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NR565 Pharmacology Final.pdf
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- Chamberlain College Of Nursing
NR565 Pharmacology F
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NR565 Pharmacology FinalSigns and symptoms of hypothyroidism – answer Face is pale, puffy, and
expressionless.
Skin is cold and dry.
hair is brittle, and hair loss occurs.
Heart rate and temperature are lowered. The patient lethargy, fatigue, and intolerance
to cold.
Mentation may be impaired.
Signs and symptoms of hyperthyroidism - answer Heart Rate is Rapid; Possible
arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist
Weight loss occurs if caloric intake fails to match the increase in metabolic rate
,Severe hypothyroidism answer - Myxedema
Hypothyroid Treatment answer - Levothyroxine is the drug of choice for most patients
who require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - answer Resolution of signs and symptoms
of hypothyroidism and restoration of normal laboratory values for serum thyroid-
stimulating hormone (TSH) and free thyroxine (T4).
Major forms of hyperthyroidism - answer Graves disease and toxic nodular goiter (also
known as Plummer disease).
Graves Disease - answer Most common cause of excessive thyroid hormone secretion
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism
other than thyroid specific medications? - answer β-Blockers and nonradioactive iodine
may be used as adjunctive therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
,Monitoring needs and intervals for Levothyroxine - answer Check TSH 6-8 weeks after
initiating therapy and after any dosage change.
Check TSH at least once a year after serum TSH is stabilized.
Hyperthyroid Treatment - thionamide drugs answer —methimazole and propylthiouracil
(PTU)—suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - answer (1) reduction of thyroid hormone production in
Graves' disease, (2) control of hyperthyroidism until the effects of radiation on the
thyroid become manifest, (3) suppression of thyroid hormone production before subtotal
thyroidectomy, (4) treatment of thyrotoxic crisis.
Monitoring needs and intervals for Methimazole - answer Check CBC with differential if
signs or symptoms of infection. Check LFTs if signs or symptoms of liver dysfunction.
High Risk Patients for Methimazole - answer Should be avoided in the first trimester of
pregnancy.
, Methimazole Toxicity - answer Agranulocytosis is the most dangerous toxicity.
PTU High Risk Warning - answer Carries a risk for liver toxicity. Although rare, the FDA
recommends against using as a first-line treatment due to potential for hepatic toxicity.
Effects of maternal hypothyroidism on offspring and appropriate patient teaching related
to need for treatment. - answer Can cause delay in mental development and
derangement of growth. In the absence of thyroid hormones, the child develops a large
and protruding tongue, potbelly, and dwarfish stature. Development of the nervous
system, bones, teeth, and muscles is impaired.
Congenital Hypothyroidism Treatment - answer requires replacement therapy with
thyroid hormones. If treatment is initiated within a few days of birth, physical and mental
development will be normal.
replacement therapy should continue for 3 years, after which it should be stopped for 4
weeks to determine whether thyroid deficiency is permanent or transient.
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