Graded A+
Key drugs that can cause hypothyroidism "I TALC"
Interferons
Tyrosine Kinase Inhibitors
Amiodarone
Lithium
Carbamazepine
Conditions: Hashimoto's disease
Levothyroxine IV:PO 0.75:1 (IV:PO)
Full replacement dose levothyroxine 1.6 mcg/kg/day (IBW)
If known CAD: start with 12.5-25 mcg daily
,Levothyroxine tablet colors Orangutans Will Vomit On You Right Before They Become
Large Proud Giants
25 Orange
50 White (no dye)
75 Violet
88 Olive
100 Yellow
112 Rose
125 Brown
137 Turquoise
150 Blue
175 Lilac
200 Pink
300 Green
Drug induced causes of hyperthyroidism Iodine
Amiodarone
Interferons
Radiographic contrast media
, treatment for thyroid storm Antithyroid (PTU preferred- give 1 hour before iodide)
Inorganic iodide therapy (SSKI or Lugol's)
Beta Blocker (Propranolol)
Systemic steroid (dexamethasone)
Aggressive cooling (APAP, cooling blankets, supportive
treatments)
Hyperthyroid in pregnancy Hyperthyroidism during pregnancy should be treated with
propylthiouracil (PTU) during the first trimester then
methimazole during the second and third trimesters. Although
methimazole is a teratogen, the teratogenic effects are less
during the second and third trimesters, and PTU can cause
liver failure, which is why it is substituted out.
Cushing's syndrome Adrenal gland produces too much cortisol or
exogenous steroids are taken in doses higher than
normal amounts of endogenous cortisol
Addison's disease a condition that occurs when the adrenal glands do not
produce enough cortisol; Addisonian crisis (volume depletion
and hypotension, which can be fatal)