Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
44Activity
0 of .
Results for:
No results containing your search query
P. 1
Synthroid (levothyroxine)

Synthroid (levothyroxine)

Ratings:

5.0

(1)
|Views: 14,739|Likes:
Published by E

More info:

Published by: E on Oct 19, 2008
Copyright:Attribution Non-commercial

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
download as DOC, PDF, TXT or read online from Scribd
See more
See less

04/22/2013

pdf

text

original

 
Clinical Medications Worksheets
Generic Name
levothyroxine
Trade Name
Synthroid
Classification
Thyroid preparations
Dose
125 mcg
Route
PO
Time/frequency
qd
Peak 
1-3 wk 
Onset
unknown
Duration
1-3 wk 
Normal dosage range
 Hypothyroidism
--50 mcg as a single dose initially; may be increased q2-3 wk; usual maintenance dose is 75-125 mcg/day (1.5 mcg/kg/day).
Severe hypothyroidism
--12.5-25 mcg/day; may increase q 2-4 wk by 25mcg/day; usual maintenance dose is 75-125 mcg/day (1.5 mcg/kg/day).
Geriatric Patients and Patients with Increased Sensitivity toThyroid Hormones:
12.5-25 mcg as a single dose initially; may beincreased q 6-8 wk; usual maintenance dose is 75 mcg/day.
Why is your patient getting this medication
Replacement/substitution in diminished or absent thyroidfunction.
For IV meds, compatibility with IV drips and/or solutions
 N/A
Mechanism of action and indications
(Why med ordered)
Levothyroxine acts like the endogenous thyroid hormonethyroxine (T
4
, a tetra-iodinated tyrosine derivative). In the liver and kidney, T
4
is converted to T
3
, the active metabolite. Inorder to increase solubility, the thyroid hormones attach tothyroid hormone binding proteins, thyroxin-binding globulin,and thyroxin-binding prealbumin (transthyretin). Transport and binding to thyroid hormone receptors in the cytoplasm andnucleus then takes place. Thus by acting as a replacement for natural thyroxine, symptoms of thyroxine deficiency arerelieved.
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Hypersensitivity, recent MI, thyrotoxicosis. Cardiovascular disease(initiate therapy with lower doses), secere renal insufficiency,uncorrected adrenocortical disorders, swallowing difficulty.Desiccated thyroid preparations (Armour thyroid, Thyrar) appear onBeers list due to concerns about cardiac effects. Also, Geriatric patientsareextremely sensitive to thyroid hormones in general and initialdosage should be markedly reduced. Myxedematous patients(extremely sensitive to thyroid hormones--initial dosage should bemarkedly reduced).
Common side effects
Insomnia, irritability, nervousness, CARIOVASCULAR COLLAPSE,arrhythmias, tachycardia, weight loss
Interactions with other patient drugs, OTC or herbalmedicines
(ask patient specifically)
Lanoxin
: The clearance of or sensitivity to digitalis glycosidesmay be increased in previously hypothyroid patients when aeuthyroid state is achieved after the addition of thyroidhormones.
Lantus, NovoLog
: The efficacy of oral hypoglycemic agentsand insulin may be diminished by certain drugs, includingthiazides and other diuretics, corticosteroids, estrogens, progestins, thyroid hormones, human growth hormone, phenothiazines, atypical antipsychotics, sympathomimeticamines, protease inhibitors, phenytoin, clozapine, megestrol,danazol, isoniazid, asparaginase, pegaspargase, diazoxide,temsirolimus, as well as pharmacologic dosages of nicotinicacid and adrenocorticotropic agents. These drugs may interferewith blood glucose control because they can causehyperglycemia, glucose intolerance, new-onset diabetesmellitus, and/or exacerbation of preexisting diabetes.
Food interactions
: Consumption of certain foods as well asthe timing of meals relative to dosing may affect the absorptionof T4 thyroid hormone (i.e., levothyroxine). T4 absorption isincreased by fasting and decreased by foods such as soybeanflour (e.g., infant formula), cotton seed meal, walnuts, dietaryfiber, calcium, and calcium fortified juices.
Lab value alterations caused by medicine
Monitor thyroid function studies prior to and during therapy. Monitor  blood and urine glucose in diabetic patients. Insulin or oralhypoglycemic dose may need to be increased.
Be sure to teach the patient the following about this medication
Instruct patient to take medication as directed at the same time eachday. Take missed doses as soon as remembered unless almost time for next dose. If more than 2-3 doses are missed, notify health care professional. Do not discontinue without consulting health care professional. Instruct patient and family on correct technique for checking pulse. Dose should be withheld and health care professionalnotified if resting pulse >100 bpm. Explain to patient that medicationdoes not cure hypothyroidism; it provides a thyroid hormone. Therapyis lifelong. Caution patient not to change brands of thyroid preparations, as this may affect drug bioavailability. Advise patient tonotify health care professional if headache, nervousness, diarrhea,excessive sweating, heat intolerance, chest pain, increased pulse rate, palpitations, weight loss >2 lb/wk, or any unusual symptoms occur.Caution patient to avoid taking other medications concurrently withthyroid preparations unless instructed by health care professional.Instruct patient to inform health care professional of thyroid therapy.Emphasize importance of follow-up exams to monitor effectiveness of therapy. Thyroid function tests are performed at least yearly.
Synthroid (levothyroxine)

Activity (44)

You've already reviewed this. Edit your review.
1 hundred reads
1 thousand reads
Shelby Thomey liked this
Alex Varughese liked this
Annie Marling liked this
Paige Rae Strope liked this
Nikki Bumbarger liked this
Colleen Berry liked this
Marmie24 liked this

You're Reading a Free Preview

Download
scribd
/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->