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Meals you can make in under 30 minutes a 56 dollar value yours free when you make a healthy wager through pharmacy pearls dot-com / healthy simply email your purchase receipt – bonuses at pharmacy pearls calm then lose the weight and get paid simple as that in this episode of pharmacy pearls we’ll review medications used to treat hypothyroidism at the end of
The video complete the review quiz in order to test your understanding reinforce the material and apply it to real world clinical scenarios the thyroid gland is part of the body’s endocrine system it secretes hormones that contribute to increased metabolism and growth and development the secretion of thyroid hormones is regulated by input from the hypothalamus
And the anterior pituitary gland thyroid disease is extremely common with women more frequently affected than men as we will see the symptoms associated with thyroid disease are often nonspecific so in order to prevent affected patients from falling through the cracks it is recommended to combine a high index of suspicion with a low threshold for screening for
Thyroid disease in normal circumstances the production of thyroid hormones designated t3 and t4 is regulated by thyroid stimulating hormone or tsh with released by the pituitary gland when additional thyroid hormones are no longer required a process called negative feedback inhibition blocks the further release of tsh this feedback loop promotes homeostasis
Hypothyroidism is a condition of underactive or low thyroid it occurs when the thyroid gland does not produce enough thyroid hormone there are multiple causes in the developing world for example iodine deficiency is the most common cause in north america it is usually the result of autoimmune thyroid disease primary hypothyroidism that is hypothyroidism not
Secondary to other causes is indicated by an elevated tsh measurement if the body is lacking sufficient thyroid hormones the pituitary gland responds by working overtime to try to bring about thyroid hormone secretion hence the elevated tsh level conversely hyperthyroidism or thyrotoxicosis is suggested by a low tsh level common symptoms of hypothyroidism
Include fatigue impaired memory constipation cold intolerance and changes in skin and hair physical examination may reveal a telltale appearance consisting of course features dry skin and thinning hair or hair loss as well as hypertension bradycardia or delayed relaxation phase of reflexes rarely in extreme cases a medical emergency called mix edema coma may
Occur when performing initial screening for hypothyroidism it is sufficient to check the tsh level by itself additional laboratory tests can be performed if the tsh level is abnormal remember if a patient’s judgment or motor skills are significantly impaired consider their fitness to drive to quickly review here is an overview of the symptoms associated with
Hypothyroidism and here is a picture demonstrating the clinical presentation of hypothyroidism before and after treatment hypothyroidism is treated by supplementing with thyroid hormones the treatment of choice is levothyroxine or lt4 the goal of treatment is to normalize the sh level this often takes six weeks to see the full effect after instituting treatment
Are performing dose adjustments with resolution of symptoms sometimes taking even longer in light of this delay it is recommended to only adjust the dose every four to six weeks as necessary one way to make a quick temporary dose adjustment and to allow the patient to use the tablets that they have on hand is to ask the patient to take one extra tablet per week
If tsh is slightly above target or one fewer per week if tsh is slightly below target because thyroid hormone supplementation could possibly worse an angina it is recommended to start with doses as low as 12.5 micrograms per day in the elderly and those with established coronary artery disease for patients who are clinically stable monitored tsh levels at least
Annually and more often if symptoms occur achieving balance is important as too high a dose of levothyroxine could bring about symptoms of hyperthyroidism or thyrotoxicosis levothyroxine is notorious for its poor absorption as a result it is best to take it on an empty stomach with a glass of water spaced at least a half hour from other medications or food and
Drink many substances such as antacids calcium and iron will decrease its absorption and the dose may have to be adjusted for patients starting estrogen or proton pump inhibitors finally it may also affect blood sugar levels or the effect of warfarin lieth iranian or triiodothyronine abbreviated t3 is another thyroid hormone supplement its use is usually reserved
For the short-term management of patients with thyroid cancer undergoing withdrawal of levothyroxine when recombinant tsh is not an option in order to prepare for radioactive iodine therapy it has a similar side effect and drug interaction profile as levothyroxine though its absorption is not affected by iron there is no benefit and possible harm associated with
Combining levothyroxine and lieth iranian this is because both hormones reduce the same effects within the body in fact levothyroxine is actually converted to lieth iranian outside of the thyroid gland additionally lieth iranian is absorbed rapidly from the intestine and may trigger mild thyroid hormone toxicity in certain patients which explains why levothyroxine
Is the treatment of choice a third option desiccated thyroid is sourced from animals it does not provide reliable dosing and presents no therapeutic advantage over the previously mentioned treatments the appropriate management of hypothyroidism is particularly important before in during pregnancy this is because hypothyroidism is associated with infertility
Miscarriage and lower intelligence in children women with hypothyroidism should be advised to increase their level i rock sand dose by two extra tablets per week immediately following a positive pregnancy test subsequent dose adjustments should be based on measured tsh levels reassure patients that thyroid hormone supplementation is safe during pregnancy and
Breastfeeding and should not be discontinued thank you so much for watching if you enjoyed this video please show your support for pharmacy pearls by hitting like and subscribing to my youtube channel think you know your stuff test your knowledge of hypothyroidism by completing the review quiz available here or by clicking on the link in the description and don’t
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Transcribed from video
Managing Hypothyroidism with Medications By Pharmacy Pearls
