thyroid cards.txt

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sjw77
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107882
Filename:
thyroid cards.txt
Updated:
2011-10-19 17:13:30
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thyroid
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Description:
thyroid and parathyroid agents
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  1. Hypercalcemia
    Excessive calcium levels in the blood
  2. Hyperparathyroidism
    Excessive parathormone
  3. Hyperthyroidism
    • Excessive levels of thyroid hormone produced and released into the circulation.
    • (Graves disease, Goiter)
  4. Hypocalcemia
    Calcium deficiency
  5. Hypoparathyroidism
    Rare condition of absence of parathormone, may be seen after thyroidectomy
  6. Hypothyroidism
    • Lack of sufficient thyroid hormone to maintain metabolism
    • *Absence of the thyroid gland
    • *Lack of sufficient iodine in the diet to produce the needed level of thyroid hormone
    • *Lack of sufficient functioning thyroid tissue due to tumor or autoimmune disorders
    • *Lack of TSH due to pituitary disease
    • *Lack of TRH related to a tumor or disorder of the hypothalamus
  7. Thyroid Hormone
    Prototype: Levothyroxine (Synthroid)
    • Synthetic salt of T4. The most frequently used replacement hormone because of its predictable bioavailability and reliability.
    • Metabolize in liver. Excrete in bile.
    • Don't use generic form.
    • Actions: Increase metabolic rate of body tissues, increase O2 consumption, respiration, and heart rate; rate of fat, protein, and carb metabolism; and growth and maturation.
    • Indications: Replacement therapy in hypothyroidism; suppression of thyroid-stimulating hormone (TSH) release; treatment of myxedema coma and thyrotoxicosis; euthyroid goiters, management of thyroid cancer
    • Contraindications: Allergy to the drugs or their binders, acute throtoxicosis, or during acute MI (increase heart rate). Caution for lactation and with hypoadrenal conditions (Addison's disease)
    • Adverse effects: Few if correct dosage given. Skin reactions, hair loss (esp. in children), cardiac-tachycardia, arrhythmias, hypertension; CNS-tremors, anxiety, sleeplessness, headache; difficulty swallowing (take with full glass of water); GI-diarrhea, nausea, vomiting.
    • Drug-drug interactions: Cholestyramine (decreased absorption)- 2 hrs apart if necessary; anticoagulants (increased effectiveness-increased bleeding); Decreased effectiveness of digitalis glycosides with drugs combined; Theophylline clearance decreased (resp. toxic level), Multi-Vitamin (2 hours).
    • Nursing Considerations: Assess allergy, skin lesions, CNS, Vitals. Single dose before breakfast (30 mins before food), full glass of water, monitor cardiac response, blood tests, monitor response, monitor adverse effects.
  8. Antithyroid Agents
    Prototype: Propylthiouracil (PTU) and Iodine Solutions
    • Metabolize in liver. Excrete in kidneys.
    • Oral route
    • Short half-life: given t.i.d.
    • Indications: treatment of hyperthyroidism
    • Contraindications: allergy to iodine solutions, pregnancy, lactation
    • Adverse effects: effects of hypothyroidism, GI (nausea, vomiting, parasthesis, stained teeth {drink through straw}, dry mouth, sore gums and teeth), drowsiness, lethargy, bradycardia, goiter
    • Drug-drug interations: oral anticoagulants (increase level) = bleeding
    • Nursing considerations: Assess allergy, skin lesions, CNS, Vitals. Single dose before breakfast (30 mins before food), full glass of water, monitor cardiac response, blood tests, monitor response, monitor adverse effects.
  9. Parathyroid Drugs
    Antihypocalcemic Agents
    Prototype: Calcitriol (Rocaltrol)
    • Metabolize in liver. Excrete in bile.
    • Actions: a Vitamin D compound that regulates absorption of calcium and phosphate from small intestines, mineral resporption in bone, and reabsorption of phosphate from renal tubules, increasing serum calcium level
    • Indications: Management of hypocalcemia in patients on chronic renal dialysis, management of hypocalcemia associated with hypoparathyroidism
    • Contraindications: allergy, pregnancy, lactation
    • Adverse effects: metallic taste in mouth, GI (dry mouth, constipation, nausea, vomiting), CNS (weakness, headache, irritability-electrolyte change)
    • Drug-drug interactions: Magnesium antacids
    • Nursing Considerations: allergy, lesions, CNS, vitals, hydration, arrange for vitamin, calcium, and hormone replacements if indicated, monitor blood levels and renal function, monitor response, monitor adverse effects
  10. Antihypercalcemic Agents
    Prototype: Alendronate (Fosamax)
    • Weeks onset (1x per month)
    • No metabolism to urine almost unchanged
    • Actions: slows normal and abnormal bone resorption without inhibiting bone formation and mineralization
    • Indications: osteoporosis in post-menopausal women and in men, glucocorticoid-induced osteoporosis, Paget disease
    • Adverse effects: esophogeal erosion, headache, nausea, diarrhea, increased or recurrent bone pain
    • Drug-drug interactions: Antacids (30 mins), calcium-containing supplements (30 mins), Aspirin (bleeding, irritation, reflux)
    • Nursing Considerations: allergy, lesions, CNS, vitals, hydration, arrange for vitamin, calcium, and hormone replacements if indicated, administer Alendronate with full glass of water upon arising in the morning, sit upright 30 mins., monitor blood levels and renal function, monitor response, monitor adverse effects

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