Question

B. A 55-year-old patient returns to the clinic for an annual evaluation of her thyroid status. She was diagnosed with hypothyroidism at age 25 and has taken Synthroid ever since. She feels well and answers all questions that lead to a belief that she is stable. She is on 100 mcg of the medication a day She has maintained that dose as "her dose" no matter the thyroid-stimulating hormone (TSH) value so that she can "function with her fast paced lifestyle". The chart shows that her TSH values are typically 0.02 or less since placed on the medication at time of diagnosis 1. What concerns do you have about this practice? Consider both short- and long-term considerations. 2. What labs or other tests do you need to order to establish whether there has been a hidden problem developing that is associated with her preference? 3. What organ systems has she placed at risk with this dosing schema?

please give patho of the disease and medication, medication of choice, dosage, education and side effects

Answer 1

Hypothyroidism results from hyposecretion of thyroid hormones T3 and T4 and characterized by a decreased rate of body metabolism. Thyroid hormones control the metabolic rate of tissues and accelerate heat production and oxygen consumption. Thyroid hormones are used to replace the thyroid hormone deficit in conditions such as hypothyroidism and myxedema. IT enhances the action of oral anticoagulants, sympathomimetics, and antidepressants and decrease the action of insulin, oral hypoglycemics, and digitalis preparations; the action of thyroid hormones is decreased by phenytoin and Tegretol. Thyroid hormones include Levothyroxine sodium, Liotrix. Levothyroxine sodium is the drug of choice.

Sideffects

• Nausea and decreased appetite.
• Abdominal cramps and diarrhea.
• Weight loss
• Nervousness and tremors
• Insomnia
• Sweating and heat intolerance
• Tachycardia,hypertension,headache.

Dosage

12.5 to 25mcg.

Patient education

• Instruct the client to take the medication at the same time each day, in the morning without food.
• Instruct the client on how to monitor the pulse rate.
• Instruct the client to avoid foods that can inhibit thyroid secretion, such as strawberries, peaches, pears.
• Advise the client to avoid over-the-counter medications.