NR565 Pharmacology Final
Signs and symptoms of hypothyroidism - correct 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 - correct 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 - correct answer Myxedema
Hypothyroid Treatment - correct answer Levothyroxine is the drug of choice for most patients
who require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - correct 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 - correct answer Graves disease and toxic nodular goiter (also
known as Plummer disease).
Graves Disease - correct answer Most common cause of excessive thyroid hormone secretion
,NR565 Pharmacology Final
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism other
than thyroid specific medications? - correct 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 - correct 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 - correct answer thionamide drugs—methimazole and propylthiouracil
(PTU)—suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - correct 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 - correct 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 - correct answer Should be avoided in the first trimester of
pregnancy.
Methimazole Toxicity - correct answer Agranulocytosis is the most dangerous toxicity.
PTU High Risk Warning - correct 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.
,NR565 Pharmacology Final
Effects of maternal hypothyroidism on offspring and appropriate patient teaching related to
need for treatment. - correct 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 - correct 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.
Patient Teaching for Methimazole - correct answer Tell your healthcare providers that you are
taking this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are pregnant, especially in the first
trimester.
If you are pregnant or become pregnant while taking this drug, call your healthcare provider
right away.
Tell your healthcare provider if you are breast-feeding to discuss risks to the baby.
Have your baby's thyroid checked if you are using this drug and breast-feeding.
Agranulocytosis is the most dangerous toxicity risk for this medication but is very rare. Sore
throat and fever should be reported immediately.
Patient Teaching for Levothyroxine - correct answer works best if you take it on an empty
stomach, 30 to 60 minutes before breakfast.
take the medicine at the same time each day.
Ideal HbA1C goal for diabetic, non-pregnant adults - correct answer less than 7%.
, NR565 Pharmacology Final
HbA1C 8% - correct answer history of severe hypoglycemia, limited life expectancy, or advanced
microvascular or macrovascular complications
HBA1C Value considered diagnostic of diabetes. - correct answer a value of 6.5% or greater
HbA1C Measuring Interval - correct answer every 3 months until value is <7%; every 6 months
thereafter
HbA1C Goal for Older Adults - correct answer <7.5% [58 mmol/mol]), while those with multiple
coexisting chronic illnesses, cognitive impairment, or functional dependence should have less
stringent glycemic goals (such as A1C <8.0-8.5% [64-69 mmol/mol]).
Criteria for the Diagnosis of Diabetes Mellitus - correct answer -Fasting plasma glucose ≥126
mg/dL
-Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetes
-Oral glucose tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dLcor
-Hemoglobin A1c 6.5% or higher
T1DM Etiology and MOA - correct answer Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA - correct answer Unknown—but there is a strong familial association,
suggesting that heredity is a risk factor; Insulin resistance and inappropriate insulin secretion
the total daily dose (TDD) of insulin calculation - correct answer total weight of the patient in
kilograms (kg), multiplied by 0.6 units
Signs and symptoms of hypothyroidism - correct 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 - correct 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 - correct answer Myxedema
Hypothyroid Treatment - correct answer Levothyroxine is the drug of choice for most patients
who require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - correct 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 - correct answer Graves disease and toxic nodular goiter (also
known as Plummer disease).
Graves Disease - correct answer Most common cause of excessive thyroid hormone secretion
,NR565 Pharmacology Final
What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism other
than thyroid specific medications? - correct 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 - correct 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 - correct answer thionamide drugs—methimazole and propylthiouracil
(PTU)—suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - correct 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 - correct 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 - correct answer Should be avoided in the first trimester of
pregnancy.
Methimazole Toxicity - correct answer Agranulocytosis is the most dangerous toxicity.
PTU High Risk Warning - correct 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.
,NR565 Pharmacology Final
Effects of maternal hypothyroidism on offspring and appropriate patient teaching related to
need for treatment. - correct 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 - correct 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.
Patient Teaching for Methimazole - correct answer Tell your healthcare providers that you are
taking this drug.
Check blood work as directed.
Taking this drug may cause harm to the unborn baby if you are pregnant, especially in the first
trimester.
If you are pregnant or become pregnant while taking this drug, call your healthcare provider
right away.
Tell your healthcare provider if you are breast-feeding to discuss risks to the baby.
Have your baby's thyroid checked if you are using this drug and breast-feeding.
Agranulocytosis is the most dangerous toxicity risk for this medication but is very rare. Sore
throat and fever should be reported immediately.
Patient Teaching for Levothyroxine - correct answer works best if you take it on an empty
stomach, 30 to 60 minutes before breakfast.
take the medicine at the same time each day.
Ideal HbA1C goal for diabetic, non-pregnant adults - correct answer less than 7%.
, NR565 Pharmacology Final
HbA1C 8% - correct answer history of severe hypoglycemia, limited life expectancy, or advanced
microvascular or macrovascular complications
HBA1C Value considered diagnostic of diabetes. - correct answer a value of 6.5% or greater
HbA1C Measuring Interval - correct answer every 3 months until value is <7%; every 6 months
thereafter
HbA1C Goal for Older Adults - correct answer <7.5% [58 mmol/mol]), while those with multiple
coexisting chronic illnesses, cognitive impairment, or functional dependence should have less
stringent glycemic goals (such as A1C <8.0-8.5% [64-69 mmol/mol]).
Criteria for the Diagnosis of Diabetes Mellitus - correct answer -Fasting plasma glucose ≥126
mg/dL
-Random plasma glucose ≥ 200 mg/dL plus symptoms of diabetes
-Oral glucose tolerance test (OGTT): 2-h plasma glucose ≥200 mg/dLcor
-Hemoglobin A1c 6.5% or higher
T1DM Etiology and MOA - correct answer Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA - correct answer Unknown—but there is a strong familial association,
suggesting that heredity is a risk factor; Insulin resistance and inappropriate insulin secretion
the total daily dose (TDD) of insulin calculation - correct answer total weight of the patient in
kilograms (kg), multiplied by 0.6 units
