Podcasts about myxedema

This podcast is sponsored by YARAL Pharma.  In this episode, we are focusing on the management of hypothyroidism -- a treatable, but not curable condition – and will explore unique challenges for patients with hypothyroidism in long-term care – from tolerability and formulation considerations to consistent dosing and patient needs. Dr. Tamara Ruggles is not affiliated with YARAL Pharma. All views and opinions regarding hypothyroidism are solely her own and are not attributable to YARAL or the Pharmacy Podcast Network. IMPORTANT SAFETY INFORMATION for levothyroxine sodium capsules INDICATION AND USAGE Levothyroxine sodium capsules are L-thyroxine (T4) indicated for adults and pediatric patients 6 years and older with: Hypothyroidism - As replacement therapy in primary (thyroidal), secondary (pituitary), and tertiary (hypothalamic) congenital or acquired hypothyroidism Pituitary Thyrotropin (Thyroid-Stimulating Hormone, TSH) Suppression - As an adjunct to surgery and radioiodine therapy in the management of thyrotropin-dependent well differentiated thyroid cancer Limitations of Use: Levothyroxine sodium capsules are not indicated for suppression of benign thyroid nodules and nontoxic diffuse goiter in iodine-sufficient patients as there are no clinical benefits and overtreatment with Levothyroxine sodium capsules may induce hyperthyroidism. Levothyroxine sodium capsules are not indicated for treatment of transient hypothyroidism during the recovery phase of subacute thyroiditis WARNING: NOT FOR THE TREATMENT OF OBESITY OR FOR WEIGHT LOSS Thyroid hormones, including levothyroxine sodium capsules, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss. In euthyroid patients, doses within the range of daily hormonal requirements are ineffective for weight reduction. Larger doses may produce serious or even life-threatening manifestations of toxicity, particularly when given in association with sympathomimetic amines such as those used for their anorectic effects. Contraindications Uncorrected adrenal insufficiency Warnings and Precautions Cardiac adverse reactions in the elderly and in patients with underlying cardiovascular disease: Initiate Levothyroxine sodium capsules at less than the full replacement dose because of the increased risk of cardiac adverse reactions, including atrial fibrillation Myxedema coma: Do not use oral thyroid hormone drug products to treat myxedema coma Acute adrenal crisis in patients with concomitant adrenal insufficiency: Treat with replacement glucocorticoids prior to initiation of levothyroxine sodium capsules treatment Prevention of hyperthyroidism or incomplete treatment of hypothyroidism: Proper dose titration and careful monitoring is critical to prevent the persistence of hypothyroidism or the development of hyperthyroidism Worsening of diabetic control: Therapy in patients with diabetes mellitus may worsen glycemic control and result in increased antidiabetic agent or insulin requirements. Carefully monitor glycemic control after starting, changing, or discontinuing thyroid hormone therapy Decreased bone mineral density associated with thyroid hormone over-replacement: Over-replacement can increase bone reabsorption and decrease bone mineral density. Give the lowest effective dose Adverse Reactions Common adverse reactions with levothyroxine therapy are primarily those of hyperthyroidism due to therapeutic overdosage. They include the following: General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating Central Nervous System: headache, hyperactivity, nervousness, anxiety, irritability, emotional ability, insomnia Musculoskeletal: tremors, muscle weakness Cardiovascular: palpitations, tachycardia, arrythmias, increased pulse and blood pressure, heart failure, angina, myocardial infarction, cardiac arrest Respiratory: dyspnea Gastrointestinal (GI): diarrhea, vomiting, abdominal cramps, elevations in liver function tests Dermatologic: hair loss, flushing Endocrine: decreased bone mineral density Reproductive: menstrual irregularities, impaired fertility Adverse Reactions in Children Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving levothyroxine therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height. Seizures have been reported rarely with the institution of levothyroxine therapy. Hypersensitivity Reactions Hypersensitivity reactions to inactive ingredients (in this product or other levothyroxine products) have occurred in patients treated with thyroid hormone products. These include urticaria, pruritis, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to levothyroxine itself is not known to occur. Drug Interactions: Many drugs and some foods can exert effects on thyroid hormone pharmacokinetics (e.g., absorption, synthesis, secretion, catabolism, protein binding, and target tissue response) and may alter the therapeutic response to Levothyroxine sodium capsules. Administer at least 4 hours before or after drugs that are known to interfere with absorption. See full prescribing information for drugs that affect thyroid hormone pharmacokinetics and metabolism. To report SUSPECTED ADVERSE REACTIONS, contact Yaral Pharma Inc. at 1-866-218-9009, or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. For Full Prescribing Information, including Boxed Warning, go to www.yaralpharma.com/levothyroxine-pi.

