synthetic – a. 合成的
thyroid hormone – 甲状腺激素
levothyroxine – n. 左甲状腺素 Synthroid – n. 【奥】辛思罗德 Levoxyl – n. 【奥】雷沃思尔 Levothroid – n. 左甲状腺素钠
synthetic salt – 合成盐
predictable – a. 可预测的
bioavailability – n. 生物利用度
desiccated – a. 烘干的，干燥的
desiccated thyroid – 干燥甲状腺剂 Armour Thyroid – 甲状腺素片
liothyronine – n. 碘塞罗宁 Cytomel – n. 碘塞罗宁钠 Triostat – n. 复方碘塞罗宁
liotrix – n. 复方甲状腺素 Thyrolar – n. 三碘合剂商品名
maturation – n. 成熟
deiodination – n. 去碘，脱碘 注：带“【奥】”标记者为奥医临时用名，只为方便学员复习记忆，不得作为临床诊疗依据！
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Thyroid Hormones 甲状腺激素
Several replacement hormone products are available for treating hypothyroidism. These hormones replace the low or absent levels of natural thyroid hormone and suppress the overproduction of TSH by the pituitary. These products can contain both natural and synthetic thyroid hormone. Levothyroxine (Synthroid, Levoxyl, Levothroid), a synthetic salt of T4, is the most frequently used replacement hormone because of its predictable bioavailability and reliability. Desiccated thyroid (Armour Thyroid, and others) is prepared from dried animal thyroid glands and contains both T3 and T4; although the ratio of the hormones is unpredictable and the required dose and effects vary widely, this drug is inexpensive, making it attractive to some. Additional thyroid hormones include liothyronine (Cytomel, Triostat), a synthetic salt of T3, and liotrix (Thyrolar), a synthetic preparation of T4 and T3 in a standard 4:1 ratio.
The thyroid replacement hormones increase the metabolic rate of body tissues, increasing oxygen consumption, respiration, heart rate, growth and maturation, and the metabolism of fats, carbohydrates, and proteins. They are indicated for replacement therapy in hypothyroid states, treatment of myxedema coma, suppression of TSH in the treatment and prevention of goiters, and management of thyroid cancer. In conjunction with antithyroid drugs, they also are indicated to treat thyroid toxicity, prevent goiter formation during thyroid overstimulation, and treat thyroid overstimulation during pregnancy. These drugs are not approved for weight loss, and carry a warning that they are not to be used for weight loss.
These drugs are well absorbed from the gastrointestinal (GI) tract and bound to serum proteins. Because it contains only T3, liothyronine has a rapid onset and a long duration of action. Deiodination of the drugs occurs at several sites, including the liver, kidney, and other body tissues. Elimination is primarily in the bile. Thyroid hormone does not cross the placenta and seems to have no effect on the fetus. Thyroid replacement therapy should not be discontinued during pregnancy, and the need for thyroid replacement often becomes apparent or increases during pregnancy. Thyroid hormone does enter breast milk in small amounts. Caution should be used during lactation.
1. Nurse Oliver should expect a client with hypothyroidism to report which health concerns?
A. Increased appetite and weight loss
B. Puffiness of the face and hands
C. Nervousness and tremors
D. Thyroid gland swelling 2. A patient is being educated on how to take their anti-thyroid medication. Which of the following statements are INCORRECT?
A. “I will continue taking aspirin daily.”
B. “I will take this medication at the same time every day.”
C. “It may take a while before I notice that the medication is helping my condition.”
D. “I will avoid foods containing high levels of iodine.”
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答案 Answers 1. B. Puffiness of the face and hands Rationale: Hypothyroidism (myxedema) causes facial puffiness, extremity edema, and weight gain. Signs and symptoms of hyperthyroidism (Graves’ disease) include an increased appetite, weight loss, nervousness, tremors, and thyroid gland enlargement (goiter). 2. A. “I will continue taking aspirin daily.” Rationale: The patient needs to be instructed NOT to take aspirin because it increases thyroid hormones. All the other statements are correct.
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