How are Thyroids made?
People with hypothyroidism are treated with a synthetic T4 hormone, which enzymes convert to T3
Hypothyroidism medication
Levothyroxine
Thyroid hormone use
treat an under active thyroid gland
Thyroid hormone
thyroid replacement is used for the treatment of hypothyroidism
maintenance of thyroid hormone levels after surgery or radiation of the thyroid
Overmedicaiton
can result in manifestations of thyrotoxicosis ( anxiety, tachycardia, chest pain, nervousness, tremors, palpitations)
Thyroid hormone
Pregnancy risk category A
Thyroid Hormone
increases cardia responsiveness to catecholamines ( epinephrine, dopamine) thereby increasing the risk of dysrhythimas
Medication HYPOthyroid
full effect of the medication can take 6-8 weeks
thyroid hormone
monitor t4 and TSH levels
med is dosed in MICROGRAMS
Education on med hormone use
take on empty stomach 30-60 minutes before breakfast
lifelong !!
Decreased TSH levels
Evaluation of TSH should not be done until 6-8 weeks following the start of treatment
Propylthiouracil (PTU)
med pregnant population used in first trimester!!!
hyperthyroidism: blocks the synthesis of thyroid hormones
Methimazole
replaced after the first trimester in pregnant wm
Graves Disease
goiter
thyroidectomy
Methimazole ( first-line) therapy
treament of thyrotoxicosis
Thryotoxicosis
clinical state of inappropriately high levels of circulating thyroid hormones (T3 and or T4)
Hypothyroidism
is a result of overmedicaitons
s/s of hypothyroidism
drowsiness, weight gain, bradycardia, cold intolerance, depression
Pregnancy Risk Category D
Methimazole in the first trimester
PTU is ...
safer in first trimester
Methimazole and Propylthiouracil
Do NOT destroy the thyroid hormone, but rather prevent the continued synthesis of TH
medication HYPERthyroid
medication takes 1-2 weeks for full effect
Radioactive Iodine 131
possible to destroy the thyroid with ONE dose
Raditoactive Iodine
pregancy risk X
Emergency treatment of thyrotoxicosis
Nonradioactive iodine
Iodine products
intake of foods high in iodine increases the risk for iodism
Iodine products
avoid foods high in potassium
Addison disease lacks 2 essential steroid hormone
( aldosterone and cortiso l )
Hypocoritsol
mimics cortisol given to patient with addison
Addison's crisis
Small, weak, and tanned
Addison's diseases effects
- Affects electrolyte balance : sodium and potassium levels low
- salt craving
Cushing's disease
caused by a somatic gene defect or long-term use of corticosteroids
Cush disease
- Big, round, and hair s/s
- Bp and sugar are HIGH
- Genetic or induced ( too many steroids)
- Purple stretch marks
- “Hursutism “
Addison disease medication
- hydrocortisone
- Prednisone,dexamethasone
- 125 mg is going to do the trick
Adrenal hormone replacement COMPLICATIONS
- Glucose intolerance
- osteoporosis
- adrenal suppression
DM Type 1
cannot make enough insulin or does not make it at all
- genetic abnormality
Insulin and Glucagon
produced by cluster of cells in the pancreas called Islet of Langerhans
Type 1 s/s
3 P's : polyphasia, polyuria, polydipsia, glycosuria (glucose in the urine)
DM Type 2
makes insulin but the tissue doesn't respond well to it
Insulin Resistant!
Management of DM type 2
weight loss, exercise, healthy diet , antidiabetic meds
s/s of DM 2
increased thirst, frequent urination, increased hunger, fatigue, blurred vision ( diabetic retinopathy)
Risk factors DM 2
- htn
-obestiy
- genetics
- lack of exercise
HYPOglycemic reactions to insulin are most likely to occur during
THE PEAK TIME
IV glucose
if client is not conscious, DO NOT risk aspiration
administer glucose IV or SQ/IM
Glipizide
sulfonylurea that tells your pancreas to release insulin
Metformin
Biquanide, lowers the amount of sugar the body makes and absorbs from food
DO NOT take with ALCOHOL