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Chapter 31: Thyroid and Anti-Thyroid Test, Hypothyroidism, Pharmacology for Nurses:

The key terms in this Pharmacology course include Thyroid and anti-thyroid, Hypothyroidism, Levothyroxine (Synthroid), Pharmacology for Nurses: Practical Applications

A 19-year-old woman has been diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 6 months, she calls the nurse to say that she feels better and wants to stop the medication. Which response by the nurse is correct?

“You can stop the medication if your symptoms have improved.”

“Medication therapy for hypothyroidism is usually lifelong, and you should not stop taking the medication.”

“You need to stay on the medication for at least 1 year before a decision about stopping it can be made.”

“You need to stay on this medication until you become pregnant.”

These medications must never be abruptly discontinued, and lifelong therapy is usually the norm. The other options are incorrect.

The order reads, “Give levothyroxine (Synthroid), 200 mg, PO once every morning.” Which action by the nurse is correct?

Give the medication as ordered.

Change the dose to 200 mcg because that is what the prescriber meant.

Hold the drug until the prescriber returns to see the patient.

Question the order because the dose is higher than 200 mcg.

Levothyroxine is dosed in micrograms. A common medication error is to write the intended dose in milligrams instead of micrograms. If not caught, this error would result in a thousandfold overdose. Doses higher than 200 mcg need to be questioned in case this error has occurred. The other options are incorrect.

A patient with hypothyroidism is given a prescription for levothyroxine (Synthroid). When the nurse explains that this is a synthetic form of the thyroid hormone, he states that he prefers to receive more “natural” forms of drugs. What will the nurse explain to him about the advantages of levothyroxine?

It has a stronger effect than the natural forms.

The half-life of levothyroxine is long enough to permit once-daily dosing.

Levothyroxine is less expensive than the natural forms.

The synthetic form has fewer adverse effects on the gastrointestinal tract.

One advantage of levothyroxine over the natural forms is that it can be administered only once a day because of its long half-life. The other options are incorrect.

A patient, newly diagnosed with hypothyroidism, receives a prescription for a thyroid hormone replacement drug. The nurse assesses for which potential contraindication to this drug?

Diabetes mellitus

Liver disease

Recent myocardial infarction


Contraindications to thyroid preparations include known drug allergy to a given drug product, recent myocardial infarction, adrenal insufficiency, and hyperthyroidism. The other options are incorrect.

An elevated Thyroid Stimulating Hormone value confirms the diagnosis of hyperthyroidism.



Which drug below can cause both hypothyroidism and hyperthyroidism ?

a. flecanide

b. sotolol

c. amidarone

d. adenosine