): ||Advanced Pharmacology
Fundamentals||
Timeframe for re-check of labs after starting levothyroxine
- ANSWER-6-8 weeks (long half-life). Yearly after stable.
Signs and symptoms of hypothyroidism - ANSWER-Dry
hair, puffy face, goiter in the neck, slow heartbeat, weight
gain, constipation, infertility, increased risk of miscarriages,
irregular menstrual cycle, cold intolerance.
Drug of choice for hypothyroidism - ANSWER-
Levothyroxine (Synthroid)
,§ Signs and symptoms of hyperthyroidism - ANSWER-Hair
loss, bulging eyes, goiter, rapid heartbeat, weight loss,
diarrhea, menstrual periods loss often or longer.
Drug of choice for hyperthyroidism - ANSWER-
Methimazole (Tapazole)
What labs are used to diagnose hypo/hyper thyroid? -
ANSWER-TSH, T3, and T4. High TSH = hypo and low
TSH = hyper. Opposites.
Treatment of thyroid storm - ANSWER-high doses of
potassium iodide or strong iodine solution are given to
suppress thyroid hormone release. Methimazole is given
,to suppress thyroid hormone synthesis. Beta blocker given
to reduce HR. additional measures include sedation,
cooling, and giving glucocorticoids and IV fluids.
Result of not treating hypothyroidism during pregnancy: -
ANSWER-Permanent neuro-psychological deficits in the
child. Decrease IQ/neuropsychological function. First
trimester.
Medication to treat symptoms of hyperthyroidism (notice
this is treating symptoms and not the hyperthyroidism
itself): - ANSWER-Beta blockers (tachycardia) -
propranolol/atenolol most popular.Non-radioactive iodine.
ADJUNCTIVE THERAPY.
, Drug/Food/Supplement interactions with levothyroxine: -
ANSWER-Do not take antacids, Calcium or Iron, how to
take it (morning 30-60 min b4 eat.
How to confirm a diagnosis of DM prior to beginning
treatment: - ANSWER-Fasting plasma glucose above 126.
A random plasma glucose of over 200 plus symptoms of
diabetes, an oral glucose tolerance test of two hours,
plasma glucose of over 200, or a A1C higher than 6.5.
A1c general goals - ANSWER-<7, patients that experience
severe hypoglycemia/have a limited life expectancy may
have an A1C goal of <8.