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Mechanisms
What am I?
Adverse effects
Lecture Qs
100
Peripheral metabolism of this drug is Deiodination.
What is Levothyroxine.
100
Large doses of Iodine inhibit iodide organification
What is Wolff-Chaikoff blocking effect
100
These can reduce the effectiveness of Levothyroxine. (Name 3)
What is food, gastric acid, Aluminum containing antacids, bile acid sequestrants, Calcium carbonate, iron salts, CYP3A4 Inducers
100
___________is a synthetic salt of T4 and is the drug of choice for treating hypothyroidism
What is Levothyroxine
200
Inhibit the thyroid peroxidase-catalyzed reaction and blocking iodine organification. Also, they block coupling of Iodotyrosines
What is Thioamides
200
I am a preferred drug. Here are some facts about me. My Oral absorption 80%, I am administered Oral, IV , I am Highly protein bound, 1x/day administration with a T ½ = 7 days
What is Levothyroxine.
200
Features of this are Stupor, Hypothermia, respiratory depression, Bradycardia, macroglossia, delayed reflexes, dilution hyponatremia and dry, rough skin
What is Myxedema Coma.
200
A pregnant patient with 20 weeks gestation is determined to have hypothyroidism. What should you counsel this patient regarding taking thyroid hormones? A. Take this medication at the same time as your prenatal vitamins B. Do not breastfeed while taking this medication C. Take this medication after a major meal D. Take this medication with antacids to relieve GI discomfort E. Take this medication on an empty stomach to increase absorption
What is E. Take this medication on an empty stomach to increase absorption
300
These block the uptake of iodide by gland through the competitive inhibition of the iodide transport mechanism
What are Anion Inhibitors: as Perchlorate (ClO4-), Pertechnetate (TcO4-) and Thiocyanate (SCN-)
300
Severe hepatitis
What is Propylthiouracil
300
A 32-year-old housewife complains of progressive weight gain of 20 pounds in 1 year, fatigue, postural dizziness, loss of memory, slow speech, deepening of her voice, dry skin, constipation, and cold intolerance. She is determined to have hypothyroidism. This patient calls you to tell you she is now pregnant. What should you advise this patient about taking thyroid hormones during pregnancy?
What is to continue to take thyroid hormones during pregnancy, because it is essential for the baby t have T4, T3 to have proper growth and maturation of the brain.
400
Inhibit organification and hormone release and decrease the size and vascularity of the hyperplastic gland
What is Iodides
400
Used during 1st trimester of pregnancy for thyrotoxicosis because it is more strongly protein bound and therefore crosses the placenta less readily.
What is Propylthiouracil.
400
These are associated with aplastic anemia
What is Perchlorate (ClO4-), Pertechnetate (TcO4-) and Thiocyanate (SCN-)
400
A 27-year-old woman is noted to have tachycardia, heat intolerance, weight loss and an enlarged thyroid. She is currently in her first trimester of pregnancy and has been diagnosed with hyperthyroidism. Which of the following is the most appropriate treatment for this patient?
What is Propylthiouracil. Rare cases of embryopathy, including aplasia cutis, have been reported with use of methimazole during pregnancy.
500
Acneiform rash, swollen salivary glands, mucous membrane ulcerations, conjunctivitis, rhinorrhea, drug fever, metallic taste, bleeding disorders and rarely anaphylactoid reactions
What is Iodides
500
A 60-year-old woman with history of atrial fibrillation, hypertension and Type 2 Diabetes presents to ED complaining of feeling nervous and difficulty with sleep. She admits to having only mild palpitation. Her medication includes amiodarone 200mg daily, metoprolol XL 50mg daily, metformin 500mg BID, and simvastatin 20mg bedtime. She also takes one calcium supplement daily. Neck exam shows slight tenderness and mild enlarged thyroid, heart exam is tachycardia with regular rhythm and a soft systolic murmur. The remaining of exam is within normal limits. Which of her medications contain iodine and could be causing adverse effects on her thyroid gland?
What is Amiodarone.