Treatments for Autoimmune thyroid diseases
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Discussion of treatments for Autoimmune thyroid diseases:
The symptoms of
hypothyroidism are controlled with replacement thyroid hormone pills; however,
complications from over- or under-replacement of the hormone can occur.
Treatment of hyperthyroidism requires long-term anti-thyroid drug therapy or
destruction of the thyroid gland with radioactive iodine or surgery. Both of
these treatment approaches carry certain risks and long-term side effects.
Autoimmune thyroid diseases afflict as many as 4 out of 100 women and are
frequently found in families where there are other autoimmune diseases.
(Source: excerpt from
Understanding Autoimmune Disease: NIAID)
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Book Excerpts: Treatment of Autoimmune thyroid diseases
Treatments of Autoimmune thyroid diseases: Online Medical Books
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Thyroid cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
❑Total or subtotal thyroidectomy, with modified node dissection (bilateral or unilateral) on the side of the primary cancer (papillary or follicular cancer)
❑Total thyroidectomy and radical neck excision (for medullary, giant, or spindle cell cancer)
❑Radiation (131I) with external radiation (for inoperable cancer and sometimes postoperatively in lieu of radical neck excision) or alone (for metastasis)
❑Adjunctive thyroid suppression, with exogenous thyroid hormones suppressing TSH production, and simultaneous administration of an adrenergic blocking agent such as propranolol, increasing tolerance to surgery and radiation
❑Chemotherapy for symptom-producing, widespread metastasis is limited, but doxorubicin is sometimes beneficial.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Thyroiditis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Appropriate treatment varies with the type of thyroiditis. Drug therapy includes levothyroxine for accompanying hypothyroidism, analgesics and anti-inflammatory drugs for mild subacute granulomatous thyroiditis, propranolol for transient hyperthyroidism, and steroids for severe episodes of acute inflammation. Suppurative thyroiditis requires antibiotic therapy. A partial thyroidectomy may be necessary to relieve tracheal or esophageal compression in Riedel’s thyroiditis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Thyroid enlargement:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Instruct the patient to watch for signs and symptoms of hypothyroidism, such as lethargy, restlessness, dry skin, and sensitivity to cold. Advise the patient with Graves’disease to use artificial tears frequently if proptosis causes his eyes to become dry. If the hyperthyroid patient is receiving therapy with radioactive iodine, tell him not to expectorate or cough freely after treatment because his saliva is radioactive for 24 hours.
Inform the patient that lifelong thyroid hormone replacement therapy is necessary after thyroidectomy or radioactive destruction of the thyroid gland. Tell him to watch for signs of an overdose, such as nervousness and palpitations.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Chronic fatigue and immune dysfunction syndrome:
Treatment
(Handbook of Diseases)
Treatment is aimed at the cause, if one can be found. Supportive therapy includes an anti-inflammatory, an antihistamine, and rest.
Treatment of symptoms may include a tricyclic antidepressant (doxepin), a histamine2-blocker (cimetidine), and an anxiolytic (alprazolam). In some patients, avoidance of environmental irritants and certain foods may help to relieve symptoms.
Experimental treatments include the antiviral acyclovir and selected immunomodulators, such as I.V. gamma globulin, ampligen, and transfer factor.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Thyroid cancer:
Treatment
(Handbook of Diseases)
❑ Total or subtotal thyroidectomy, with modified node dissection (bilateral or unilateral) on the side of the primary cancer (papillary or follicular cancer)
❑ Total thyroidectomy and radical neck excision (for medullary, giant, or spindle cell cancer)
❑ Radiation (with or without surgery)
❑ Adjunctive thyroid suppression, with exogenous thyroid hormones suppressing thyrotropin production, and simultaneous administration of an adrenergic blocking agent such as propranolol, increasing tolerance to surgery and radiation
❑ Chemotherapy for symptomatic, widespread metastasis is limited, but doxorubicin is sometimes beneficial.
UNDER STUDY: Researchers are excited about recent advancements in the treatment of thyroid cancer:
❑ Researchers have identified the genetic cause of medullary thyroid carcinoma, which makes it possible to identify carriers of the abnormal gene.
❑ Improvements in imaging studies have proven helpful in the treatment of patients who present with clinically challenging conditions such as the presence of antithyroglobulin antibodies.
❑ New treatments such as the use of agents to improve iodine uptake in follicular cell tumors are in early investigation.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Thyroiditis:
Treatment
(Handbook of Diseases)
Appropriate treatment varies with the type of thyroiditis. Drug therapy includes levothyroxine for accompanying hypothyroidism, analgesics and anti-inflammatory drugs for mild subacute granulomatous thyroiditis, propranolol for transient thyrotoxicosis, and ster-oids for severe episodes of acute inflammation. Suppurative thyroiditis requires antibiotic therapy.
A partial thyroidectomy may be necessary to relieve tracheal or esophageal compression in Riedel’s thyroiditis.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Thyroid enlargement:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to watch for signs and symptoms of hypothyroidism, such as lethargy, restlessness, dry skin, and sensitivity to cold. If the patient has Graves’disease, proptosis may cause his eyes to become dry, so advise him to use artificial tears frequently. If the hyperthyroid patient is receiving therapy with radioactive iodine, tell him not to expectorate or cough freely after treatment because his saliva is radioactive for 24 hours. If the patient has a goiter, support him as he expresses his feelings related to his appearance.
After thyroidectomy or radioactive destruction of the thyroid gland, explain to the patient that lifelong thyroid hormone replacement therapy is necessary. Tell him to watch for signs of overdose, such as nervousness and palpitations.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Thyroid enlargement:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, which may include needle aspiration, ultrasound, and radioactive thyroid scanning.
▪ Prepare the patient for surgery or radiation therapy, if necessary.
▪ Provide specific interventions, depending on whether the patient is hypothyroid or has thyroiditis.
▪ Provide postoperative care for the patient who has undergone thyroidectomy.
Patient teaching
▪ Explain the underlying disorder and treatment plan.
▪ Explain the signs and symptoms of hypothyroidism to report.
▪ Explain posttreatment precautions to the patient undergoing radioactive iodine therapy.
▪ Teach thyroid hormone replacement therapy and signs of thyroid hormone overdose to report.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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