27.2 Thyroid and Antithyroid Drugs
3 min read•june 18, 2024
Thyroid and play a crucial role in managing thyroid disorders. These medications help regulate hormone levels, addressing both underactive and overactive thyroid conditions. Understanding how they work is key to effective treatment.
Proper use of thyroid medications can dramatically improve quality of life for those with thyroid issues. From dosing to potential side effects, nurses need to know the ins and outs of these drugs to provide the best care for their patients.
Thyroid and Antithyroid Drugs
Key features of thyroid and antithyroid medications
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- Thyroid medications
- (, ) synthetic form of () used to treat by replacing the missing thyroid hormone in the body
- () synthetic form of () sometimes used in combination with levothyroxine to provide a more comprehensive thyroid hormone replacement therapy
- Antithyroid medications
- () inhibits to reduce thyroid and treat , including , by decreasing the production of excess
- () also inhibits thyroid peroxidase enzyme to reduce thyroid hormone synthesis and is preferred over PTU due to its lower risk of causing severe liver injury as a side effect
Therapeutic effects and potential side effects of thyroid hormone replacement drugs
- Therapeutic effects
- Restores normal thyroid hormone levels in the body to alleviate symptoms of hypothyroidism (fatigue, weight gain, cold intolerance)
- Improves overall metabolic function and quality of life for patients with hypothyroidism
- Potential side effects
- Overtreatment may lead to symptoms of hyperthyroidism (, , , anxiety, insomnia, weight loss) if the dosage is too high
- Allergic reactions, although rare, can cause symptoms such as rash, itching, or swelling
- Interactions with other medications (warfarin, cholestyramine, iron supplements) may decrease absorption of levothyroxine and require dosage adjustments or timing modifications
Nursing considerations when administering antithyroid medications
- Assess for signs and symptoms of hyperthyroidism (tachycardia, tremors, heat intolerance, weight loss) before and during treatment to monitor the effectiveness of the medication and adjust dosage as needed
- Monitor (TSH, free T4) regularly to ensure the medication is effectively controlling the patient's hyperthyroidism and to guide dosage adjustments based on lab results and clinical response
- Educate patients about potential side effects and the importance of regular follow-up, especially for rare but serious side effects like (fever, sore throat, signs of infection) and hepatotoxicity (jaundice, abdominal pain, dark urine)
- Emphasize the importance of taking medication as prescribed and not discontinuing without consulting a healthcare provider to ensure consistent control of hyperthyroidism and prevent relapse of symptoms
Patient education plan for someone starting thyroid hormone therapy
- Explain the purpose of the medication and how it works to replace missing thyroid hormone and restore normal body functions, helping the patient understand the importance of adhering to the treatment plan
- Provide instructions on how to take the medication
- Take on an empty stomach, 30-60 minutes before breakfast or 4 hours after the last meal to maximize absorption
- Avoid taking with calcium, iron, or multivitamins, as they can interfere with absorption and reduce the effectiveness of the medication
- Discuss potential side effects (overtreatment symptoms, allergic reactions) and when to contact a healthcare provider for guidance on managing side effects or adjusting the treatment plan
- Emphasize the importance of regular follow-up and monitoring, including blood tests to assess thyroid function and adjust dosage as needed, and annual physical examinations to evaluate overall health and treatment progress
- Encourage a healthy lifestyle (balanced diet, regular exercise, stress management techniques) to support overall well-being and optimize the benefits of thyroid hormone replacement therapy
Key Terms to Review (58)
Agranulocytosis: Agranulocytosis is a severe and potentially life-threatening condition characterized by a significant reduction in the number of granulocytes, a type of white blood cell that plays a crucial role in the body's immune response. This term is particularly relevant in the context of mood stabilizers and thyroid/antithyroid drugs, as these medications can potentially induce this adverse effect.
Antithyroid drugs: Antithyroid drugs are medications used to manage hyperthyroidism by inhibiting the production of thyroid hormones. Commonly prescribed antithyroid drugs include methimazole and propylthiouracil (PTU).
Antithyroid Drugs: Antithyroid drugs are a class of medications used to treat hyperthyroidism, a condition characterized by an overactive thyroid gland. These drugs work by interfering with the production and release of thyroid hormones, effectively reducing their levels in the body and alleviating the symptoms of hyperthyroidism.
