Adrianne Bazo 11-18-08 Generic Name
Trade Name
levothyroxine
Synthroid
Clinical Medications Worksheets Classification Dose Route hormones 100 mcg PO
Peak
Onset
Duration
1-3 wk
unknown
1-3 wk
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
Time/frequency qD
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
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