Thyroid gland

1. SURGERY
2. Radioactive Iodine(I-131)
3. Antithyroid Medications
   1. Propylthiouracil(PTU)
   2. Methimazole
   3. Thioamides
      1. mainly for graves disease
   4. Iodides
4. Beta Blockers

   Annotations:

   • Should be used until the more specific anti-thyroid medication effect takes place  The  peripheral T4 to T3 conversion (propranolol, nadolol)   is inhibited.

1. primary
   1. Due to problem in the thyroid gland itself
2. secondary
   1. due to problem in pituitary gland

1. Levotriothone

   Annotations:

   • Think "it varies": -Ratio of hormones varies -The products vary in potency among the brands
2. Levothyroxine

   Annotations:

   • Combination of  Synthetic T4 AND T3 It is predictable and stable NOT dispensed often though
   • Adverse reactions: Rare but clinical pharmacology does note itching, hypersensitivity and a skin rash
   1. drug-drug interaction
      1. Warfarin

         Annotations:

         • Elevated INR and bleeding risk
      2. Digoxin

         Annotations:

         • More digoxin may be needed if using levothyroxine
3. TRH agonist

Annotations:

• TSH is high T4 and T3 are low. Note Radioactive Iodide Uptake is not used in diagnosis.

1. Primary
   1. refrers to a deficient release of hormone due to a problem in the thyroid gland
2. Secondary
   1. problem in pituitary gland aka TSH levels

1. surgery
2. Radioactive iodine activity
3. congenital

1. TSH
   1. T3-T4

1. PBL 11 Week 12