Autoimmune Thyroiditis: Autoimmune thyroiditis is a condition in which the body's immune system mistakenly attacks and damages the thyroid gland, leading to thyroid dysfunction. This term is particularly relevant in the context of 27.2 Thyroid and Antithyroid Drugs, as autoimmune thyroiditis can significantly impact the management of thyroid-related disorders and the use of thyroid medications.
Cytomel: Cytomel is a brand name for liothyronine sodium, a synthetic form of the thyroid hormone triiodothyronine (T3). It is used to treat hypothyroidism and other thyroid-related conditions.
Desiccated thyroid extract: Desiccated thyroid extract is a natural thyroid hormone replacement derived from porcine thyroid glands. It contains both thyroxine (T4) and triiodothyronine (T3).
Goiter: A goiter is an abnormal enlargement of the thyroid gland. It can result from iodine deficiency, autoimmune diseases, or other thyroid disorders.
Goiter: A goiter is an abnormal enlargement of the thyroid gland, often resulting from an iodine deficiency or other underlying thyroid disorders. This condition can affect the body's ability to produce and regulate thyroid hormones, which are essential for metabolism, growth, and development.
Graves' Disease: Graves' disease is an autoimmune disorder that causes the thyroid gland to overproduce thyroid hormones, leading to a condition known as hyperthyroidism. It is the most common cause of hyperthyroidism and is associated with specific symptoms and complications.
Hormone Synthesis: Hormone synthesis is the biological process by which hormones are produced within the body. Hormones are chemical messengers that play a crucial role in regulating various physiological processes, including metabolism, growth, development, and homeostasis. The synthesis of hormones is a complex and tightly regulated process that occurs in specialized endocrine glands and tissues.
Hyperthyroidism: Hyperthyroidism is a condition in which the thyroid gland produces an excessive amount of thyroid hormones, leading to an overactive metabolism. This imbalance can have significant impacts on various bodily functions and is an important consideration in the context of hormonal therapy, potassium channel blockers, and thyroid-related disorders.
Hypothyroidism: Hypothyroidism is a condition in which the thyroid gland produces an insufficient amount of thyroid hormones, leading to a slowing of various metabolic processes in the body. This term is relevant across multiple topics, including osmolality, vitamins and minerals, mood stabilizers, potassium channel blockers, growth hormones, thyroid and parathyroid functions, thyroid and antithyroid drugs, and weight management.
Iodination: Iodination is the process of introducing iodine atoms into organic compounds, which is a crucial step in the synthesis of thyroid hormones. This chemical reaction is particularly important in the context of thyroid and antithyroid drugs, as it directly impacts the production and regulation of these essential hormones.
Iodine: Iodine is an essential trace element crucial for the synthesis of thyroid hormones T3 and T4. It plays a key role in regulating metabolism, growth, and development.
Iodine Uptake: Iodine uptake refers to the process by which the thyroid gland actively absorbs and concentrates iodine from the bloodstream. This is a crucial step in the production of thyroid hormones, which are essential for regulating metabolism, growth, and development in the body.
Iodotyrosines: Iodotyrosines are iodinated derivatives of the amino acid tyrosine, which are crucial intermediates in the synthesis of thyroid hormones. These compounds include monoiodotyrosine (MIT) and diiodotyrosine (DIT).
Iodotyrosines: Iodotyrosines are amino acid derivatives that contain one or more iodine atoms and are precursors to the thyroid hormones thyroxine (T4) and triiodothyronine (T3). They are essential components in the regulation of thyroid function and metabolism within the body.
Levothyroxine: Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormones. It is the primary treatment for an underactive thyroid and helps restore normal thyroid function by supplementing the body's natural thyroid hormones.
Levothyroxine sodium: Levothyroxine sodium is a synthetic form of the thyroid hormone thyroxine (T4) used to treat hypothyroidism. It helps restore adequate hormone levels, thereby aiding in normal metabolic functions.
Levoxyl: Levoxyl is a brand name for levothyroxine, a synthetic form of the thyroid hormone thyroxine (T4). It is used to treat hypothyroidism by supplementing low levels of thyroid hormones in the body.
Liothyronine: Liothyronine, also known as triiodothyronine (T3), is a synthetic thyroid hormone that is used to treat hypothyroidism and other thyroid-related conditions. It is a structural and functional analog of the natural thyroid hormone, T3, and is known for its rapid onset and short duration of action compared to other thyroid medications.
Liothyronine sodium: Liothyronine sodium is a synthetic form of the thyroid hormone triiodothyronine (T3) used to treat hypothyroidism. It is more potent and faster-acting than levothyroxine.
