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endocrine review.docx

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NURS 2050
Cynthia Barkhouse Mckeen

Hypothyroidism: Triiodothyronine (T3) Tetraiodothyronine (T4) - synthetic= liothyronine **more potent - synthetic = levothyroxine - Indicated for all hypothyroidism - More T4 than T3 released from gland (5:1) (Majority of T4 released is converted in the periphery to T3 (deiodinated by deiodinases)) Half life: 1.5 days (more potent) Half life: 1 week (takes 4-5 weeks to get to steady state) This is a twice a day drug miss one pill = not a big deal, its a once a day drug - Highly protein bound and hepatically metabolized - Highly protein bound and hepatically metabolized (Some CYP 450 interactions) (Some CYP 450 interactions) - Test: Serum for free/bound, TSH - Test: Serum for free/bound, TSH Adverse effects: look like hyperthyroidism Drug Interactions: 1. Absorption: Cholestyramine, antacids, iron, calcium supplements 2. Warfari: ↑the degradation of vit K dependent clotting factors (↑ INR) 3. Lithium: ↓ thyroid hormone release 4. Amiodarone: Contains iodine & can cause hypo/hyperthyroidism 5. Catecholamines: ↑cardiac responsiveness Compared to T4: Special Notes: Almost always given po - Shorter t1/2 and duration of action –given bid - IV formulation is available - More rapid onset of action - Therapy monitored by TSH measures - More costly - Used when: Patients unable to take p.o. for extended - Adverse effect profile – More CV effects periods, or Emergency situations (e.g. myxedema coma) - Bottom line – no more effective than levothyroxine Thyroid Release ↑ Glucose absorption ↑ oxygen consumption Release of lipids from adipose tissue ↑ body heat production Metabolism of proteins from muscle tissue ↑
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