NR565 week 5
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Oral Routes of Administration OA exam 1 EXAM #3
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Hypothyroidism:
Thick, coarse, dry Hyporeflexia, "hung up" patella reflex Slow thought
process, Weight gain (5-10 lbs./2.25-4.5 kg) Constipation, Menorrhagia,
Cold intolerance: Cold all the time
Signs and symptoms of
hypothyroidism and Hyperthyroidism (aka graves disease):
hyperthyroidism Smooth, silky Hyperreflexia, Mind racing, Weight loss (10 lbs./4.5 kg)
Diarrhea, loose, frequent stools, Oligomenorrhea, Heat intolerance:
Hot all the time
pg. 418-419
What adjunctive therapy is good to β-Blockers and nonradioactive iodine may be used as adjunctive
prescribe to control symptoms of therapy. β-Blockers suppress tachycardia by blocking β-receptors on
hyperthyroidism other than thyroid the heart. Nonradioactive iodine inhibits synthesis and release of
specific medications? thyroid hormones.
Know drug classes and examples pg. 419
of those drug classes.
, levothyroxine-Monitoring: Check TSH 6-8 weeks after initiating therapy
and after any dosage change. Check TSH at least once a year after
serum TSH is stabilized.
Methimazole-Monitoring: Check CBC with differential if signs or
Monitoring needs and intervals for
symptoms of infection. Check LFTs if signs or symptoms of liver
thyroid medications.
dysfunction.
Propylthiouracil (PTU)- Treatment continues for 1-2 years
PTU has caused rare cases of liver injury. Onset is sudden and
progression is rapid.
- Propylthiouracil (PTU) carries a Treatment continues for 1-2 years
risk for liver toxicity. Although rare, PTU has caused rare cases of liver injury. Onset is sudden and
the FDA recommends against using progression is rapid. pg 421
PTU as a first-line treatment due to
potential for hepatic toxicity.
Maternal hypothyroidism can result in permanent neuropsychological
deficits in the child.
can decrease IQ and other aspects of neuropsychological function in
the child.
teaching:
to help ensure healthy fetal development, maternal hypothyroidism
must be diagnosed and treated very early.
- Effects of maternal
hypothyroidism on offspring and some authorities currently recommend routine screening for
appropriate patient teaching hypothyroidism as soon as pregnancy is confirmed. If hypothyroidism
related to need for treatment. is diagnosed, replacement therapy should begin immediately.
the signs and symptoms of pregnancy mimics those of hypothyroidism
When women taking thyroid supplements become pregnant, dosage
requirements usually increase—often by as much as 50%. The need for
increased dosage begins between weeks 4 and 8 of gestation, levels
off at approximately week 16, and then remains steady until parturition.
pg. 418
, :levothyroxine:
should be taken on an empty stomach in the morning, at least 30 to 60
minutes before breakfast.
Inform patients about the symptoms of thyrotoxicosis and instruct
them to notify the prescriber if these develop (Sweating, irritability,
weight loss, tachycardia)Instruct patients to separate administration of
levothyroxine and these drugs by 4 hours
Overdose may cause thyrotoxicosis. Symptoms include tachycardia,
angina, tremor, nervousness, insomnia, sweating, and heat intolerance.
methamizole:
Agranulocytosis: Inform patients about early signs of agranulocytosis,
- Patient teaching for thyroid
including fever or sore throat. If follow-up blood tests reveal
medications.
leukopenia, methimazole should be stopped.
Hypothyroidism: Methimazole may cause excessive reductions in
thyroid hormone synthesis. If signs of hypothyroidism develop or if
plasma levels of T3 and T4 become subnormal, dosage should be
reduced.
Radioactive Iodine:
Inform patients about symptoms of iodism, including brassy taste,
burning sensations in the mouth, and soreness of gums and teeth.
Iodine can also cause corrosive injury to the GI tract. Instruct patients
to notify the prescriber if severe abdominal distress develops.
PTU:
can cause rare cases of liver injury