Thyroid gland

1. SURGERY
2. Radioactive Iodine(I-131)
3. Antithyroid Medications
   1. Propylthiouracil(PTU)
   2. Methimazole
   3. Thioamides
      1. mainly for graves disease
   4. Iodides
4. Beta Blockers

   Annotations:

   • Should be used until the more specific anti-thyroid medication effect takes place  The  peripheral T4 to T3 conversion (propranolol, nadolol)   is inhibited.

1. primary
2. secondary

1. Levotriothone

   Annotations:

   • Think "it varies": -Ratio of hormones varies -The products vary in potency among the brands
2. Levothyroxine

   Annotations:

   • Combination of  Synthetic T4 AND T3 It is predictable and stable NOT dispensed often though
   • Adverse reactions: Rare but clinical pharmacology does note itching, hypersensitivity and a skin rash
   1. drug-drug interaction
      1. Warfarin

         Annotations:

         • Elevated INR and bleeding risk
      2. Digoxin

         Annotations:

         • More digoxin may be needed if using levothyroxine
3. TRH agonist

Annotations:

• TSH is high T4 and T3 are low. Note Radioactive Iodide Uptake is not used in diagnosis.

1. Primary
2. Secondary

1. surgery
2. Radioactive iodine activity
3. congenital

1. TSH
   1. T3-T4