Ch. 37 Drugs Used to Treat Thyroid Disease
Drug Class: antithyroid medications
Drug: Iodine-131 (131I) Actions: Selectively destroy hyperactive thyroid tissue Uses: Treat hyperthyroidism for select individuals Common and serious adverse effects: Tenderness in the thyroid gland; hyperthyroidism; hypothyroidism Drug interactions: Lithium carbonate
hypothyroidism
a condition of hyposecretion of the thyroid gland causing low thyroid levels in the blood that result in sluggishness, slow pulse, and, often, obesity *Drug of choice for this is Levothyroxin
Myxedema
advanced hypothyroidism in adults characterized by sluggishness, slow pulse, puffiness in the hands and face, and dry skin
Thyroid Replacement Hormones
Actions: Replace deficient T3 and T4 hormones Uses:Return patient to normal thyroid state Common and serious adverse effects: Signs of hyperthyroidism; hyperglycemia
Antithyroid Medicines (Drugs: Propylthiouracil (PTU, Propacil), Methimazole (Tapazole))
Actions: Block synthesis of T3 and T4 Uses: Long-term treatment for hyperthyroidism, Presurgical treatment Common and serious adverse effects: Purpuric, maculopapular rash; headache; nephrotoxicity; hepatotoxicity; bone marrow suppression, lymph node enlargement
Thyroid Functions
Anterior pituitary secretes thyroid-stimulating hormone (TSH) in response to TRH, Thyroid gland secretes T3 and T4 in response to TSH
T3 and T4 regulate
General body metabolism, Carbohydrate, protein, lipid metabolism, Thermal regulation, Cardiovascular function, Growth and maturation, Lactation and reproduction
Diseases causing overproduction
Graves' disease, nodular goiter, thyroiditis, thyroid carcinoma, tumors of the pituitary gland, Overdose of thyroid hormones
Hypothyroidism Nursing Interventions
History of prior treatment for thyroid disorders, cardiac disease, or adrenal insufficiency, Request list of medications being taken, Perform focused assessment of body systems, Nutritional requirements (low-calorie diet), Activity restrictions
Hyperthyroidism
Nutritional requirements (high-calorie diet), Activity restrictions
Hyperthyroidism treatments
Subtotal thyroidectomy, Radioactive iodine, Antithyroid medications
Two classes of drugs
Thyroid replacement hormones (hypothyroid), Antithyroid agents (hyperthyroid)
Drug interactions of thyroid replacement hormones
Warfarin, digoxin, estrogens, cholestyramine
Cretinism
condition of congenital hypothyroidism in children that results in a lack of mental development and dwarfed physical stature; the thyroid gland is either congenitally absent or imperfectly developed
hyperthyroidism
excess thyroxine production (may be caused by Grave's disease), caused by autoimmune disorder. Symptoms; enlarged thyroid, muscle weakness, increased metabolic rate, sweating etc.. Treatment; remove thyroid, drugs & radioactive iodine.
Thyrotoxicosis
hyperthyroidism, an overactive thyroid gland
Hypothalamus secretes
thyrotropin-releasing hormone (TRH)