Synthroid – Pharmacology for Nurses: Practical Applications

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

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


A patient has been taking levothyroxine (Synthroid) for more than one decade for primary hypothyroidism. Today she calls because she has a cousin who can get her the same medication in a generic form from a pharmaceutical supply company. Which is the nurse’s best advice?

“It’s better not to switch brands unless we check with your doctor.”

“This would be a great way to save money.”

“There’s no difference in brands of this medication.”

“This should never be done; once you start with a certain brand, you must stay with it.”

Switching brands of levothyroxine during treatment can destabilize the course of treatment. Thyroid function test results need to be monitored more carefully when switching products.


A 19-year-old student was diagnosed with hypothyroidism and has started thyroid replacement therapy with levothyroxine (Synthroid). After 1 week, she called the clinic to report that she does not feel better. Which response from the nurse is correct?

“Is it possible that you did not take your medication as instructed?”

“Let’s review your diet; it may be causing absorption problems.”

“The full therapeutic effects may not occur for several weeks.”

“It will probably require surgery for a cure to happen.”

Patients need to understand that it may take several weeks to see the full therapeutic effects of thyroid drugs. The other options are incorrect.


The nurse is giving morning medications. The Medication Administration Record has an order for levothyroxine, 25 mcg PO. The drug-dispensing cabinet contains levothyroxine tablets in milligram strengths instead of micrograms. Calculate the milligram equivalent dose of 25 mcg. __

Correct Answer

0.025 mg

There are 1000 mcg in 1 mg
1000 mcg:1 mg :: 25 mcg:x mg.
(1000 × x) = (1 × 25); 1000x = 25; x = 0.025 mg


A patient, newly diagnosed with hypothyroidism, has received a prescription for thyroid replacement therapy. The nurse will instruct the patient to take this medication at which time of day?

With the evening meal

At bedtime

With the noon meal

In the morning

If possible, it is best to administer thyroid drugs taken once daily in the morning so as to decrease the likelihood of insomnia that may result from evening dosing.


A patient who is taking propylthiouracil (PTU) for hyperthyroidism wants to know how this medicine works. Which explanation by the nurse is accurate?

It slows down the formation of thyroid hormone.

It inactivates already existing thyroid hormone in the bloodstream.

It promotes the formation of thyroid hormone.

It destroys overactive cells in the thyroid gland.

Propylthiouracil impedes the formation of thyroid hormone but has no effect on already existing thyroid hormone. The other options are incorrect.


During a teaching session for a patient on antithyroid drugs, the nurse will discuss which dietary instructions?

Avoiding foods containing iodine

Increasing intake of sodium- and potassium-containing foods

Using iodized salt when cooking

Restricting fluid intake to 2500 mL/day

Patients on antithyroid therapy need to avoid iodine-containing foods. These foods may interfere with the effectiveness of the antithyroid drug. The other options are incorrect.