Course:PHAR451/Hypothyroidism

From UBC Wiki
Jump to: navigation, search
Thyroid Therapeutics
Wiki.png
PHAR 451
Section:
Instructor: Dr. Peter Loewen
Email: peter.loewen@ubc.ca
Office: PHRM 3512
Office Hours:
Class Schedule:
Classroom:
Important Course Pages
Syllabus
Lecture Notes
Assignments
Course Discussion


Contents

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 hypothyroidism on the basis of signs and symptoms combined with biochemical tests.
  2. design, implement and monitor (efficacy/toxicity) an effective pharmacotherapeutic plan for managing primary hypothyroidism.
  3. dentify and manage common drug related-causes of hypothyroidism.

Pre-Session Assignment

  1. Obtain PL's Thyroid Physiology, Pharmacology, & Pharmacotherapy PLOP.
  2. Read McDermott MT. Hypothyroidism. Ann Intern Med. 2009; ITC6 (1DEC09)
  3. Complete the self-assessment questions below
  4. Obtain and review the session slides (color) | session slides (B&W)

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

  1. ASCE / ATA Clinical Practice Guidelines for Hypothyroidism in Adults Endocrine Practice 2012;18(6):989-1027.
  2. Levy M. How to interpret thyroid function tests. Clin Med 2013;13:282–6.
  3. Nygaard B. Hypothyroidism (Primary). ClinicalEvidence 2010;01:605.
  4. Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial. Arch Intern Med. 2010 Dec 13;170(22):1996-2003.
  5. Pham & Shaugnessy. Should we treat subclinical hypothyroidism? BMJ 2008;337:a834 doi:10.1136/bmj.a834

Pregnancy & Hypothyroidism

  1. Yassa L, et al. J Clin Endocrinol Metab 2010;95: 3234–3241.
  2. Alexander EK et al. NEJM 2004;351:241-9
  3. Bungard & Hurlburt CMAJ 2007;176: 1077-8
Personal tools
Namespaces
Variants
Actions
Login
Tools

 

UBC Wiki
Email: wiki.support@ubc.ca

Emergency Procedures | Accessibility | Contact UBC