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Pharm NUR140 > Chapter 37 > Flashcards

Chapter 37 Flashcards

1
Q

Thyroid Hormone Prototype for Hypothyroidism

A

Levothyroxine (Synthroid, Levoxyl, Levo-T, Levothroid)

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2
Q

Levothyroxine (Pharmacotherapeutics)

A

Used as a replacement therapy for hypothyroidism

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3
Q

Levothyroxine (Pharmacokinetics)

A

Administered: Oral,
Metabolism: Liver,
Excreted: Bile,
Onset: 6-8 hours

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4
Q

Levothyroxine (Pharmacodynamics)

A

Acts as a replacement for natural thyroid hormone

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5
Q

Levothyroxine (Contraindications & Precautions)

A

Hypersensitivity,
Thyrotoxicosis,
Acute MI complicated by hypothyroidism

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6
Q

Levothyroxine (Adverse Effects)

A 
Hypertension,
Tachycardia,
Arrhythmias,
Anxiety,
Headache,
Nervousness,
GI irritation,
Sweating,
Heat intolerance
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7
Q

Levothyroxine (Drug Interactions)

A

Many drugs

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8
Q

Levothyroxine (Maximizing Therapeutic Effects)

A

Replacement therapy is a lifelong occurrence,

During drug therapy, monitor cardiovascular response and serum thyroid function

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9
Q

Levothyroxine (Minimizing Adverse Effects)

A

Young adults without evidence of CAD can begin a full replacement dose

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10
Q

Levothyroxine (Patient and Family Education)

A

Explain the purpose of drug therapy,

Advise patients to avoid OTC drugs

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11
Q

Levothyroxine (Ongoing assessment and evaluation)

A

Monitor serum thyroid hormone levels periodically

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12
Q

Levothyroxine (Pregnancy Category)

A

A (No risk)

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13
Q

Antithyroid Agents

A

Propylthiouracil (PTU),
Methimazole (Tapazole),
Potassium iodide (Iosat, Thyrosafe, Thyroshield),
Sodium iodide I131 (generic)

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14
Q

Antithyroid Prototype

A

Methimazole (Tapazole)

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15
Q

Methimazole (Pharmacotherapeutics)

A

Palliative treatment of hyperthyroidism

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16
Q

Methimazole (Pharmacokinetics)

A

Administered: Oral,
Metabolism: Liver,
Excreted: Kidneys

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17
Q

Methimazole (Pharmacodynamics)

A

Inhibits the synthesis of thyroid hormones

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18
Q

Methimazole (Contraindications and precautions)

A

Hypersensitivity

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19
Q

Methimazole (Adverse effects)

A 
Hives,
Itching,
Rash,
Fever,
Arthralgia,
Joint swelling,
Vertigo,
Drowsiness,
Nausea & Vomiting,
Altered taste sensation
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20
Q

Methimazole (Drug interactions)

A

Beta-Blocking Agents,
Theophylline,
Warfarin

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21
Q

Methimazole (Maximizing Therapeutic Effects)

A

Ensure drug is being administered appropriately

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22
Q

Methimazole (Minimizing Adverse Effects)

A

During drug therapy arrange for periodic blood tests to monitor for hematologic and thyroid functions,
Monitor the patient’s bone marrow function

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23
Q

Methimazole (Patient and Family Education)

A

Explain purpose of therapy,

If drug is taken in divided doses instruct patients to taken them every eight hours around the clock

24
Q

Methimazole (Ongoing Assessment and Evaluation)

A

Monitor serum thyroid hormone levels periodically to evaluate the effectiveness of MMI and to assess the need for replacement thyroid hormone because the thyroid gland is suppressed

25
Q

Iodine Solutions (Actions)

A

Cause the thyroid cells to become oversaturated with iodine and stop producing thyroid hormone

26
Q

Iodine Solutions (Indications)

A

Presurgical suppression of the thyroid gland,

Acute thyrotoxicosis

27
Q

Iodine Solutions (Pharmacokinetics)

A

Absorbed from GI tract,
Well distributed throughout the body,
Excreted through the urine

28
Q

Iodine Solutions Prototype

A

Strong Iodine Products

29
Q

Propylthiouracil (PTU)

A

Inhibits conversion of T4 to T3,
Usually used in preparation for surgery,
For thyrotoxic crisis

30
Q

Strong Iodine solution (Lugol’s Solution)

A

To reduce Thyroid Storm,
Also used before surgery,
Reduces the size and Vascularity of the Thyroid Gland

31
Q

Iodine 131: Radioactive Iodine Therapy

A

Pregnancy Category: X (Contraindicated),
Treatment for Thyroid Cancer,
Alternate for patients who cannot have surgery,