Q-BANK: https://www.patreon.com/highyieldfamilymedicineIntro (0:35),Thyroid physiology (1:49),Thyroid function testing (4:34),Hypothyroidism (7:01),Myxedema coma (9:43),Hypothyroidism in pregnancy (10:45),Hyperthyroidism (11:55),Thyroid storm (16:59),Subacute thyroiditis (20:03),Postpartum thyroiditis (21:33),Painless thyroiditis (22:54),Thyroid nodules (23:41),Thyroid cancer (25:37),Practice questions (28:44)

In this episode, Nurse Mo breaks down the critical information you need to know about myxedema coma, a life-threatening complication of hypothyroidism. Learn how to recognize, assess, and treat this condition using the Straight A Nursing LATTE Method. Tune in to boost your confidence in both exams and clinical practice! Hit play on this episode to learn:  Key symptoms and patient presentation for myxedema coma How to assess and monitor patients, including vital signs and neurological status Critical lab tests and diagnostic evaluations used for diagnosis Treatment options, including thyroid hormone replacement and supportive therapies Essential patient education to prevent myxedema coma and manage hypothyroidism This episode is packed with important info to help you feel more confident when caring for patients with this complicated condition. Don't miss it! ___________________ Full Transcript - Read the article "Myxedema Coma Basics" and view references FREE CLASS - If all you've heard are nursing school horror stories, then you need this class! Join me in this on-demand session where I dispel all those nursing school myths and show you that YES...you can thrive in nursing school without it taking over your life! Study Sesh - Change the way you study with this private podcast that includes dynamic audio formats that help you review and test your recall of important nursing concepts on-the-go. Free yourself from your desk with Study Sesh!  Med Surg Solution - Are you looking for a more effective way to learn Med Surg? Enroll in Med Surg Solution and get lessons on 57 key topics and out-of-this-world study guides.  Straight A Nursing App - Study on-the-go with the Straight A Nursing app! Review more than 5,000 flashcards covering a wide range of subjects including Fundamentals, Pediatrics, Med Surg, Mental Health, Maternal Newborn, and more! Available for free in the Apple App Store and Google Play Store. LATTE Method Template - Download the free LATTE Method Template so you can streamline how you study and focus on what a nurse needs to know. 

Show notes at pharmacyjoe.com/episode822. In this episode, I'll discuss the dose of IV levothyroxine used for myxedema coma. The post 822: How Much IV levothyroxine is Enough for Myxedema Coma? appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode822. In this episode, I ll discuss the dose of IV levothyroxine used for myxedema coma. The post 822: How Much IV levothyroxine is Enough for Myxedema Coma? appeared first on Pharmacy Joe.

In this episode, we discuss an overview of inpatient management of can't miss endo emergencies. Our esteemed guest, Dr. Sara Markley Webster (Emory University, @smarkleywebster) walks us through identification, workup and management of adrenal crisis, myxedema coma, and thyroid storm. Free CME for this episode at curbsiders.vcuhealth.org Episodes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME! Show Segments ●  Intro, disclaimer, guest bio ●  Guest one-liner, Picks of the Week* ●  Case 1 from Kashlak ●  Adrenal crisis identification, workup and management ●  Case 2 from Kashlak ●  Myxedema identification, workup and management ●  Case 3 from Kashlak ●  Thyroid storm identification, workup and management ●  Outro Credits ●  Written, Produced, and Hosted by: Monee Amin, MD and Meredith Trubitt, MD ●  Show Notes, Infographic and Cover Art: Caroline Coleman, MD ●  Reviewer: Emi Okamoto, MD ●  Showrunner: Matthew Watto MD, FACP; Paul Williams MD, FACP ●  Technical Production: PodPaste ●  Guest: Sara Markley Webster, MD Sponsor: Locumstory If you would like to learn more about locums visit locumstory.com Sponsor: Pattern Visit patternlife.com/curbsiders to get a free disability insurance quote. 

