Actions of the thyroid
Hormones responsible for regulating metabolism
t3 and t4
Thioamides
Propylthiouracil
Methimazole
Indicated for Hyperthyroidism.
Reduce Metabolism
Hypoparathyrodism
Absence of parathyroid hormone
most likely occurs from removal of parathyroid in surgery
LEADS TO HYPOCALCEMIA
Prototype
Calcitrol
Indications
Lower calcium levels
Treat Paget Disease Osteoporosis
Calcitonin (must have adequate iodine to produce)
Iodine solutions
Radioactive iodine
Adjunct therapy for hyperthyroidism
presurgical suppression of thyroid
Acute thyrotoxicosis
Hyperparathyroidism
Excess production of Parathyroid hormone
Can occur as result of tumor or genetic disorder
LEADS TO HYPERCALCEMIA
Use
management of hypocalcemia in chronic renal dialysis patients
treatment of hypoparathyroidism
Bisphosphonates
Alendronate
Act on serum levels to slow or block bone resorption
What are the signs and symptoms of hypothyroidism
Low metabolism
Myxedema Coma - ACUTE COMPLICATION
Treat with thyroid hormone replacement
Nursing considerations
Reduction in metabolism
Give through straw to decrease staining
Nursing considerations
Monitor calcium levels
Monitor Magnesium, phosphate
Radiographs of bone
Dialysis management
Calcitonins
CALCITONIN SALMON!
Secrete by thyroid to balance PTH
Signs and symptoms of Hyperthyroidism
High metabolism
Thyrotoxicosis-ACUTE COMPLICATION
Treat with thioamides or Iodine
May need surgical removal
Complications of antithyroid agents
Hypothyroidism
liver injury
Radiation sickness
Myelosuppression
Bone pain
Metallic Taste
N/V
Weakness
Dry mouth
Considerations
Monitor calcium levels
Adequately hydrate
Prevention of complications from osteoporosis/pagets disease
Arrange for Vit. D, Ca+ supplements and hormone replacement
Ensure comfort/Analgesics for bone pain
Considerations for thyroid agents
Increased metabolism
Consistent regimen and brand
Admin daily before breakfast
Chronic overtreatment can lead to hyperthyroidism
Overmedication- anxiety, tachycardia, chest pain, tremors
Levothyroxine (THYROID AGENT NOT ANTI THYROID)
synthetic t4 salt
increase basal metabolic rate of body tissue
replacement therapy in myxedema coma and hypothyroidism
Action
Increase serum calcium levels
Bisphosphonate Specifics
Associate with esophageal erosion, sit upright 30 min