NR565 Pharmacology Final Test
Solved
Signs and symptoms of hypothyroidism - Answer Face is pale, puffy, 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.
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
Severe hypothyroidism - Answer Myxedema
Hypothyroid Treatment - Answer Levothyroxine is the drug of choice for most patients who require
thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - Answer Resolution of signs and symptoms of
hypothyroidism and restoration of normal laboratory values for serum thyroid-stimulating hormone
(TSH) and free thyroxine (T4).
Major forms of hyperthyroidism - Answer Graves disease and toxic nodular goiter (also known as
Plummer disease).
Graves Disease - Answer Most common cause of excessive thyroid hormone secretion
,What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism 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.
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.
Hyperthyroid Treatment - Answer thionamide drugs—methimazole and propylthiouracil (PTU)—
suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - Answer (1) reduction of thyroid hormone production in Graves' disease,
(2) control of hyperthyroidism until the effects of radiation on the thyroid become manifest, (3)
suppression of thyroid hormone production before subtotal thyroidectomy, (4) treatment of thyrotoxic
crisis.
Monitoring needs and intervals for Methimazole - Answer Check CBC with differential if signs or
symptoms of infection. Check LFTs if signs or symptoms of liver dysfunction.
High Risk Patients for Methimazole - Answer Should be avoided in the first trimester of pregnancy.
Methimazole Toxicity - Answer Agranulocytosis is the most dangerous toxicity.
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.
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.
, 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.
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.
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.
Ideal HbA1C goal for diabetic, non-pregnant adults - Answer less than 7%.
HbA1C 8% - Answer history of severe hypoglycemia, limited life expectancy, or advanced microvascular
or macrovascular complications
HBA1C Value considered diagnostic of diabetes. - Answer a value of 6.5% or greater
HbA1C Measuring Interval - Answer every 3 months until value is <7%; every 6 months thereafter
HbA1C Goal for Older Adults - Answer <7.5% [58 mmol/mol]), while those with multiple coexisting
chronic illnesses, cognitive impairment, or functional dependence should have less stringent glycemic
goals (such as A1C <8.0-8.5% [64-69 mmol/mol]).
Solved
Signs and symptoms of hypothyroidism - Answer Face is pale, puffy, 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.
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
Severe hypothyroidism - Answer Myxedema
Hypothyroid Treatment - Answer Levothyroxine is the drug of choice for most patients who require
thyroid hormone replacement.
Levothyroxine (Synthroid) Therapeutic Goal - Answer Resolution of signs and symptoms of
hypothyroidism and restoration of normal laboratory values for serum thyroid-stimulating hormone
(TSH) and free thyroxine (T4).
Major forms of hyperthyroidism - Answer Graves disease and toxic nodular goiter (also known as
Plummer disease).
Graves Disease - Answer Most common cause of excessive thyroid hormone secretion
,What adjunctive therapy is good to prescribe to control symptoms of hyperthyroidism 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.
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.
Hyperthyroid Treatment - Answer thionamide drugs—methimazole and propylthiouracil (PTU)—
suppress synthesis of thyroid hormones.
Methimazole Therapeutic Goal - Answer (1) reduction of thyroid hormone production in Graves' disease,
(2) control of hyperthyroidism until the effects of radiation on the thyroid become manifest, (3)
suppression of thyroid hormone production before subtotal thyroidectomy, (4) treatment of thyrotoxic
crisis.
Monitoring needs and intervals for Methimazole - Answer Check CBC with differential if signs or
symptoms of infection. Check LFTs if signs or symptoms of liver dysfunction.
High Risk Patients for Methimazole - Answer Should be avoided in the first trimester of pregnancy.
Methimazole Toxicity - Answer Agranulocytosis is the most dangerous toxicity.
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.
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.
, 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.
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.
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.
Ideal HbA1C goal for diabetic, non-pregnant adults - Answer less than 7%.
HbA1C 8% - Answer history of severe hypoglycemia, limited life expectancy, or advanced microvascular
or macrovascular complications
HBA1C Value considered diagnostic of diabetes. - Answer a value of 6.5% or greater
HbA1C Measuring Interval - Answer every 3 months until value is <7%; every 6 months thereafter
HbA1C Goal for Older Adults - Answer <7.5% [58 mmol/mol]), while those with multiple coexisting
chronic illnesses, cognitive impairment, or functional dependence should have less stringent glycemic
goals (such as A1C <8.0-8.5% [64-69 mmol/mol]).
