Levothyroxine (t4)

INDEX Generic Name levothyroxine Peak 3-4 wk

Trade Name

Onset

NURS 2236 Clinical Form 3: Clinical Medications Worksheet (You will need to made additional copies of these forms) Classification Dose Route Time/Frequency Throid hormone

50 mcg

Duration 1-3 wk

Normal Dosage range

Why is your patient taking this medication? Thyroid replacement hormone Mechanism of action and indications Hypothyroidism, myxedema coma; thyroid hormone replacemnt; congenital hypothyroidism; some types of thyroid cancer. Increases metabolic rate, controls protein synthesis, increases cardiac output, renal blood flow, O2 consumption, body temp, blood volume, growth, development at cellular level, exact mechanism unknown.

Interactions with other patient drugs, OTC, or herbal medicines (ask patient specifically) Cholestyramine; colestipol; epinephrine; norepinephrine oral anticoagulants.

Nursing Process - Assessment (Pre-administration assessment Monitor pulse, if >100 call doctor; Monitor Blood pressure; weight; PT; signs of bleeding, bruising; increased nervousness; excitability; angina; palpitation; chest pain.

PO

qday

50 mcg/day max 200 mcg/day For IV meds, compatability with IV drips and/or solutions

Nursing Implications (what to focus on) Contraindications/warnings/interactions Adrenal insufficiency, recent MI thyrotoxicosis; hypersensitivity to beef, alcohol intolerance. severe cardiovascular conditions; obesity treatment. Caution in: cardiac disease; angina pectoris; cardiac arrhythmias; hypertension; diabetes mellitus. Common side effects Irritability; nervousness; insomnia; headache; tremors; palpitations; tachycardia; arrhythmias; angina pectoris; hypertension; nausea; diarrhea; change in appetite; menstrual irregularities; weight loss; heat intolerance; sweating; fever; leg cramps; temporary hair loss.

Lab value alterations caused by medicine T3, T4, FTIs, which are decreased; radioimmunassay of TSH, increased; radio uptake, increased if patient is on too low a dose. Closely monitor PT/INR for bleeding; Be sure to teach the patient the following about this medication Thyroid replacement is lifelong; self monitoring of pulse rate; notify doctor if pulse is >100, chest pain, palpations, nervousness. The drug is not to be taken for weight loss; avoid iodine food, iodized salt, soybeans, tofu, turnips, high-iodine seafood, some bread. drug doesn't cure but controls symptoms and treatment is lifelong. Assessment Evaluation Why would you hold or not give Check after giving this med? absence of depression; increased weight loss, pulse >100 diuresis, pulse, appetite; absence of constipation, angina pectoris; arrhythmias; hypertension peripheral edema, cold intolerance, pale, cool, dry skin, brittle nails, alopecia, coarse hair, menorrhagia, night blindness, syncope, stupor, coma, rosy cheeks.

tion,