Thyroid Meds PDF

Classification Therapeutic Uses Mechanism of Adverse Effects Drug Exemplars Action Thyroid Hormone Hypothyroidism Synthetic form Few if any when Levothyroxine Replacement (remember it is li...

Classification Therapeutic Uses Mechanism of Adverse Effects Drug Exemplars Action Thyroid Hormone Hypothyroidism Synthetic form Few if any when Levothyroxine Replacement (remember it is likely of thyroxine (T4, correct dose used; (Synthroid) AUTOIMMUNE!!!!; T3, or both) annually check know difference with thyroid function blood levels to other Increase the tests kind) metabolic rate (SPEEDING UP) Skin reactions, Treatment of of body tissues, loss of hair, myxedema coma increasing especially during (severe oxygen 1st month of tx in hypothyroidism) and consumption, children, diarrhea, thyrotoxicosis respiration, n/v heart rate, Suppression of TSH in growth and Symptoms of the maturation, and hyperthyroidism treatment/prevention metabolism of (anxiety, tremors, of goiters fat, weight loss, carbohydrates, palpitations, and protein tachycardia, chest pain, sweating) if dose too high; start with low dose and then increase slowly Less predictable effects: cardiac (arrhythmias, HTN), CNS (anxiety, sleeplessness, headache), difficulty swallowing (take drug with full glass of water to alleviate this effect) Antithyroid Agents Hyperthyroidism Prevents Effects of thyroid Propylthiouracil (Graves) formation of suppression; GI (PTU) and thyroid effects Methimazole hormone in the (Tapazole) thyroid cells, s/s of lowering the hypothyroidism serum level; also partially PTU: n/v, GI  inhibit complaints, severe conversion of T4 liver toxicity to T3 GI and liver tox less prominent in methimazole Methimazole: bone marrow suppression (pt must have frequent blood tests to monitor), paresthesia, neuritis, vertigo, drowsiness, skin rash, urticaria, skin pigmentation, n/v, epigastric distress, nephritis, arthralgia, myalgia, edema Thyroid Cancer; low Destroys thyroid Hypothyroidism Radioactive Iodine doses for dx and eval producing cells (start on (RAI) of thyroid function replacement); iodism (metallic taste and burning in the mouth, sore Thyrotoxic Inhibits thyroid teeth and gums, Potassium iodide Crisis/Storm production & diarrhea, cold sx, (Losat, Thyrosafe, Pre-Thyroidectomy hormone release stomach upset); Thyroshield) r/t high levels of staining of teeth; iodide; T3 T4 skin rash; goiter needs iodine Synthetic Vitamin Hypocalcemia Regulate GI effects: metallic Calcitriol D Analog absorption of taste, n/v, dry calcium and mouth, phosphate from constipation, and small intestine, anorexia mineral reabsorption in CNS effects: bone, weakness, reabsorption of headache, phosphate from somnolence, and renal tubes irritability; r/t  changes in electrolytes Other: muscle and bone pain Patients with liver or renal dysfunction may experience increased level of drugs and/or toxic effects Hypercalcemia when starting or increasing the dose of parathyroid hormone Interruption of treatment: severe hypocalcemia Antihypercalcemic Treatment of Paget’s Act to slow or Most common: Bisphosphonates Agents (-ates) disease (too much block bone abdominal pain, calcium) resorption but constipation, do not inhibit musculoskeletal Alendronate normal bone pain, nausea, (Fosamax) formation and diarrhea mineralization Increase in bone pain with Paget’s disease that passes after a few days to weeks Esophageal ulceration; decrease risk by taking med with water and staying upright for at least 30 mins after taking med Long-term use: increased risk of femoral shaft fractures  Osteonecrosis of the jaw Lower calcium levels Balance the Flushing of the Calcitonins effects of PTH, face and hands, Administering inhibit bone skin rash, n/v, Calcitonin salmon Calcitonin resorption urinary frequency, (Miacalcin) ONLY local inflammation READILY The primary route of at the site of AVAILABLE administration for injection; S/S calcitonin used to HYPOCALCEMIA treat Paget’s disease and postmenopausal Intranasal route: osteoporosis is via nasal dryness and subcutaneous irritation injection; intranasal route is only for pts Many of the s/e with osteoporosis lessen with time POSSIBLY ON EXAM Dilantin: check liver enzyme levels, formed blood components, assess bp, skin FILTER for IV usage STATUS Epilepticcus: more than 5 mins or multiple seizures CRITICAL Benzodiazepine Ativan, lirica CHECK THE BOOK FOR ALL MEDS CAUSE NOT ALL ARE THERE IN THE MED SHEET Ergot— causes constriction of cranial DO NOT GIVE WITH BETA blocker??? Synthroid: CONSIDER anticoagulants taking; watching bruising can be WORSE