Thyroid conditions

Question 1

Sx of hyperthyroidism?

Answer 1

tachycardia, ↑BP, nervousness and emotional instability, anxiety, weight loss, diarrhea, warm, moist flushed skin, heat intolerance.

Question 2

Medication for hyperthyroidism, thyrotoxicosis, and Grave’s disease?

Answer 2

Methimazole

Question 3

MOA of Methimazole?

Answer 3

1. Prevents the oxidation of iodine
2. Blocks the synthesis of thyroid hormones
3. Blocks the conversion of T4 to T3

Question 4

Adverse effects of Methimazole?

Answer 4

agranulocytosis, hypothyroidism, and it is considered a hazardous drug

Question 5

Interactions with Methimazole?

Answer 5

anticoagulants b/c it can increase anticoagulation

Monitor: PT, INR, aPTT

Question 6

Methimazole contraindications?

Answer 6

pregnancy and lactation

Question 7

How long will it take to reach therapeutic effect after administration of thyroid medication?

Answer 7

3-12 weeks

Question 8

Schedule dosing for Methimazole?

Answer 8

QD at the same time every day

Question 9

What are early signs of agranulocytosis?

Answer 9

Fever and ST

Monitor: CBC

Question 10

T/F. Patients do not need to avoid seafood and iodized salt when taking Methimazole

Answer 10

False; they do need to avoid

Question 11

Route of administration of Methimazole?

Answer 11

PO

Question 12

Prototype for Thyroid supplement?

Answer 12

Levothyroxine (Synthroid)

Question 13

MOA of Levothyroxine?

Answer 13

synthetic form of thyroxine (T4)

Question 14

Therapeutic uses of Levothyroxine?

Answer 14

hypothyroidism, myxedema coma

Question 15

Adverse effects of Levothyroxine?

Answer 15

hyperthyroidism, A fib, bone loss, tachycardia, diarrhea, insomnia

Question 16

S/sx of hypothyroidism?

Answer 16

bradycardia, anemia, slow speech and body mvts, emotional and mental dullness, excessive sleeping, increased weight, constipation, cold intolerance, and dry coarse thickened skin

Question 17

Interactions with Levothyroxine?

Answer 17

• antacids, H2 blockers, PPIs, calcium and iron supplements, because they reduced absorption of the medication.
• Use with Warfarin can increase the anticoagulant effects by breaking down vitamin K.

Question 18

When should patients take Levothyroxine?

Answer 18

Daily 30-60 min before breakfast

Question 19

What sx should patients report to provider with use of Levothyroxine?

Answer 19

sx of cardiac excitability like CP, palpitations, and dysrhythmias

Question 20

T/F. Therapy of Levothyroxine starts with a low dose that progressively increases in 3 week intervals.

Answer 20

False; 2 week intervals

Question 21

How long may it take to see full effects after Levothyroxine use?

Answer 21

6-8 weeks; wait until then to monitor for decreased TSH levels