Hyperthyroidism Medications

PTU and MethimazoleDexamethazoneBeta Blockers

PTU and Methimazole

ANTITHYROID MEDMOA: inhibit production of thyroid hormonesIndication: hyperthyroidismAdmin: PTU 3x/day Methimazole 1x/day w/ food, same time each day, do not stop abruptlyPt Edu: avoid eating foods high in iodine (seafood, soy sauce, tofu, and iodized salt) Drug-to-Drug: anticoagulants inc risk of bleeding with PTU, theophylline, metoprolol, propranolol, digitalisAE: hypothyroidism, liver + bone marrow tox, report fever (indicates infection), rash, sore throat, jaundice (indicates hepatotoxicity), monitor CBC (causes leukopenia)

Dexamethazone

ANTITHYROID MEDAnti-inflammatory and Immunosuppressant

Beta Blockers

Used for symptomatic relief

Hypothyroidism Meds

LevothyroxineIodine

Iodine

INCREASE T3T4 PRODUCTIONSodium or Potassium Iodide: inc feedback to the Hypothalamus and Ant Pituitary, inc amount of hormone produced Pt Edu: administer after meals, dilute in milk, juice, water, give through straw (stains teeth)

Levothyroxine

THYROID HORMONEMOA: Inc metabolic rate of body tissues, inc oxygen consumption, respiration, HR, fat, protein, and carb metabolism, growth and maturationIndications: hypothyroidismAE: Skin reactions, hyperthyroidism, cardiac stimulation, CNS effectsDrug-to-Drug: Cholestyramine, Oral anticoagulants, Digitalis, Theophylline, Calcium products (should not take within 4 hrs)Pt Edu: Drug of choice, dose adjusted every 4-6 w, take 1st thing in morning without food, same time every day, wean up, lifelong therapy, low cal diet promotes wt loss

Hyperparathyroid Meds

Anti-hyper-calcemic Agents (we don't want a HIGH Ca+) prevents/minimizes mineral resorption from bone and phos reabsorption (removed from circulation) in kidneysAlendronate (bisphosphonates)Calcitonin salmon (calcitonins)

•Bisphosphonates (alendronate)

Slow normal and abnormal release of Ca and Phos from bones into blood, lowering serum Ca+Contraindications: Hypocalcemia, pregnancy/ lactation, renal dysfunction, GI disease, inability to sit upright* must sit upright for 30 mins after adminDrug to Drug: antacids, calcium products, iron, or multiple vitamins (decreased absorption of drug) and aspirin (significant GI distress)SE: HA, N, and diarrhea

Calcitonins (calcitonin salmon)

Hormones secreted by thyroid gland to balance effects of PTHInhibit bone resorption of Ca+ and P from bones into blood, lowers serum Ca+, increases excretion of Ca, P, and Na at kidneysContraindications: Pregnancy, renal dysfunction, pernicious anemia (would exacerbate)SE: flushing of face and hands, skin rash, urinary frequency

Hypoparathyroid Meds

Antihypocalcemic agents increase serum CaCalcitriol promotes mineral resporption (release) from bone into blood

Calcitriol

Synthetic version of Vit D (also called calcitriol) stimulates abs of Ca+ from food into blood, and inc resorption of Ca+ and phos from bones to blood, inc Ca+ resorption from kidneys, stimulation of cells in kidney to produce calcitriolIndications: hypocalcemia RT hypoparathyroidismPharm: excreted in bileContraindications: allergy to vit D, hypercalcemia, vitamin D tox, pregnancyCaution: Hx renal stonesAE: GI (constipation, N/V, metallic taste, anorexia)CNS (weakness, HA, somnolence, irritability) hypercalcemiaDrug-to-Drug: Magnesium containing antacids (hypermagnesemia), Cholestyramine or mineral oil (reduces absorption-take 2hrs apart)