Course:PHAR451/Hyperthyroidism

Thyroid Therapeutics
PHAR 451
Section:
Instructor:	Dr. Peter Loewen
Email:	peter.loewen@ubc.ca
Office:	PHRM 6624
Office Hours:
Class Schedule:
Classroom:
Important Course Pages
	Syllabus
	Lecture Notes
	Assignments
	Course Discussion

Pre-session Objectives

1. Be able to describe the physiology of thyroid function.
2. Be able to explain the biochemical parameters used to evaluate thyroid function.
3. Be able to describe the pathophysiology of the most common causes of hyper- and hypothyroidism.
4. Be able to name the signs and symptoms of hyper- and hypo-thyroidism.

Session Objectives

By the end of the the session and upon further study and reflection, students should be able to

1. rationalize a diagnosis of hyperthyroidism on the basis of signs and symptoms combined with lab tests.

2. design, implement and monitor (efficacy/toxicity) an effective pharmacotherapeutic plan for managing Graves’ Disease.

Pre-session Assignment

1. Obtain Peter Loewen's Thyroid Physiology, Pharmacology, & Pharmacotherapy PLOP.
2. Read Brent GA. Graves’ Disease. N Engl J Med 2008;358:2594-605.
3. Complete the self-assessment questions below
4. Obtain and review the session slides, posted in Connect.

Preparatory self-assessment questions

1. The predominant hormone secreted by the thyroid gland is

a. Triiodothyronine

b. Tetraiodothyronine

c. Liothyronine

d. Parathyroid hormone

2. The metabolically active thyroid hormone, (________), is produced mainly (_________)

a. T3, in peripheral tissues

b. T4, in peripheral tissues

c. T3, in the thyroid

d. T4, in the thyroid

3. The most common cause of hypothyroidism in North America is

a. Iodine deficiency

b. Graves’ disease

c. Amiodarone

d. Autoimmune thyroiditis

4. The most common cause of hyperthyroidism in North America is

a. Iodine excess

b. Graves’ disease

c. Autoimmune thyroiditis

d. Toxic multinodular goitre

5. Which constellation of symptoms is most consistent with hyperthyroidism

a. Depression, constipation, ascites, bradycardia

b. Normocytic anemia, pleural effusion, menorrhagia, myalgia

c. Bradyphasia, eczema, proptosis, paresthesia

d. Thinning of hair, amenorrhea, osteoporosis, muscle weakness

References & Additional Reading

• ASCE / ATA Clinical Practice Guidelines for Hypothyroidism in Adults Endocrine Practice 2012;18(6):989-1027.
• Nygaard B. Hyperthyroidism in Pregnancy. ClinicalEvidence 2010;07:611.
• Bruere H, Fauchier L, Bernard Brunet A, et al. History of Thyroid Disorders in Relation to Clinical Outcomes in Atrial Fibrillation. Am J Med. 2015;128(1):30-37.
• Subclinical hyperthyroidism and the risk of coronary heart disease and mortality. Arch Intern Med. 2012;172(10):799-809
• Chiha M, Samarasinghe S, Kabaker AS. Thyroid Storm: An Updated Review. J Intensive Care Med 2013;
• Brent GA. Graves’ Disease. N Engl J Med 2008;358:2594-605.