Hypothyroidism Causes - Answers Gland malfunction
Pituitary tumor
Removal of gland
iodine deficiency
Hypothyroidism S/Sx - Answers tired
poor memory
dry skin
brittle hair and nails
bradycardia
constipation
heavy menses
cold intolerant
weight gain
Levothyroxine (Synthyroid) - Answers MOA: synthetic T4 converted to T3
Food interferes with absorption (esp. Ca)
Very highly protein bound= long T 1/2
Safe in pregnancy
Levothyroxine Adverse Effects - Answers Rare if TSH in therapeutic range
OD is thyrotoxic crisis
-hyperthermia
-tachycardia
-restlessness
-tremor
-weight loss
,Levothyroxine Pt Education - Answers Take early AM on empty stomach
Generic/brand consistency
Regular lab monitoring
Report thyrotoxic symptoms
Hyperthyroidism Causes - Answers Grave's Disease
Toxic nodular goiter
Hyperthyroidism S/Sx - Answers anxious
poor concentration
hungry
tachycardia
chest pain
hyper defecation
irregular to no menses
heat intolerance
weight loss
Methimazole & Propylthiouracil (PTU) - Answers MOA: inhibit thyroid hormone synthesis
PTU also suppresses conversion of T4 to T3 in the body
PTU preferred in pregnancy
Methimazole & Propylthiouracil (PTU) Adverse Effects - Answers Teratogenic (methimazole)
Too much can cause hypothyroidism
Pt Education: frequent lab monitoring required
Glucocorticoids Physiologic Levels - Answers Minimal adverse effects
-glucose for the brain
-protein metabolism
-fat metabolism
, -keeps BP in check
-maintains blood cells
Glucocorticoids Pharmacologic Levels - Answers Higher risk of adverse effects
Treating other conditions:
-allergic rxns
-lung conditions
-inflammation
-dermatologic conditions
Addison's Disease` - Answers Not enough hormone
Requires lifelong supplementation with glucocorticoid
Needs extra steroid dose during times of physical stress (fever, illness, surgery, trauma)
Addison's Disease S/Sx - Answers Bronzed skin (increase melatonin synthesis)
Hypoglycemia (glucocorticoid deficiency)
Orthostatic hypotension (volume depletion)
Weight loss ( loss of appetite & dehydration)
GI upset (N/V/D)
Weakness & fatigue
Adrenal Crisis - Answers - Profound fatigue
- Dehydration
- Vascular collapse (low bp)
- Renal shut down
- Low serum Na
- High serum K
Glucocorticoid Adverse Effects - Answers Prominent at higher and longer
systemic/pharmacologic doses
-hyperglycemia