Ang Isang Dahilan na Patuloy Tayong Nagkakasala

Ang Isang Dahilan na Patuloy Tayong Nagkakasala

In Part 1 of our 2-part series on bradycardia and bradydysrhythmias we discussed a practical approach with electrophysiologist Paul Dorian and EM doc Tarlan Hedayati. In this, part 2, we discuss details of treatment. We answer questions such as: When should pacing be prioritized over medications and vice versa? What are the latest recommendations about dosing of atropine and when is atropine likely to be detrimental? How is the treatment of bradycardia different in the patient with hypothermia? Cardiac ischemia? Myxedema coma? AV nodal blocker overdose? What are the most common pitfalls in utilizing transcutaneous and transvenous pacing? and many more... The post Ep 155 Treatment of Bradycardia and Bradydysrhythmias appeared first on Emergency Medicine Cases.

A different take on IV T3 for Myxedema

Thyroid storm's boring brother is still a life threat--you need to know it!

It's always important to talk about the extreme complications of any disease process. Today we talk about the fatal complication of hypothyroidism, myxedema coma. Let's Review!

Show notes at pharmacyjoe.com/episode529. In this episode, I ll discuss the dose of IV levothyroxine used for myxedema coma. The post 529: What dose of IV levothyroxine is used for myxedema coma? appeared first on Pharmacy Joe.

Episode 37 is here! LJ and Zach dive into some varied topics today, first talking about myxedema coma, then the coronavirus outbreak in China, and finally another news roundup in which they answer the all important question, should you be allowed to bring a turkey on an airplane? If you've got a question or comment for us, send us an email at chiefcomplaintpod@gmail.com, tweet us @ChiefPod, or find us on Instagram @ChiefComplaintPodcast. See you next week for a brand new episode!Links:Coronavirus: https://www.nytimes.com/2020/01/24/world/asia/china-coronavirus.htmlParaguayan President: https://www.medscape.com/viewarticle/924060Airline Support Animals: https://www.reuters.com/article/us-usa-airlines-pets/no-turkeys-no-possums-us-to-let-airlines-limit-service-animals-on-planes-to-trained-dogs-idUSKBN1ZL22KRadiology and Lead Aprons: https://www.medscape.com/viewarticle/924205#vp_2Music:You're There by The Mini VandalsAll Night by IksonNews Sting by Kevin McCleod (incompetech.com)

Welcome to 2020, everyone! In this fresh new podcast we cover all things severe hypothyroidism; AKA Myxedema Coma. Diagnosis. Treatment. Whats the deal with T4 vs T3. Who gets the roids. Come listen to it all!

Blake is going to England, Iltifat is going to shift. Which one sounds better? Its a rapid board bomb for a SLOW topic, Myxedema Coma. High mortality and high yield for boards. Know how to act fast on these sluggish patients. Website: www.emboardbombs.com

Show notes at pharmacyjoe.com/episode421. In this episode, I’ll discuss why steroids are given in myxedema coma. The post 421: Why are steroids given in myxedema coma? appeared first on Pharmacy Joe.

Author: Gretchen Hinson, MD Educational Pearls: Clinical manifestations of severe hypothyroidism may include: Pale, cool, diaphoretic skin Myxedema is the non-pitting edema seen in hypothyroidism Hypothermia, heart failure, hypotension and shock Shortness of breath Cholestasis, constipation Encephalopathy and coma   Mortality is 30-50% Specific treatment includes thyroid hormone (T3, T4, or both) and glucocorticoids (for potential adrenal insufficiency)   References: Kwaku MP, Burman KD. Myxedema coma. J Intensive Care Med. 2007 Jul-Aug;22(4):224-31. Review. PubMed PMID: 17712058. Ono Y, Ono S, Yasunaga H, Matsui H, Fushimi K, Tanaka Y. Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan. J Epidemiol. 2017 Mar;27(3):117-122. doi: 10.1016/j.je.2016.04.002. Epub 2017 Jan 5. PubMed PMID: 28142035; PubMed Central PMCID: PMC5350620. Lee CH, Wira CR. Severe angioedema in myxedema coma: a difficult airway in a rare endocrine emergency. Am J Emerg Med. 2009 Oct;27(8):1021.e1-2. doi: 10.1016/j.ajem.2008.12.027. PubMed PMID: 19857436. Summarized by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD

