First Line Agents
Cabergoline
The most common form of primary hypothyroidism
Hashimoto's disease
Agent which should be separated by 30-60 minutes from breakfast and not taken with any other medications
Levothyroxine
Adverse effects of steroids
Psychosis, retention of fluid, weight gain, diabetes, no menstrual period, infection, stomach issues (PUD), osteoporosis, NA+ retention, eye issues (glaucoma/cataracts)
Normal range for total T4
4.5-10.9 mcg/dl
Treatments for primary and secondary adrenal insufficiency
Hydrocortisone, cortisone, fludrocortisone
Excessive GH production, headache, visual disturbances, sweating, neuropathies, joint pain, and paresthesias are signs and symptoms of this condition
Acromegaly
Dopamine agonists can cause these side effects
CNS symptoms, GI effects, thickening of bronchial secretions, nasal congestion, rarely psychiatric disturbances
The treatments for Cushing's Syndrome
Surgical resection, irradiation of pituitary, tapering of steroids or discontinuation of glucocorticoids ASAP
Normal range for total T3
60-181 ng/dl
Drug of choice in adults and children, except in thyroid storm and 1st trimester pregnancy, for treating hyperthyroidism
Methimazole
Central obesity and moon face are symptoms of this disorder
Cushing's syndrome
Injection site pain, GI upset, flu-like symptoms, elevations in LFT
The treatment for acromegaly in most patients
Transsphenoidal surgery
Normal range for TSH
0.5-4.7 mIU/L
Treatment of choice for myxedema coma
IV levothyroxine 200 mcg, followed by 100 mcg IV once daily
Autoimmune process where antibodies stimulate TSH receptors causing overproduction of thyroid hormones
Graves' Disease
GI upset, injection site reactions, arrythmias, biliary disorders, hypothyroidism, gallstones, etc.
GH concentration of >1ng/L is characteristic of this condition
Acromegaly
Prolactin >25 ng/L
Agent of choice for thyroid storm in 1st trimester pregnancy
Propylthiouracil
Signs and symptoms of hypothyroidism
Fatigue, muscle cramping, weight gain, lethargy, hair thinning, dry skin, depression, elevated TSH, low T, etc.
Monitoring parameters for patients on antithyroid medication
Free T4 and T3 4 weeks after initiation, TSH later in treatment as this is not typically valuable early on, CBC at baseline and liver profile, follow up every 6-12 months after remission
The treatment for short stature
Somatotropin
Peak GH concentration <10 ng/L following a GH provocation test is characteristic of this condition
Short stature