Levothyroxine (synthroid)

INDEX Generic Name levothyroxine

Trade Name Synthroid

Peak Onset 1-3 weeks unknown Why is your patient taking this medication?

NURS 2236 Clinical Form 3: Clinical Medications Worksheet (You will need to made additional copies of these forms) Classification Dose Route Time/Frequency hormones 75-125mcg PO daily (1.5mcg/kg/day) thyroid preparations Duration 1-3 weeks

Mechanism of action and indications Replacement/substitution in diminished or absent thyroid function. Thyroid cancer (some forms) Replacement in deficiency states with restoration of normal hormonal balance. Suppression of thyrotropin-dependent thyroid cancers.

Interactions with other patient drugs, OTC, or herbal medicines (ask patient specifically) Bile acid sequestrants; warfarin; insulin; oral hypoglycemic agents; estrogen; adrenergics; beta blockers.

For IV meds, compatability with IV drips and/or solutions

Nursing Implications (what to focus on) Contraindications/warnings/interactions Hypersensitivity; recent MI; thyrotoxicosis; alcohol intolerance; hypersensitivity to beef; use cautiously in: CVD; severe renal insufficiency; uncorrected adrenocortical disorders; swallowing difficulty; geriatric. Common side effects insomnia; irritablity; nervousness; headache; cardiovascular collapse; arrhythmias; tachycardia; angina pectoris; hypotension increased BP; increased CO; cramps; diarrhea; vomiting; levothyroxine tablets; choking; gagging; dysphagia; increase sweating; hyperthyroidism; menstrual irregularities; weight loss; heat intolerance; Lab value alterations caused by medicine

Be sure to teach the patient the following about this medication Take at same time every day; check apical pulse (hold if >100); call doctor for HA; nervousness; diarrhea; excessive sweating; heat intolerance; chest pain; palpitations; weight loss (>2lb/wk); take with water (may get stuck in throat, and difficulty swallowing if not. Nursing Process - Assessment (Pre-administration assessment Vital signs (apical pulse BP) for tachyarrhythmias and chest pain.

Assessment Why would you hold or not give this med? hyperthyroidism pulse >100

Evaluation Check after giving Resolution of symptoms of hypothyroidism; Diuresis; weight loss; increased sense of well being; increased energy; pulse rate; appetite; psychomotor activity; normalization of skin texture and hair; correction of constipation.