Dr. Leonard Wartofsky is Professor of Medicine, Georgetown University School of Medicine and Chairman Emeritus, Department of Medicine, MedStar Washington Hospital Center.  He trained in internal medicine at Barnes Hospital, Washington University and in endocrinology with Dr. Sidney Ingbar, Harvard University Service, Thorndike Memorial Laboratory, Boston.   Dr. Wartofsky is past President of both the American Thyroid Association and The Endocrine Society.  He is the editor of books on thyroid cancer for both physicians and for patients, and thyroid cancer is his primary clinical focus.   He is the author or coauthor of over 350 articles and book chapters in the medical literature, is recent past Editor-in-Chief of the Journal of Clinical Endocrinology & Metabolism, and is the current Editor-in-Chief of Endocrine Reviews. In this episode, Dr. Wartofsky discusses the following: Bioavailability versus content of a thyroid replacement tablet, and how it is absorbed. Hypothyroidism causes When is replacement thyroid replacement hormone necessary? The history of replacement thyroid hormone going back to 1891 The early treatment included a chopped up sheep thyroid and served as a ‘tartar’, often resulting in vomiting Myxedema coma The danger of taking generic T4; are cheaper, larger profit margin, but the content varies. Synthroid versus generic Manufacturing plants in Italy, India, Puerto Rico are known to produce generics Content versus absorption when taking generic T4 An explanation of TSH 1.39 is a healthy TSH level for women in the U.S. Symptoms of hypothyroidism, such as a slow mind, poor memory, dry skin, brittle hair, slow heart rate, problems with pregnancy, miscarriage, and hypertension. Screening TSH levels if contemplating pregnancy T4 is the most prescribed drug in the U.S. Hypothyroidism is common when there is a family history Auto-immune disease is often associated with hypothyroidism An explanation of T3 An explanation of desiccated thyroid The T3 ‘buzz’ Muhammed Ali’s overdose of T3 Dangers of too much T3 When to take T4 medication, and caution toward taking mediations that interfere with absorption Coffee and thyroid hormone absorption Losing muscle and bone by taking too much thyroid hormone Taking ownership of your disease NOTES Listen to Doctor Thyroid Related Episode : 37: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University American Thyroid Association Leonard Wartofsky

On this episode, we review the pathophysiology, signs/symptoms, and treatment of hypothyroidism. We compare and contrast the pharmacotherapy options and the evidence that supports current guideline recommendations. We then move into the management of myxedema coma. We close by summarizing the various drugs that have become FDA approved over the last month.

Dr. Wartofsky is Professor of Medicine, Georgetown University School of Medicine and Chairman Emeritus, Department of Medicine, MedStar Washington Hospital Center.  He trained in internal medicine at Barnes Hospital, Washington University and in endocrinology with Dr. Sidney Ingbar, Harvard University Service, Thorndike Memorial Laboratory, Boston.   Dr. Wartofsky is past President of both the American Thyroid Association and The Endocrine Society.  He is the editor of books on thyroid cancer for both physicians and for patients, and thyroid cancer is his primary clinical focus.   He is the author or coauthor of over 350 articles and book chapters in the medical literature, is recent past Editor-in-Chief of the Journal of Clinical Endocrinology & Metabolism, and is the current Editor-in-Chief of Endocrine Reviews. In this episode, Dr. Wartofsky discusses the following: Hypothyroidism causes When is replacement thyroid hormone necessary? The history of replacement thyroid hormone going back to 1891 The early treatment included a chopped up sheep thyroid and served as a ‘tartar’, often resulting in vomiting Myxedema coma The danger of taking generic T4; are cheaper, larger profit margin, but the content varies. Synthroid versus generic Manufacturing plants in Italy, India, Puerto Rico are known to produce generics Content versus absorption when taking generic T4 An explanation of TSH 1.39 is a healthy TSH level for women in the U.S. Symptoms of hypothyroidism, such as a slow mind, poor memory, dry skin, brittle hair, slow heart rate, problems with pregnancy, miscarriage, and hypertension. Screening TSH levels if contemplating pregnancy T4 is the most prescribed drug in the U.S. Hypothyroidism is common when there is a family history Auto-immune disease is often associated with hypothyroidism An explanation of T3 An explanation of desiccated thyroid The T3 ‘buzz’ Muhammed Ali’s overdose of T3 Dangers of too much T3 When to take T4 medication, and caution toward taking mediations that interfere with absorption Coffee and thyroid hormone absorption Losing muscle and bone by taking too much thyroid hormone Taking ownership of your disease Related episodes: 37: Adding T3 to T4 Will Make You Feel Better? For Some the Answer is ‘Yes’ with Dr. Antonio Bianco from Rush University NOTES Leonard Wartofsky American Thyroid Association  

Today's episode is a quick review of Thyroid emergencies by Dr. Patrick Ng, a 3rd year EM resident in San Antonio, recorded by Jacob Schriner MS-3.  Thyroid emergencies can be difficult to recognize in the ED because they present in so many different ways.  Today's episode will review how to recognize these emergencies, order the right tests, and provide the correct critical treatments.

Clinical presentation and treatment of myxedema.