32
Q

Antihypercalcemic, Calcium-Regulator Drugs Use

A

Do not directly affect the parathyroid gland but rather inhibit bone resorption of calcium,
Frequently used in the treatment of Paget disease

33
Q

Antihypercalcemic, Calcium-Regulator Drug Agents

A 
Alendronate (Forsamax),
Etidronate (Didronel),
Pamidronate (Aredia),
Risedronate (Actonel),
Tiludronate (Skelid)
34
Q

Antihypercalcemic, Calcium-Regulator Drug Prototype

A

Calcitonin Salmon (Miacalcin)

35
Q

Calcitonin Salmon (Pharmacotherapeutics)

A

Treatment of symptomatic Paget disease

36
Q

Calcitonin Salmon (Pharmacokinetics)

A

Administered: SC, IM, or Intranasal,
Metabolism: Kidneys,
Excreted: Kidneys

37
Q

Calcitonin Salmon (Pharmacodynamics)

A

A synthetic polypeptide with essentially the same actions as calcitonin

38
Q

Calcitonin Salmon (actions)

A

Inhibits bone reabsorption,
Lowers elevated serum calcium in children and patients with Paget’s disease,
Increases the excretion of filtered phosphate, calcium, and sodium by the kidneys

39
Q

Calcitonin Salmon (Indications)

A

Paget’s Disease,
Postmenopausal osteoporosis,
Emergency treatment of hypercalcemia

40
Q

Calcitonin Salmon (Contraindications & Precautions)

A

Pregnancy Category: C,
Should not be used during lactation,
Should not be used with a known allergy to salmon or fish products,
Be used with caution in patients with renal dysfunction and pernicious anemia

41
Q

Calcitonin Salmon (Adverse Effects)

A

Flushing of face and hands,
Nausea & VomitinLocal inflammatory reactions at the injection site,
Nasal irritation if the nasal form is used

42
Q

Calcitonin Salmon (Drug Interactions)

A

No clinically important reactions

43
Q

Antihypocalcemic Agents Drugs

A

Calcitriol (Rocaltrol),
parathyroid hormone (Naptara),
teriparatide (Forteo)

44
Q

Antihypocalcemic Agents Prototype

A

Calcitriol (1, 25-dihydroxyvitamin D3)

45
Q

Calcitriol (Actions)

A

A vitamin D compund that regulates the absorption of calcium and phosphate from the small intestine, mineral resoption in bone, and reabsorption of phosphate from the renal tubules increasing the serum calcium level

46
Q

Calcitriol (Pharmacotherapeutics)

A

Management of hypocalcemia in patients on chronic renal dialysis,
Managment of hypocalcemia associated with hypoparathyroidism

47
Q

Calcitriol (Pharmacokinetics)

A

Administered: oral or IV,
Metabolism: liver,
Excreted: urine and feces

48
Q

Calcitriol (Pharmacodynamics)

A

Is a fat-soluble vitamin derived from natural sources (fish liver oils) or from conversion of provitamins

49
Q

Calcitriol (Contraindications and Precautions)

A

Given carefully to patients at risk for hypercalcemia and hypercalciuria

50
Q

Calcitriol (Adverse Effects)

A 
Weakness,
Headache,
Nausea & Vomiting,
Dry mouth,
Constupation,
Bone pain
51
Q

Calcitriol (Drug Interactions)

A

Thiazide Diuretics

52
Q

Calcitriol (Maximizing Therapeutic Effects)

A

Capsules should be swallowed whole rather than crushed or chewed,
When high therapeutic doses are used, frequent serum and urinary calcium, phosphate, and BUN determinations are necessary

53
Q

Calcitriol (Minimizing Adverse Effects)

A

Chronic dialysis patients should avoid magnesium-containing antacids while taking these drugs

54
Q 
In which of the following ways does the thyroid gland use iodine?
A. To stimulate the production of TSH
B. To produce the thyroid hormones
C. To regulate parathyroid production
D. To destroy part of the thyroid gland
A

B. To produce the thyroid hormones

55
Q

Paget’s Disease is a genetically-linked disorder. It is a condition involving overactive osteoclasts that are eventually replaced by enlarged and softened bony structures. WHAT ARE THE CLINICAL MANIFESTATIONS OF PAGET’S DISEASE?

A. Deep bone pain
B. Increased hearing acuity
C. Increased visual acuity
D. Cardiac arrhythmias

A

A. Deep bone pain

Patients report deep bone pain, headaches, and hearing loss and usually have cardiac failure and bone malformation

56
Q

True or False

The hormones PTH and calcitonin work together to maintain a delicate balance of serum calcium levels in the body and also to keep serum calcium levels within normal range

A

True

Renal tubular phosphate reabsorption is balanced by calcium secretion into the urine, which causes a drop in serum calcium, stimulating PTH secretion.

Pharm NUR140 (5 decks)

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