Pharmacology Final

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Pharmacology Final
2011-04-26 16:59:50
Thyroid Drugs

Thyroid Drugs
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  1. T3
    more active than T4
  2. T2 and rT3
  3. T4
    longer duration of action than T3
  4. Normal range of T3
    70-195 ng/dl
  5. Normal range of T4
    5-12 mcg/dl
  6. Normal range of TSH
    0.3-5.0 mIU/L
  7. Normal range for T3U
  8. Free thyroxine index normal range
    4 to 11
  9. High levels in hyperthyroid
    • T3
    • T4
    • T3U
    • Free Thyroxine index
  10. low levels in hyperthyroid
  11. Low levels in Hypothydroid
    • T3
    • T4
    • T3U
    • Free thyroxine index
  12. High levels in hypothyroid
  13. Conditions attributed to hyperthyroidism
    • grave's disease
    • congenital thyrotoxicosis
    • transient hyperthyroidism
    • metastatic thyroid carcinoma
  14. Levothyroxine indication
    used in treatment of hypothyroidism
  15. Warnings with levothyroxine
    should not be used for weight loss
  16. Levothyroxine drug interactions
    • increases response to oral anticoagulation therapy
    • effects of digitalis glycosides may be reduced by levothyroxine
  17. Liothyronine indication
    • treatment of hypothyroidism
    • can be used in pt allergic to desiccated thyroid or thyroid extract derived from pork or beef
  18. ADEs with liothyronine
  19. Drug interactions with liothyronine
    • thyroid hormones increase catabolism of vitamin K dependant clotting factors
    • may cause increases in insulin or oral hypoglycemic requirements
    • estrogens increase serum thyroxine binding globulin decreasing levothyroxine
  20. Use of thyroid products with imipramine or other tricyclic antidepressants
    • leads to increased receptor sensitivity and enhanced anti-depresant activity
    • transient cardiac arrhythmias have been observed
  21. Thyroid hormone replacement and digitalis
    TH increases metabolic rate which requires an increase in digitalis dosing
  22. THR with ketamine
    when administered together may cause hypertension and tachycardia
  23. THR and adrenergic response
    TH increases adrenergic effect of catecholamines such as epinephrine and norepinephrine
  24. Methimazole indications
    • hyperthyroidism
    • may lead to remission of the disease
    • used when thyroidectomy is contraindicated
  25. Methimazole ADEs
    • Agranulocytosis
    • Granulocytopenia
    • Thrombocytopenia
  26. Drug interactions with Methimazole
    • Anticoagulants
    • Beta adrenergic blocking agents
    • Digitalis glycosides
    • Theophylline
  27. Anticoagulants + methimazole
    activity of anticoag may be potentiated by methimazole
  28. B-adrenergic blockers + Methimazole
    When pt. has hyperthyroidism, they will have increased clearance of beta blockers. When their thyroid is fixed they will require a dose reduction.
  29. Digitalis + methimazole
    Digitalis levels increased when pt returns to euthyroid
  30. Theophylline + methimazole
    theophylline clearance may decrease when hyperthyroid pt becomes euthyroid. pt will require a dose reduction.