Endocrine

Question 1

Low thyroid function

Causes low TH levels, sx of slow metabolism

Thyroid works harder, grows larger

Severe form is called Myxedema

Can cause death if left untreated

Answer 1

hypothyroidism

Question 2

Drugs that cause synthetic T4 is converted to T3 (a more potent form of the thyroid hormone and more capable of penetrating cell nucleus and producing thyroid mediating hormone effects

Usually lifelong

Answer 2

TH replacement drugs

Ex: levothyroxine sodium (Synthroid)- synthetic form of thyroxine (T4)

Question 3

Side effects & adverse effects of levothyroxine sodium (Synthroid)

Answer 3

Side effects – thyrotoxicosis (tachycardia, tremors, angina, insomnia, heat intolerance) hypertension, increased bowel movements, weight loss, N/V

Adverse effects –MI, HF, seizures, palpitations

Question 4

Pt teaching when administering TH replacement drugs

Answer 4

-Teach symptoms of hyperthyroidism
-Take exactly as prescribed (preferably on an empty stomach, before breakfast)
-Not to be taken for weight loss
-Dietary fiber supplements (and increased fiber in the diet) decrease absorption
-Monitor TSH levels after 6-8 weeks (should decrease)
-Take pulse at scheduled times: before taking drug & before bedtime

Question 5

Overactive thyroid–Increase in circulating T4 and T3 levels

Metabolism much faster than normal

Severe form – “thyroid crisis” or “thyroid storm”

Symptoms more severe, life-threatening

Without treatment, death can occur from heart failure

Answer 5

Hyperthyroidism

Question 6

Drugs that block the action of thyroid peroxidase (inhibiting hormone synthesis

PTU blocks conversion of T4 to the more active form of T3

Answer 6

Thyroid-Suppressing Drugs

Ex: methimazole (Tapazole), propylthiouracil (PTU)

Question 7

Side effects & adverse effects of propylthiouracil (PTU)

Answer 7

Side effects include agranulocytosis and rash

PTU may cause hepatotoxicity

Question 8

Pt teaching when administering Thyroid-Suppressing

Answer 8

Medical follow-up
Administer meds with meals
Do NOT stop suddenly
Regular monitoring of blood counts
Monitor for jaundice; report if present
Monitor vital signs, weight

Question 9

What needs to be checked before and after administering thyroid-suppressing drugs?

Answer 9

Check before: liver function tests

Check after: blood counts; assess for jaundice