thyrotoxicosis – n. 甲状腺毒症
antithyroid – a. n. 抗甲状腺的(药)
hypoadrenal – a. 肾上腺功能障碍的
Addison disease – 阿迪生病
liothyronine – n. 碘塞罗宁
liotrix – n. 三碘合剂
alleviate – v. 减轻，使…缓和
cholestyramine – n. 考来烯胺
anticoagulant – n. 抗凝血药
glycoside – n. (糖)苷
digitalis glycoside – 洋地黄糖甙类
digitalis – n. 洋地黄
theophylline – n. 茶碱
clearance – n. 清除率
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Thyroid Hormones 甲状腺激素
Contraindications and Cautions 禁忌与注意事项
Thyroid hormones should not be used with any known allergy to the drugs or their binders to prevent hypersensitivity reactions, during acute thyrotoxicosis (unless used in conjunction with antithyroid drugs), or during acute myocardial infarction (unless complicated by hypothyroidism), because the thyroid hormones could exacerbate these conditions. Caution should be used during lactation because the drug enters breast milk and could suppress the infant’s thyroid production, and with hypoadrenal conditions such as Addison disease because the body will not be able to deal with the drug effects. Liothyronine and liotrix have a greater incidence of cardiac side effects and are not recommended for use in patients with potential cardiac problems or patients who are prone to anxiety reactions.
When the correct dose of the replacement therapy is being used, few if any adverse effects are associated with these drugs. Thyroid function tests should be checked annually in long-term therapy to ensure the correct levels are being maintained. Skin reactions and loss of hair are sometimes seen, especially during the first few months of treatment in children. Symptoms of hyperthyroidism may occur as the drug dose is regulated. Some of the less predictable effects are associated with cardiac stimulation (arrhythmias, hypertension), central nervous system (CNS) effects (anxiety, sleeplessness, headache), and difficulty swallowing and esophageal irritation (taking the drug with a full glass of water is strongly recommended to alleviate this effect).
Decreased absorption of the thyroid hormones occurs if they are taken concurrently with cholestyramine. If this combination is needed the drugs should be taken 2 hours apart. The effectiveness of oral anticoagulants is increased if they are combined with thyroid hormone. Because this may lead to increased bleeding, the dose of the oral anticoagulant should be reduced and the bleeding time checked periodically.
Decreased effectiveness of digitalis glycosides can occur when these drugs are combined. Consequently, digitalis levels should be monitored, and increased dose may be required.
与洋地黄糖甙类药物联用时，洋地黄糖甙效果下降。因此，应监测洋地黄糖甙水平，并可能需要增加剂量。
Theophylline clearance is decreased in hypothyroid states. As the patient approaches normal thyroid function, the theophylline dose may need to be adjusted frequently.
甲状腺功能减退者茶碱清除率下降。当患者甲状腺功能接近正常时，可能需要频繁调整茶碱剂量。
★Video ★
Thyroid Hormone Medications
★Test ★
1. The nurse is preparing to administer liothyronine to a client diagnosed with hypothyroidism. Which data should cause the nurse to question administering the medication?
A. The client is reporting being nervous.
B. The client's oral temperature is 98.9°F (37.1°C).
C. The client's blood pressure is 110/70.
D. The client is reporting being tired. 2. A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect?
A. Dysuria
B. Leg cramps
C. Tachycardia
D. Blurred vision
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答案 Answers
1. A. The client is reporting being nervous. Rationale: liothyronine (Cytomel) is a thyroid hormone. Nervousness, jitteriness, and irritability are signs or symptoms of hyperthyroidism; therefore, the nurse should question administering thyroid hormone. 2. C. Tachycardia Rationale: Levothyroxine, a synthetic thyroid hormone, is given to a client with hypothyroidism to simulate the effects of thyroxine. Adverse effects of this agent include tachycardia. The other options aren’t associated with levothyroxine.
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