Methimazole: Methimazole is an antithyroid medication used to treat hyperthyroidism by inhibiting thyroid hormone synthesis. It is often prescribed as a part of long-term treatment or prior to thyroid surgery.
Myelosuppressive Drugs: Myelosuppressive drugs are a class of medications that can suppress the production and function of blood cells, particularly white blood cells, red blood cells, and platelets, in the bone marrow. This can lead to various hematological side effects and complications.
Negative Feedback: Negative feedback is a regulatory mechanism in which the output of a system acts to reduce or oppose the changes in that system. It is a key concept in understanding the homeostatic control of various physiological processes in the body, including the regulation of the adrenal cortex, pituitary, and thyroid gland functions.
Organification: Organification is the process by which iodine is chemically bound to the tyrosine residues of thyroglobulin in the thyroid gland, forming monoiodotyrosine (MIT) and diiodotyrosine (DIT). This is a crucial step in the synthesis of thyroid hormones.
Palpitations: Palpitations refer to the awareness of an abnormal or irregular heartbeat, often described as a fluttering, pounding, or racing sensation in the chest. This term is particularly relevant in the context of cardiac emergencies, the use of beta-adrenergic blockers, and thyroid disorders.
Patient Education: Patient education is the process of providing patients with the knowledge, skills, and resources necessary to actively participate in their own healthcare. It empowers patients to make informed decisions, manage their conditions, and maintain optimal health. This term is particularly relevant in the context of drug administration, medication management, and the treatment of various medical conditions.
Pituitary Gland: The pituitary gland is a small, pea-sized endocrine gland located at the base of the brain. It is often referred to as the 'master gland' due to its crucial role in regulating various physiological processes in the body, including hormone production, growth, and metabolism.
Potassium iodide: Potassium iodide (KI) is a medication and dietary supplement used to treat hyperthyroidism and protect the thyroid gland from radiation. It works by saturating the thyroid with stable iodine, thereby preventing the uptake of radioactive iodine.
Propylthiouracil: Propylthiouracil is an antithyroid medication used to treat hyperthyroidism by inhibiting the synthesis of thyroid hormones. It is particularly effective in managing Graves' disease.
PTU: PTU (Propylthiouracil) is an antithyroid medication used to manage hyperthyroidism. It inhibits the synthesis of thyroid hormones by blocking iodine oxidation in the thyroid gland.
Radioactive Iodine Uptake: Radioactive iodine uptake (RAIU) is a diagnostic test that measures the amount of radioactive iodine absorbed by the thyroid gland. It is used to evaluate thyroid function and diagnose conditions related to the thyroid, such as hyperthyroidism and thyroid cancer.
Synthroid: Synthroid is a brand name for levothyroxine, a synthetic thyroid hormone used to treat hypothyroidism. It works by replacing or providing more thyroid hormone, which is normally produced by the thyroid gland.
T3: T3, or triiodothyronine, is a thyroid hormone that plays a crucial role in regulating the body's metabolism, growth, and development. It is one of the two main thyroid hormones, the other being T4 (thyroxine), and is essential for maintaining proper thyroid function.
T4: T4, or thyroxine, is a hormone produced by the thyroid gland that plays a crucial role in regulating the body's metabolism, growth, and development. It is one of the two main thyroid hormones, the other being T3 (triiodothyronine).
Tachycardia: Tachycardia refers to a rapid heart rate, typically defined as a resting heart rate exceeding 100 beats per minute. This abnormally fast heart rhythm can have various underlying causes and is an important consideration in several medical conditions and drug therapies.
Tapazole: Tapazole (methimazole) is an antithyroid medication used to treat hyperthyroidism by inhibiting the production of thyroid hormones. It is commonly prescribed for conditions such as Graves' disease.
Thyroglobulin: Thyroglobulin is a glycoprotein produced by the thyroid gland, serving as a precursor to thyroid hormones T3 and T4. It plays a crucial role in the synthesis and storage of these hormones.
Thyroid Axis: The thyroid axis, also known as the hypothalamic-pituitary-thyroid (HPT) axis, is a complex hormonal system that regulates the production and secretion of thyroid hormones. It involves the coordinated interaction between the hypothalamus, pituitary gland, and thyroid gland to maintain proper thyroid function and homeostasis within the body.
Thyroid drugs: Thyroid drugs are medications used to treat disorders of the thyroid gland, such as hypothyroidism or hyperthyroidism. They help regulate hormone levels to maintain metabolic balance.
