NU 578 Exam – Questions With Full Solutions (A+)
Treatments for Hypothyroidism Accurate Answer:- Levothyroxine (T4),
Liothyronine (T3), Liotrix, Thyroid (Desiccated)
Levothyroxine (T4) Accurate Answer:- Drug of choice for patients who
require thyroid hormone replacement. Absorption is reduced by food. Most of
the does is converted to T3. Highly bound to protein and half life is about 7
days. Used for cretinism, myxedema coma, simple goiter, and primary
hypothyroidism in adults and children. With overdose s/s of thyroid toxicosis
may result. Chronic overdose is associated with accelerated bone loss and
increased risk of atrial fibrillation, especially in older adults.
What are the signs and symptoms of thyrotoxicosis? Accurate Answer:-
Tachycardia, angina, tremor, nervousness, insomnia, hyperthermia, heat
intolerance, and sweating.
Drugs that reduce Levothyroxine Absorption Accurate Answer:-
Histamine (H2) receptor blockers like cimetidine (Tagamet), Proton pump
inhibitors like lansoprazole (Prevacid), Sucralfate (Carafate), Cholestyramine
(Questran), Colestipol (Colestid), Aluminum-containing antacid, Calcium
supplements, Iron supplements, Magnesium salts, Orlistat (Xenical). Separate
administration of (blank) by 4 hours .
Drugs that accelerate Levothyroxine Metabolism Accurate Answer:-
Phenytoin, Carbamazepine (Tegretol, Carbatrol), Rifampin (Rifadin),
Sertraline (Zoloft) and Phenobarbital. Patient's may need an increase in
(blank) medication if taking these drugs.
What happens when Levothyroxine and Warfarin are taken together ?
Accurate Answer:- Levothyroxine (blank) the degradation of vitamin K-
dependent clotting factors which results in (blank) effects of warfarin. Dosage
of Warfarin may need to be (blank)
a.) accelerates, enhanced, reduced
b.) slows, decreased, increased
c. No change in Warfarin
answer is a.
, What happens when Levothyroxine and Catecholamines are taken together?
Accurate Answer:- Thyroid hormones (blank) cardiac responsive to
catecholamines (epinephrine, dopamine, dobutamine) thereby (blank) the
risk of catecholamine induced dysrhythmias.
a.) decrease, reducing,
b. increase, increasing
c. No change in medication
answer is b.
Levothyroxine can (blank) requirements for insulin and digoxin and dosages
may need to be (blank) Accurate Answer:- a.) decrease, reduced
b.) not change
c.) increase, increased
answer is c
Levothyroxine administration Accurate Answer:- Oral doses should be
taken 30-60 minutes before eating. IV can be used if patient's can't swallow.
What is the TSH target level with Levothyroxine? Accurate Answer:- a.)
0.5-2 microunits/ml
b.) 3-5 microunits/ml
c.) 10-15 microunits/ml
answer is a
What is the average adult dosage for Levothyroxine? Accurate Answer:-
a.) 1.6 mcg/kg/day for most patients
b. 1000 mcg/day for all patients
c. 10-20 mcg/kg/day for most patient
answer is a
note: most patients <age 50 can be started on full replacement doses (100-
125 mcg/day for 70 kg adult)
What is the Levothyroxine dosage for older patients? Accurate Answer:-
a.) 100 mcg/day
b.) same as the adult dose
c.) 25 to 50 mcg/day
Treatments for Hypothyroidism Accurate Answer:- Levothyroxine (T4),
Liothyronine (T3), Liotrix, Thyroid (Desiccated)
Levothyroxine (T4) Accurate Answer:- Drug of choice for patients who
require thyroid hormone replacement. Absorption is reduced by food. Most of
the does is converted to T3. Highly bound to protein and half life is about 7
days. Used for cretinism, myxedema coma, simple goiter, and primary
hypothyroidism in adults and children. With overdose s/s of thyroid toxicosis
may result. Chronic overdose is associated with accelerated bone loss and
increased risk of atrial fibrillation, especially in older adults.
What are the signs and symptoms of thyrotoxicosis? Accurate Answer:-
Tachycardia, angina, tremor, nervousness, insomnia, hyperthermia, heat
intolerance, and sweating.
Drugs that reduce Levothyroxine Absorption Accurate Answer:-
Histamine (H2) receptor blockers like cimetidine (Tagamet), Proton pump
inhibitors like lansoprazole (Prevacid), Sucralfate (Carafate), Cholestyramine
(Questran), Colestipol (Colestid), Aluminum-containing antacid, Calcium
supplements, Iron supplements, Magnesium salts, Orlistat (Xenical). Separate
administration of (blank) by 4 hours .
Drugs that accelerate Levothyroxine Metabolism Accurate Answer:-
Phenytoin, Carbamazepine (Tegretol, Carbatrol), Rifampin (Rifadin),
Sertraline (Zoloft) and Phenobarbital. Patient's may need an increase in
(blank) medication if taking these drugs.
What happens when Levothyroxine and Warfarin are taken together ?
Accurate Answer:- Levothyroxine (blank) the degradation of vitamin K-
dependent clotting factors which results in (blank) effects of warfarin. Dosage
of Warfarin may need to be (blank)
a.) accelerates, enhanced, reduced
b.) slows, decreased, increased
c. No change in Warfarin
answer is a.
, What happens when Levothyroxine and Catecholamines are taken together?
Accurate Answer:- Thyroid hormones (blank) cardiac responsive to
catecholamines (epinephrine, dopamine, dobutamine) thereby (blank) the
risk of catecholamine induced dysrhythmias.
a.) decrease, reducing,
b. increase, increasing
c. No change in medication
answer is b.
Levothyroxine can (blank) requirements for insulin and digoxin and dosages
may need to be (blank) Accurate Answer:- a.) decrease, reduced
b.) not change
c.) increase, increased
answer is c
Levothyroxine administration Accurate Answer:- Oral doses should be
taken 30-60 minutes before eating. IV can be used if patient's can't swallow.
What is the TSH target level with Levothyroxine? Accurate Answer:- a.)
0.5-2 microunits/ml
b.) 3-5 microunits/ml
c.) 10-15 microunits/ml
answer is a
What is the average adult dosage for Levothyroxine? Accurate Answer:-
a.) 1.6 mcg/kg/day for most patients
b. 1000 mcg/day for all patients
c. 10-20 mcg/kg/day for most patient
answer is a
note: most patients <age 50 can be started on full replacement doses (100-
125 mcg/day for 70 kg adult)
What is the Levothyroxine dosage for older patients? Accurate Answer:-
a.) 100 mcg/day
b.) same as the adult dose
c.) 25 to 50 mcg/day