated with overdosage and consists of nervousness, tremor, sweating, flushing, headache, poor concentration, tachypnoea, tachycardia, palpitations, muscle cramps, vomiting, diarrhea : you guessed it right.. symptoms of hyperthyroidism General interactions: may enhance the clinical effect of warfarin, may reduce the effect of digoxin, may affect the response to oral diabetic agents, caution if given with lithium NSAIDs and corticosteroids https://moodle.federation.edu.au/mod/book/tool/print/index.php?id=7654087&chapterid=2165050 2/3 25/10/2024, 12:55 Pathophysiology and Pharmacology Book | Moodle General nursing considerations: patient should be warned it may take few weeks for therapy to be effective, needs to be taken on an empty stomach as a single daily dose preferably at the same time, this replacement therapy is life long and may interact with other medications, thyroid function tests should be monitored regularly, patient to report signs and symptoms of overdose.  Watch Watch this video relating to hypothyroidism. It serves as a good summary Hypothyroidism and Hashimoto's Thyroiditis: Visual Explan… Explan… https://moodle.federation.edu.au/mod/book/tool/print/index.php?id=7654087&chapterid=2165050 3/3