Thyroid Function Tests: Thyroid function tests are a group of diagnostic procedures used to assess the activity and health of the thyroid gland. These tests measure the levels of various hormones produced by the thyroid, providing valuable information about its function in the body. They are particularly relevant in the context of understanding the mechanisms and effects of potassium channel blockers, as well as the management of thyroid disorders through antithyroid drugs.
Thyroid Gland: The thyroid gland is an endocrine gland located in the front of the neck that produces hormones essential for regulating metabolism, growth, and development. It plays a crucial role in the body's overall homeostasis and is closely connected to the topics of Introduction to the Thyroid and Parathyroid, as well as Thyroid and Antithyroid Drugs.
Thyroid Hormones: Thyroid hormones are a group of iodine-containing compounds produced by the thyroid gland that play a crucial role in regulating metabolism, growth, and development in the body. These hormones are essential for maintaining proper bodily functions and are particularly relevant in the context of thyroid and antithyroid drugs as well as antacids.
Thyroid Peroxidase Enzyme: The thyroid peroxidase enzyme is a critical component in the production of thyroid hormones. It catalyzes the iodination and coupling of tyrosine residues within the thyroglobulin protein, a necessary step in the synthesis of the thyroid hormones triiodothyronine (T3) and thyroxine (T4).
Thyroid Storm: Thyroid storm, also known as thyrotoxic crisis, is a life-threatening condition characterized by an extreme and rapid increase in the body's metabolism due to excessive thyroid hormone production. This medical emergency requires immediate treatment to prevent severe complications and potential fatality.
Thyroid Storm Management: Thyroid storm, also known as thyrotoxic crisis, is a life-threatening condition characterized by an extreme and sudden increase in thyroid hormone levels. Effective management of thyroid storm is crucial to prevent severe complications and ensure patient survival.
Thyroid-stimulating hormone: Thyroid-stimulating hormone (TSH) is a hormone produced by the pituitary gland that regulates the function of the thyroid gland. It plays a crucial role in maintaining proper thyroid hormone levels and overall thyroid function in the body.
Thyroidectomy: A thyroidectomy is a surgical procedure that involves the partial or complete removal of the thyroid gland, a small, butterfly-shaped endocrine gland located at the base of the neck. This procedure is typically performed to treat various thyroid-related conditions, including thyroid cancer, thyroid nodules, and hyperthyroidism.
Thyroperoxidase Inhibition: Thyroperoxidase inhibition refers to the process of blocking the activity of the enzyme thyroperoxidase, which plays a crucial role in the production of thyroid hormones. This inhibition is a key mechanism of action for certain antithyroid drugs used in the management of thyroid disorders.
Thyrosafe: Thyrosafe is a brand of potassium iodide tablets used to protect the thyroid gland from radioactive iodine exposure. It is often utilized in nuclear emergencies to prevent thyroid cancer.
ThyroShield: ThyroShield is an oral potassium iodide solution used to block radioactive iodine from being absorbed by the thyroid gland during a nuclear radiation emergency. It helps prevent thyroid cancer and other diseases caused by exposure to radioactive iodine.
Thyrotoxicosis: Thyrotoxicosis refers to the clinical syndrome caused by excessive thyroid hormone action on target tissues, resulting in hypermetabolic symptoms. It is a key term in the context of 27.2 Thyroid and Antithyroid Drugs, as it describes the condition that these medications aim to manage.
Thyroxine: Thyroxine, also known as T4, is a hormone produced by the thyroid gland that plays a crucial role in regulating the body's metabolism, growth, and development. It is the primary thyroid hormone secreted by the thyroid gland and is essential for maintaining homeostasis in the body.
Tremors: Tremors refer to the involuntary, rhythmic shaking or quivering of a body part, often the hands, head, or limbs. This neurological symptom can be associated with various medical conditions and can have different underlying causes.
Triiodothyronine: Triiodothyronine, also known as T3, is a thyroid hormone that plays a crucial role in regulating the body's metabolism, growth, and development. It is one of the two main thyroid hormones, the other being thyroxine (T4).
Triostat: Triostat is a brand name for liothyronine sodium, which is a synthetic form of the thyroid hormone triiodothyronine (T3). It is used to treat hypothyroidism and other conditions where thyroid hormone replacement is necessary.
Tyrosine Residues: Tyrosine residues are specific amino acid sequences within proteins that contain the amino acid tyrosine. These residues play a crucial role in various cellular processes, particularly in the context of thyroid and antithyroid drugs.