Chapter 16: Hormones and Drugs for Osteoporosis Vislosky: Introduction to Clinical Pharmacology, 9th Edition

MULTIPLE CHOICE 1. A patient diagnosed with hypothyroidism has been prescribed treatment with a thyroid hormone agonist. The patient asks you how long this drug will need to be taken. What is your best response? a. “You will need to take this drug for the rest of your life.” b. “You will need to take this drug until your symptoms improve.” c. “You will need to take this drug until your thyroid hormone level normalizes.” d. “You will need to take this drug incrementally until you reach the maximum tolerated dose.” ANS: A Hypothyroidism is a common problem in which the thyroid gland produces little or no thyroid hormones, slowing all aspects of metabolism, and is treated with thyroid hormone agonists. Usually this therapy is needed for the rest of the person’s life. DIF: Cognitive Level: Applying REF: p. 293 2. A patient taking levothyroxine sodium is pregnant and tells you she plans to breastfeed her baby. What should you tell this patient? a. “While it is safe to breastfeed, this drug will limit your milk supply over time.” b. “Breast-feeding is safe when taking this drug, but not with other thyroid hormones.” c. “You should not breastfeed your infant because this drug passes into your breastmilk.” d. “You may breastfeed while hospitalized and your thyroid hormone levels can be checked.” ANS: C Women taking thyroid hormone agonists are advised not to breastfeed, as the drug can be found in the mother’s breast milk. DIF: Cognitive Level: Applying REF: p. 294 3. The action of which drug is known to be increased by thyroid hormone replacement drugs? a. Warfarin (Coumadin) b. Acetaminophen (Tylenol) c. Diphenhydramine (Benadryl) d. Fiber supplements (Fibercon) ANS: A Thyroid agonists used for thyroid hormone replacement therapy enhance the action of drugs that reduce blood clotting (anticoagulants), especially warfarin. Acetaminophen is a pain reliever. Diphenhydramine is an antihistamine. And fiber supplements are dietary supplements, not drugs, and are unaffected by thyroid hormone replacement therapy although their use can inhibit intestinal uptake of thyroid agonists.