GNUR 294 EXAM 3 (INFORMATIVE & RATED 100%) : Loyola University Chicago

Classification Prototype Routes, Onset, Duration of Action Mechanisms of Action Indications Contraindications Adverse Effects Pregnancy Drug Interactions Nursing Responsibilities • Thyroid Hormone Replacement • Synthetic T4 • Levoyhtroxine (Synthroid, Levothyroid, etc.) o Liothyronine (cytomel) o Liotrix (thyrolar) o Thyroid, desiccated (armour) • PO, IV (myxedema coma) • PO: slow onset • IV: 6-8 hrs • DOA: 1-3 weeks, half life 6-7 days • Identical to thyroid hormone: increasing metabolic rate (increasing O2 consumption, resps, and HR) • Increase rate of metabolism ? promotes growth and maturation • Primary and secondary hypothyroidism, or hypothyroid state resulting from surgical removal of thyroid gland, radiation, or congenital defect • Hypersensitivity • Thyrotoxicosis • Severe CV conditions, MI • Adrenal insufficiency • Rare at therapeutic doses • At high doses: o CV (tachycardia, angina) o CNS excitability (tremors, headache, nervousness, insomnia) o ? metabolism ? can create strain on heart by making body work harder • A • Can interact with grapefruit juice ? delay absorption • Elderly pts ? go low and go slow • Measure TSH serum levels to see progression of therapy • Amount of absorption and bioavailability varies by brand ? stick to 1 brand, don’t switch • Lifelong; initially – evaluate every 2 weeks • Taken separate from other meds for absorption • Taken in morning before breakfast • Check BP, HR, temp • IF HR 100 ? DO NOT GIVE • CNS excitabilities ? check alertness