Name: Levothroxine or thyroxine (Levoxyl) (Levee on river, huge thighs on dude)MOA: T4 is converted to T3 (the active form) inside cells by one of two distinct deiodinases, depending on the tissueT3 binds to specific receptor proteins (alpha & beta) in the nucleus, resulting in altered gene expression, and increased formation of RNA and proteinSystemic effects include increased oxygen consumption by most tissues of the body and increases the basal metabolic rate and the metabolism of carbohydrates, lipids and proteins (Sand is T4, put into bags for T3, metabolism arrow up, shovel says activate inside the cell, alpha & beta binding sand bags)Indications: HypothyroidismPituitary TSH Suppression (in the treatment or prevention of various types of euthyroid goiters) (Low TSH and Pituitary inhibiting TSH in river)ADME: Taken orally, T4 has a longer half life (7 days) compared to T3 (1 day) (1/2 = ? days on T4 and T3)Adverse Effects: Symptoms resembling hyperthyroidism: nervousness, anxiety, tremor, heat intolerance, weight loss with increased appetite, palpitation (AE = arrow up thyroid)Notes: Children require greater doses than adults (Child carrying way more T3)

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