NR565 PHARMACOLOGY FINAL EXAM
Questions and Answers
1. Signs and symptoms of hypothyroidism
Answer Face is pale, putty, and expressionless. 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.
2. Signs and symptoms of hyperthyroidism
Answer Heart Rate is Rapid; Possible arrhythmia/angina
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
3. Severe hypothyroidism
Answer Myxedema
4. Hypothyroid Treatment
Answer Levothyroxine is the drug of choice for most patients who require thyroid hormone
replacement.
,5. Levothyroxine (Synthroid) Therapeutic Goal
Answer Resolution of signs and symptoms of hypothy- roidism and restoration of normal
laboratory values for serum thyroid-stimulating hormone (TSH) and free thyroxine (T4).
6. Major forms of hyperthyroidism
Answer Graves disease and toxic nodular goiter (also known as Plummer
disease).
7. Graves Disease
Answer Most common cause of excessive thyroid hormone secretion
8. What adjunctive therapy is good to prescribe to control symptoms of
hyper- thyroidism other than thyroid specific medications?
Answer β-Blockers and nonradioactive iodine may be used as adjunctive therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
9. Monitoring needs and intervals for Levothyroxine
Answer 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.
10. Hyperthyroid Treatment
,Answer thionamide drugs—methimazole and propylthiouracil (PTU)—suppress synthesis
of thyroid hormones.
11. Methimazole Therapeutic Goal
Answer (1) reduction of thyroid hormone production in Graves' disease,
(2) control of hyperthyroidism until the ettects of radiation on the thyroid become manifest, (3) suppression
of thyroid hormone production before subtotal thyroidectomy, (4) treatment of thyrotoxic crisis.
12. Monitoring needs and intervals for Methimazole
Answer Check CBC with ditterential if signs or
symptoms of infection. Check LFTs if signs or symptoms of liver dysfunction.
13. High Risk Patients for Methimazole
Answer Should be avoided in the first trimester of pregnancy.
14. Methimazole Toxicity
Answer Agranulocytosis is the most dangerous toxicity.
15. PTU High Risk Warning
Answer Carries a risk for liver toxicity. Although rare, the FDA recommends against using as a
first-line treatment due to potential for hepatic toxicity.
16. Effects of maternal hypothyroidism on offspring and
appropriate patient teaching related to need for treatment.
, Answer Can cause delay in mental development and derangement of growth. In the
absence of thyroid hormones, the child develops a large and protruding tongue, potbelly, and dwarfish
stature. Development of the nervous system, bones, teeth, and muscles is impaired.
17. Congenital Hypothyroidism Treatment
Answer 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.
18. Patient Teaching for Methimazole
Answer 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.
19. Patient Teaching for Levothyroxine
Answer 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.
20. Ideal HbA1C goal for diabetic, non-pregnant adults
Questions and Answers
1. Signs and symptoms of hypothyroidism
Answer Face is pale, putty, and expressionless. 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.
2. Signs and symptoms of hyperthyroidism
Answer Heart Rate is Rapid; Possible arrhythmia/angina
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
3. Severe hypothyroidism
Answer Myxedema
4. Hypothyroid Treatment
Answer Levothyroxine is the drug of choice for most patients who require thyroid hormone
replacement.
,5. Levothyroxine (Synthroid) Therapeutic Goal
Answer Resolution of signs and symptoms of hypothy- roidism and restoration of normal
laboratory values for serum thyroid-stimulating hormone (TSH) and free thyroxine (T4).
6. Major forms of hyperthyroidism
Answer Graves disease and toxic nodular goiter (also known as Plummer
disease).
7. Graves Disease
Answer Most common cause of excessive thyroid hormone secretion
8. What adjunctive therapy is good to prescribe to control symptoms of
hyper- thyroidism other than thyroid specific medications?
Answer β-Blockers and nonradioactive iodine may be used as adjunctive therapy.
β-Blockers suppress tachycardia by blocking β-receptors on the heart.
Nonradioactive iodine inhibits synthesis and release of thyroid hormones.
9. Monitoring needs and intervals for Levothyroxine
Answer 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.
10. Hyperthyroid Treatment
,Answer thionamide drugs—methimazole and propylthiouracil (PTU)—suppress synthesis
of thyroid hormones.
11. Methimazole Therapeutic Goal
Answer (1) reduction of thyroid hormone production in Graves' disease,
(2) control of hyperthyroidism until the ettects of radiation on the thyroid become manifest, (3) suppression
of thyroid hormone production before subtotal thyroidectomy, (4) treatment of thyrotoxic crisis.
12. Monitoring needs and intervals for Methimazole
Answer Check CBC with ditterential if signs or
symptoms of infection. Check LFTs if signs or symptoms of liver dysfunction.
13. High Risk Patients for Methimazole
Answer Should be avoided in the first trimester of pregnancy.
14. Methimazole Toxicity
Answer Agranulocytosis is the most dangerous toxicity.
15. PTU High Risk Warning
Answer Carries a risk for liver toxicity. Although rare, the FDA recommends against using as a
first-line treatment due to potential for hepatic toxicity.
16. Effects of maternal hypothyroidism on offspring and
appropriate patient teaching related to need for treatment.
, Answer Can cause delay in mental development and derangement of growth. In the
absence of thyroid hormones, the child develops a large and protruding tongue, potbelly, and dwarfish
stature. Development of the nervous system, bones, teeth, and muscles is impaired.
17. Congenital Hypothyroidism Treatment
Answer 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.
18. Patient Teaching for Methimazole
Answer 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.
19. Patient Teaching for Levothyroxine
Answer 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.
20. Ideal HbA1C goal for diabetic, non-pregnant adults
