NR565 Pharmacology Final Exam – Questions &
Solutions
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Terms in this set (266)
Signs and symptoms of Face is pale, puffy, and expressionless.
hypothyroidism 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 Heart Rate is Rapid; Possible arrhythmia/angina
hyperthyroidism 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 Myxedema
Hypothyroid Treatment Levothyroxine is the drug of choice for most patients
who require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Resolution of signs and symptoms of hypothyroidism
Goal and restoration of normal laboratory values for
serum thyroid-stimulating hormone (TSH) and free
thyroxine (T4).
Major forms of hyperthyroidism Graves disease and toxic nodular goiter (also known
as Plummer disease).
,Graves Disease Most common cause of excessive thyroid hormone
secretion
What adjunctive therapy is good to β-Blockers and nonradioactive iodine may be used
prescribe to control symptoms of as adjunctive therapy.
hyperthyroidism other than thyroid β-Blockers suppress tachycardia by blocking β-
specific medications? receptors on the heart.
Nonradioactive iodine inhibits synthesis and release
of thyroid hormones.
Monitoring needs and intervals for Check TSH 6-8 weeks after initiating therapy and
Levothyroxine after any dosage change.
Check TSH at least once a year after serum TSH is
stabilized.
Hyperthyroid Treatment thionamide drugs—methimazole and propylthiouracil
(PTU)—suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal (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 Check CBC with differential if signs or symptoms of
Methimazole infection. Check LFTs if signs or symptoms of liver
dysfunction.
High Risk Patients for Methimazole Should be avoided in the first trimester of pregnancy.
Methimazole Toxicity Agranulocytosis is the most dangerous toxicity.
PTU High Risk Warning 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 Can cause delay in mental development and
offspring and appropriate patient derangement of growth. In the absence of thyroid
teaching related to need for hormones, the child develops a large and protruding
treatment. tongue, potbelly, and dwarfish stature. Development
of the nervous system, bones, teeth, and muscles is
impaired.
Congenital Hypothyroidism Treatment 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 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 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- less than 7%.
pregnant adults
, HbA1C 8% history of severe hypoglycemia, limited life
expectancy, or advanced microvascular or
macrovascular complications
HBA1C Value considered diagnostic of a value of 6.5% or greater
diabetes.
HbA1C Measuring Interval every 3 months until value is <7%; every 6 months
thereafter
HbA1C Goal for Older Adults <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 -Fasting plasma glucose ≥126 mg/dL
Mellitus -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 Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA 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 total weight of the patient in kilograms (kg),
calculation multiplied by 0.6 units
Basal insulin replacement 50% of the total daily insulin dose which replaces
insulin from fasting (overnight) and between meals.
Bolus insulin replacement 50% of the total daily insulin dose and provides
carbohydrate coverage and high blood sugar
correction.
Solutions
Save Groups
Terms in this set (266)
Signs and symptoms of Face is pale, puffy, and expressionless.
hypothyroidism 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 Heart Rate is Rapid; Possible arrhythmia/angina
hyperthyroidism 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 Myxedema
Hypothyroid Treatment Levothyroxine is the drug of choice for most patients
who require thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Resolution of signs and symptoms of hypothyroidism
Goal and restoration of normal laboratory values for
serum thyroid-stimulating hormone (TSH) and free
thyroxine (T4).
Major forms of hyperthyroidism Graves disease and toxic nodular goiter (also known
as Plummer disease).
,Graves Disease Most common cause of excessive thyroid hormone
secretion
What adjunctive therapy is good to β-Blockers and nonradioactive iodine may be used
prescribe to control symptoms of as adjunctive therapy.
hyperthyroidism other than thyroid β-Blockers suppress tachycardia by blocking β-
specific medications? receptors on the heart.
Nonradioactive iodine inhibits synthesis and release
of thyroid hormones.
Monitoring needs and intervals for Check TSH 6-8 weeks after initiating therapy and
Levothyroxine after any dosage change.
Check TSH at least once a year after serum TSH is
stabilized.
Hyperthyroid Treatment thionamide drugs—methimazole and propylthiouracil
(PTU)—suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal (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 Check CBC with differential if signs or symptoms of
Methimazole infection. Check LFTs if signs or symptoms of liver
dysfunction.
High Risk Patients for Methimazole Should be avoided in the first trimester of pregnancy.
Methimazole Toxicity Agranulocytosis is the most dangerous toxicity.
PTU High Risk Warning 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 Can cause delay in mental development and
offspring and appropriate patient derangement of growth. In the absence of thyroid
teaching related to need for hormones, the child develops a large and protruding
treatment. tongue, potbelly, and dwarfish stature. Development
of the nervous system, bones, teeth, and muscles is
impaired.
Congenital Hypothyroidism Treatment 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 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 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- less than 7%.
pregnant adults
, HbA1C 8% history of severe hypoglycemia, limited life
expectancy, or advanced microvascular or
macrovascular complications
HBA1C Value considered diagnostic of a value of 6.5% or greater
diabetes.
HbA1C Measuring Interval every 3 months until value is <7%; every 6 months
thereafter
HbA1C Goal for Older Adults <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 -Fasting plasma glucose ≥126 mg/dL
Mellitus -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 Autoimmune process; Loss of pancreatic β cells;
T2DM Etiology and MOA 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 total weight of the patient in kilograms (kg),
calculation multiplied by 0.6 units
Basal insulin replacement 50% of the total daily insulin dose which replaces
insulin from fasting (overnight) and between meals.
Bolus insulin replacement 50% of the total daily insulin dose and provides
carbohydrate coverage and high blood sugar
correction.
