Lilly Pharm Ch 32 Thyroid & Anti-thyroid Medications Flashcards
A patient newly diagnosed with hypothyroidism received a prescription for a thyroid drug. In addition to assessing for hypersensitivity and myocardial infarction, for what should the nurse also assess before administering the thyroid drug?
a. Infections
b. Diabetes mellitus
c. Lupus erythematosus
d. Adrenal insufficiency
d. Adrenal insufficiency
Adrenal insufficiency is a contraindication to administration of thyroid drugs.
- Treating hypothyroidism without first addressing adrenal insufficiency can precipitate an adrenal crisis- a life-threatening condition characterized by severe hypotension, shock and electrolyte imbalances.
A patient with hypothyroidism is given a prescription for levothyroxine (synthroid). When the nurse explains that levothyroxine is a synthetic form of the thyroid hormone, the patient states that a more natural form of the drug would be personally preferred. What is the nurse’s best explanation to the patient for the use of levothyroxine?
a. The synthetic form has a stronger effect than natural forms.
b. Levothyroxine is less expansive than teh natural forms.
c. The oral form has fewer adverse effects on the gastrointestinal tract.
d. Because the half-life of levothyroxine is longer than that of the natural forms, once a day dosing is possible.
d. Because the half-life of levothyroxine is longer than that of the natural forms, once a day dosing is possible.
The advantage of levothyroxine over the natural forms is that it needs to be administered only once a day because of its long half-life. As well, its effects are more predictable than those of natural thyroid preparations.
The nurse is discussing thyroid replacement therapy and establishing treatment goals with a patient. What important adverse effects should the nurse discuss with the patient?
a. Edema, anemia, and hepatitis
b. pruritus, myalgia, leukopenia, and parestesia
c. tachycardia, dysrhythmias, weight loss, and fever.
d. Skin pigment changes, bleeding, and menstrual irregularities.
c. tachycardia, dysrhythmias, weight loss, and fever.
When teaching a patient on antithyroid medication about diet, which direction should be included?
a. Use iodized salt when cooking.
b. Avoid foods containing iodine.
c. Increase fluid intake to 2500 mL per day.
d. Increased intake of sodium- and potassium-containing foods.
b. Avoid foods containing iodine.
Excess iodine can reduce the effectiveness of antithyroid medications and worsen hyperthyroidism.
Foods high in iodine:
-Seaweed, kelp, nori, and algae
-iodized salt
-fish and shellfish
-dairy products
-egg yolks
-soy products (tofu)
A patient taking propylthiouracil for hyperthyroidism asks the nurse how this medication works. In answer to to the patient’s question, the nurse tells the patient that propylthiouracil:
a. blocks the action of thyroid hormone.
b. impedes the formation of thyroid hormone.
c. destroys overactive cells in the thyroid gland.
d. inactivates already exsisting thyroid hormone in the bloodstream.
b. impedes the formation of thyroid hormone.
(Impedes formation but does not affect existing thyroid hormone).
A patient has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (synthroid). After 1 week, the patient tells the nurse that she feels no better. The nurse would best tell the patient that:
a. she will probably require surgery for a cure.
b. levothyroxine does not reach its peak effect for several months.
c. she probably did not take her medication as instructed.
d. her diet may be causing absorption problems.
b. levothyroxine does not reach its peak effect for several months.
Which drugs should be avoided while taking thyroid replacement preparations?
a. Vitamin supplements
b. antibiotics
c. Anticoagulants
d. B-blockers
c. Anticoagulants
Drugs that interact with thyroid replacement preparations include anticoagulants, cholestyramine, hypoglycemic drugs, and digoxin.
Anticoagulants - levothyroxine increases its effects. > increased INR/PT levels.
Cholestyramine - binds to levothyroxine/ prevents from being absorbed properly. > can result in hypothyroidism.
Hypoglycemic drugs - Levothyroxine decreases the effectiveness of diabetes medications. > can result in hypoglycemia.
Digoxin - levothyroxine reduces digoxin levels. > decreased heart rate control in heart failure and AFIB.
Which symptoms indicate a too-high dose of thyroid replacement hormone?
a. Bradycardia, somnolence, and ataxia
b. Anxiety, weight loss, and insomnia
c. Dry skin, weakness, and weight gain
d. Drowsiness, coughing, and neck pain
b. Anxiety, weight loss, and insomnia
The adverse effects of thyroid medications are usually the result of overdose. Anxiety, weight loss, and insomnia are fex of the more common adverse effects.
Which condition may be caused by low levels of thyroid hormone in youth?
a. Goitre
b. Myxedema
c. Cretinism
d. Addison’s disease
c. Cretinism
- Hyposecretion of thyroid hormone during youth may lead to cretinism.
Cretinism is a condition caused by severe congenital hypothyroidism leading to a intellectual disability and growth retardation if left untreated. It occurs due to a lack of thyroid hormone which is crucial for brain development, metabolism , and growth.
A patient has been taking levothyroxine (synthroid) for more than a decade for primary hypothyroidism. She tells the nurse that her cousin can get her the same medication in generic form from a pharmaceutical supply company. What would be the best for the nurse to say to the patient?
a. “that would be a great way to save money”
b. “there’s no difference in brands of this medication”
c. “Switching the form of medication should never be done; once you start with a certain brand, you must stay with it”
d. “It’s better not to switch brands until we check with your doctor”
d. It’s better not to switch brands until we check with your doctor”
A patient has been diagnosed with primary hypothyroidism. Which statement accurately describes this condition?
a. Thy hypothalamus is not secreting thyrotropin-releasing hormone; therefore, thyroid-stimulating hormone (TSH) is not released from the pituitary gland.
b. The pituitary gland is dysfunctional and is not secreting TSH.
c. The abnormality is in the thyroid gland itself.
d. The abnormality is caused by an excess intake of iodine.
c. The abnormality is in the thyroid gland itself.
Primary hypothyroidism stems from an abnormality in the thyroid gland itself and occurs when the thyroid gland is not able to perform on of its many functions.
Which are the two thyroid hormones produced by the thyroid gland?
a. Diiodothyronine (T2) and triiodothyronine (T3).
b. Thyroxine (T4) and triiodothyronine (T3)
c. Levothyroxine and thyroxine
d. thyroxine and liothyronine
b. Thyroxine (T4) and triiodothyronine (T3)
(TSH is produced by the pituitary gland)
(Levothyroxine is the synthetic medication)
(T2 is a by product of T3 [one atom removed])
