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Adrianne Bazo 11-18-08 Generic Name

levothyroxine

Trade Name
Synthroid

Clinical Medications Worksheets Classification Dose Route hormones 100 mcg PO Duration
1-3 wk

Time/frequency qD

Peak
1-3 wk

Onset
unknown

Normal dose range Usual maintenance dose is 75-125 mcg/day Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity Common side effects
insomnia, irritability, nervousness, arrhythmias, tachycardia, weight loss

Mechanism of action and indications (Why med ordered)
Principal effect is increasing metabolic rate of body tissues: Promote gluconeogenesis, Increase utilization and mobilization of glycogen stores, Stimulate protein synthesis, Promote cell growth and differentiation hypothyroidism

Interactions with other patient drugs, OTC or herbal medicines (ask patient specifically)
None for this patient

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 oral hypoglycemic dose may need to be increased

Be sure to teach the patient the following about this medication
Advise patient to notify 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. Teach correct technique for checking pulse. Therapy is lifelong

Nursing Process- Assessment (Pre-administration assessment)
Assess apical pulse and blood pressure prior to and periodically during therapy. Assess for tachyarrhythmias and chest pain

Assessment Why would you hold or not give this med?
Dose should be withheld and health care professional notified if resting pulse >100 bpm. s/s of toxicity- manifested as hyperthyroidism- ↑HR, chest pain, nervousness, insomnia, diaphioresis, tremors, wt. loss

Evaluation Check after giving
Resolution of symptoms of hypothyroidism, Diuresis,Weight loss, Increased energy, pulse rate, appetite, psychomotor activity, increased T3 and T4 levels