NR 565 Advanced Pharmacology Fundamentals |Final Exam Study Guide Week 5-8| Questions With Verified Answers 2025/2026

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NR 565 Final Exam
Study Guide



Advanced Pharmacology
Fundamentals
(Chamberlain University)

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Week 5


 Thyroid
o Diagnosis & Evaluation
 What labs are used to diagnose? TSH, total T4 and T3, free T4 and T3,
also get LFTs and CBC
 Timeframe for re-check of labs after starting levothyroxine 6-8 weeks after
starting therapy, euthyroid 1 year
 Signs and symptoms of hypo and hyperthyroidism
 Hypothyroidism
 Face: Pale, Puffy, Expressionless
 Skin: Cold and dry
 Brittle and hair loss
 Heart rate and temp are lowered
 Complaints of lethargy, fatigue, intolerance to cold
 Weight gain
 Impaired mentation
 Thyroid enlargement if decreased levels of T3 and T4 promote
excessive release of TSH
 Hyperthyroidism
 Strong and Rapid Heartbeat, dysrhythmias and angina possible
 Nervousness, insomnia, rapid thought flow and speech
 Skeletal muscle may weaken and atrophy
 Skin warm and moist, intolerant to heat
 Increased appetite but patient experiences weight loss
 All symptoms are called thyrotoxicosis
 If the patient has Graves’ disease-exophthalmos

o Treatment
 Treatment of thyroid storm-PTU (Propylthiouracil) is preferred treatment
of thyroid storm. High dose potassium iodine or strong iodine solution to
suppress thyroid hormone release, or methimazole to suppress thyroid
hormone synthesis, corticosteroids, beta-blockers- reduce heart
rate, and supportive measures are needed (sedation, cooling, IV
fluids).
 Result of not treating hypothyroidism during pregnancy
Permanent neurological defects, decreased IQ, large protruding tongue,
potbelly dwarfish stature, impaired development of nervous system bone
teeth and muscles.
 Medication to treat symptoms of hyperthyroidism (notice this is treating
symptoms and not the hyperthyroidism itself)

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NR565 Final Study Guide


Metoprolol can be use to treat tachycardia experienced with
hyperthyroidism. Allopurinol is used in the management of gout.
Methylphenidate is a central nervous system stimulant.
 Drug/Food/Supplement interactions with levothyroxine
 Absorption is reduced by:
o Histamine 2 receptor blockers (Cimetidine)
o PPI (Lansoprazole, omeprazole)
o Sucralfate (Carafate)
o Cholestyramine (Questran)
o Colestipol (Colestid)
o Aluminum containing antacids (Maalox, mylanta)
o Iron Supplements
o Calcium supplements (tums)
o Magnesium Salts
o Orlistat (Xenical)
o 4 Hrs between levothyroxine and the above meds is
recommended and food reduces absorption as well
 Metabolism accelerated by:
o Phenytoin (Dilantin)
o Carbamazepine (Tegratol, Caratrol)
o Rifampin
o Sertraline
o Phenobarbital
o Patient taking these medications will need to have dose of
levothyroxine increased
 Warfarin
o Levothyroxine accelerates degradation of vitamin K
dependent clotting factors
o may need to reduce the dose of warfarin
 Catecholamines
o Increased cardiac responsiveness-at an increased risk of
catecholamine (norepinephrine,epinephrine, dopamine)-
induced dysrhythmias
 Digoxin and Insulin
o May need to have increased dosages of these if patient is
taking levothyroxine
 Diabetes
o How to confirm a diagnosis prior to beginning treatment
 Hemoglobin A1C >6.5%
 Fasting Plasma Glucose > 126 mg/dl
 Random plasma glucose > 200 mg/dl plus symptoms of diabetes
 Oral glucose tolerance test (OGTT): 2-h plasma glucose > 200 mg/dL
o A1C