Thyroid Drugs PDF
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Uploaded by UserReplaceableTuba
University of Saskatchewan
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Summary
This document provides information on different thyroid medications, including their doses, mechanisms of action (MOA), potential side effects, and overall applications. It covers both hyperthyroidism and hypothyroidism, offering a comprehensive overview of thyroid drug management.
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Hyperthyroidism Classes Drugs Dose MOA Side Effects Facts/Use Thioamides Propylthiouracil Initial: 300mg BID or TID Inhibits T3&4 Common: GI upset, rash, -not used for life...
Hyperthyroidism Classes Drugs Dose MOA Side Effects Facts/Use Thioamides Propylthiouracil Initial: 300mg BID or TID Inhibits T3&4 Common: GI upset, rash, -not used for life Maintenance: 100-150mg production joint pain -reduces severity BID or TID (prevents I from Serious: agranulocytosis binding with Tyr (0.4% of pts, occurs in first residue). Inhibits 90 days, WBC falls, Methimazole Mild coupling of MIT and abrupt, fever, sore throat, Initial: 10-15mg OD DIT. All due to malaise) Maint:5-15mg OD inhibiting thyroid Neutropenia (neutrophil Moderate peroxidase. count decline, immune Initial: 20-30mg OD system cannot properly Maint: 5-15mg OD respond) Severe Intial: 30-40mg OD Maint: 5-15mg OD Beta All beta blockers Reduces symptoms -do not directly Blockers can be used related to cardia influence thyroid except those with over stimulation hormones intrinsic MOA here sympathomimetic activity (ex/ acebutolol) Surgery Permanent curative hypothyroidism Radioactive Temporary thyroiditis then curative Iodine worsening hyperthyroidism symptoms, then hypothyroidism Hypothyroidism Classes Dose Drug Side Effects Facts/Uses Interactions Desiccated -first agent thyroid -from thyroid of animals -contains T3&4 -lifelong drug -causes high peak in T3 -not well standardized Liothyronine -Contains T3 and not T4 -fluctuates serum levels -costly -not really used unless pt has poor T4 to 3 conversions Levothyroxine Average dose: 1.6 mcg/kg/day -antiacids/PPI/ -Minimal if dosed -analog of T4 Starting Dose: 12.5 mcg/day to max weight dose H2 blockers properly -1st line Average Replacement Dose: 100mcg empirically -iron -hyperthyroidism -t ½ of 7 days Higher TSH = higher T4 dose -Ca/mineral symptoms - conversion to T3 is Recommend starting low and titrating up if: any supplements -cardiac risk regulated by body CVD, rhythm disturbances, over 50, severe or -cholestyramine increase - if TSH is high than there long-standing hypothyroidism. -raloxifene -aggravate are low T3/4 Start low at 12.5-50mcg and titrate up by 12.5- Take 2h before existing CVD -if TSH is low than T3/4 25mcg q4-6w or 4h after -bone mineral levels are high Take on empty stomach density reduction Combined T3/4
