NR565 Final Exam|Questions and Answers | 100%
Correct Advanced Pharmacology Fundamentals
What labs are used to diagnose hypo/hyper thyroid? - TSH, T3 and T4.
Timeframe for re-check of labs after starting levothyroxine - 6-8 weeks (long half-life). Yearly
after stable.
Signs and symptoms of hypothyroidism - Dry hair, puffy face, goiter in the neck, slow heartbeat,
weight gain, constipation, infertility, increased risk of miscarriages, irregular menstrual cycle,
cold intolerance.
Drug of choice for hypothyroidism - Levothyroxine (Synthroid)
§ Signs and symptoms of hyperthyroidism - Hair loss, bulging eyes, goiter, rapid heartbeat,
weight loss, diarrhea, menstrual periods loss often or longer.
Drug of choice for hyperthyroidism - Methimazole (Tapazole)
Treatment of thyroid storm - Combination of antithyroid drugs, corticosteroids, beta-blockers,
iodine solution, and supportive measures. PTU is preferred treatment.
Result of not treating hypothyroidism during pregnancy: - Permanent neuro-psychological
deficits in the child. Decrease IQ/neuropsychological function. First trimester.
, Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and not the
hyperthyroidism itself): - Beta blockers (tachycardia) - propranolol/atenolol most popular.Non-
radioactive iodine.
Drug/Food/Supplement interactions with levothyroxine: - -Histamine receptor blockers, PPIs,
sucralfate, aluminum containing antacids, calcium supplements, iron, magnesium salts.
-Separate administration of these drugs by 4 hours.
-Food reduces absorption.
-Accelerate the metabolism: Phenytoin, carbamazepine, rifampin, sertraline, and phenobarbital.
-Effects of warfarin are enhanced.
-Increase cardiac responsiveness to catecholamines.
-May need to increase requirements for insulin/digoxin.
How to confirm a diagnosis of DM prior to beginning treatment: - Fasting plasma glucose above
126. A random plasma glucose of over 200 plus symptoms of diabetes, an oral glucose tolerance
test of two hours, plasma glucose of over 200, or a A1C higher than 6.5.
A1c general goals - <7, patients that experience severe hypoglycemia/have a limited life
expectancy may have an A1C goal of <8.
A1c older adults - <8, those with multiple coexisting chronic illnesses, cognitive impairment, or
functional dependence should have less stringent glycemic goals such as <8.0-8.5.
When should insulin be considered? - For patients who have an A1c >10%, a fasting blood
glucose >300, or markedly symptomatic.
At what time interval should A1c be re-checked? - Every 2-3 months and max of 4 times a year.
If <7, every 6 months.
Correct Advanced Pharmacology Fundamentals
What labs are used to diagnose hypo/hyper thyroid? - TSH, T3 and T4.
Timeframe for re-check of labs after starting levothyroxine - 6-8 weeks (long half-life). Yearly
after stable.
Signs and symptoms of hypothyroidism - Dry hair, puffy face, goiter in the neck, slow heartbeat,
weight gain, constipation, infertility, increased risk of miscarriages, irregular menstrual cycle,
cold intolerance.
Drug of choice for hypothyroidism - Levothyroxine (Synthroid)
§ Signs and symptoms of hyperthyroidism - Hair loss, bulging eyes, goiter, rapid heartbeat,
weight loss, diarrhea, menstrual periods loss often or longer.
Drug of choice for hyperthyroidism - Methimazole (Tapazole)
Treatment of thyroid storm - Combination of antithyroid drugs, corticosteroids, beta-blockers,
iodine solution, and supportive measures. PTU is preferred treatment.
Result of not treating hypothyroidism during pregnancy: - Permanent neuro-psychological
deficits in the child. Decrease IQ/neuropsychological function. First trimester.
, Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and not the
hyperthyroidism itself): - Beta blockers (tachycardia) - propranolol/atenolol most popular.Non-
radioactive iodine.
Drug/Food/Supplement interactions with levothyroxine: - -Histamine receptor blockers, PPIs,
sucralfate, aluminum containing antacids, calcium supplements, iron, magnesium salts.
-Separate administration of these drugs by 4 hours.
-Food reduces absorption.
-Accelerate the metabolism: Phenytoin, carbamazepine, rifampin, sertraline, and phenobarbital.
-Effects of warfarin are enhanced.
-Increase cardiac responsiveness to catecholamines.
-May need to increase requirements for insulin/digoxin.
How to confirm a diagnosis of DM prior to beginning treatment: - Fasting plasma glucose above
126. A random plasma glucose of over 200 plus symptoms of diabetes, an oral glucose tolerance
test of two hours, plasma glucose of over 200, or a A1C higher than 6.5.
A1c general goals - <7, patients that experience severe hypoglycemia/have a limited life
expectancy may have an A1C goal of <8.
A1c older adults - <8, those with multiple coexisting chronic illnesses, cognitive impairment, or
functional dependence should have less stringent glycemic goals such as <8.0-8.5.
When should insulin be considered? - For patients who have an A1c >10%, a fasting blood
glucose >300, or markedly symptomatic.
At what time interval should A1c be re-checked? - Every 2-3 months and max of 4 times a year.
If <7, every 6 months.
