Thyroid and Steroidal Medications

Recap on Hyperthyroidism and Hypothyroidism

• Thyroid's Role in Metabolism

  • Thyroid hormone levels significantly influence metabolism.

  • The thyroid produces T3 (triiodothyronine) and T4 (thyroxine).

  • TSH (Thyroid Stimulating Hormone) regulates the secretion of T3 and T4.

• Hyperthyroidism

  • Characterized by elevated T3 and T4 levels.

  • TSH levels are low as it signals the thyroid to slow down.

  • Symptoms include:

  • Increased heart rate

  • Elevated blood pressure

  • Increased GI activity (resulting in diarrhea)

  • Weight loss due to excess energy expenditure

  • Anxiety and irritability

• Hypothyroidism

  • Low levels of T3 and T4 result in high TSH levels.

  • Symptoms include:

  • Decreased heart rate

  • Lowered blood pressure

  • Decreased GI activity (resulting in constipation)

  • Weight gain due to reduced metabolism

  • Depressive symptoms

• Treatment Options

  • For Hyperthyroidism:

  • Medications: Propylthiouracil (PTU), Methimazole which inhibit thyroid hormone production.

  • Surgical Options: Thyroidectomy (removal of thyroid) or Radioactive Iodine treatment.

    • Radioactive iodine destroys hyperactive thyroid tissue but renders the patient radioactive temporarily.

  • For Hypothyroidism:

  • Medication: Levothyroxine (synthetic T4) is prescribed.

    • Administer on an empty stomach, typically in the morning.

    • Must not be taken with PPIs (proton pump inhibitors) simultaneously—maintain a one-hour gap.

• Key Points for Exam Preparation

  • Aim for a euthyroid state (normal thyroid function).

  • Understand the balancing act with thyroid medications, avoiding over or under treatment.

Medications Overview - Steroid Drugs

• Function of Steroids

  • Steroids are crucial for reducing inflammation in various tissues.

  • Common in treatment for:

  • Inflammatory conditions

  • Autoimmune diseases

• Adrenal Glands:

  • Produce steroid hormones, with cortisol being the most notable.

• Impacts of Steroid Use:

  • Increased blood sugar levels; monitoring required.

  • Must taper off steroids gradually to prevent adrenal insufficiency, which can lead to severe complications.

  • Watch for side effects such as:

  • Osteoporosis risk

  • Increased risk of infection

  • Mood changes and weight gain

  • Gastric upset (often mitigated with PPIs)

• Medication Names:

  • Common steroids include: Prednisone, Dexamethasone, Hydrocortisone.

  • All end in -one to denote they are steroids.

Key Concepts on Eyes and Ears Medications

• Eye and Ear Drug Administration

  • Common medications include steroids, antibiotics, and antihistamines.

  • Mydriatic (dilates pupils) and Myotic (constricts pupils) drugs are important to understand for eye exams.

  • When administering eye drops:

  • Pull down the eyelid for drops.

  • Apply pressure on the inner canthus to prevent systemic absorption.

  • Wait 5-10 minutes between different eye drop medications.

• Specific Treatments for Glaucoma:

  • Drugs include Timolol (beta-blocker in eye drop form), Acetazolamide, and Latanoprost.

• Ear Conditions:

  • Otitis Media and Otitis Externa: Antibiotics and anti-inflammatories can be using in treatment.

  • Administration techniques similar to eye drops: pull down for infants and children, pull up for adults.

• Scopolamine for Vertigo:

  • Used for severe motion sickness; administer as a patch behind the ear for 72 hours.

  • Caution against excessive dry mouth.

Practical Nursing Considerations

• General Guidelines for Steroids:

  • Never stop abruptly without tapering.

  • Patients may require monitoring for blood glucose levels.

  • Watch for signs of infection and osteoporosis due to immune suppression.

  • In clinical settings, knowledge of time management surrounding medication administration (with respect to proper spacing with similar drugs) is vital.

• Eyes and Ears:

  • Familiarize with medication drops, patient comfort during administration, and methodical approaches for differing eye and ear medications.

  • Relate back to practical situations encountered during nursing education.