Levothyroxine Therapy Quiz
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Questions and Answers

What is the standard of care for long-term treatment of hypothyroidism?

  • Insulin
  • Levothyroxine (correct)
  • Adrenergic agents
  • Warfarin

    • What is the BLACK BOX WARNING issued by the FDA cautioning prescribers about?

  • Using levothyroxine for hypothyroidism
  • Adverse effects of levothyroxine in older adults
  • Interactions of levothyroxine with other medications
  • Ordering thyroid hormones for the treatment of obesity or weight loss (correct)

    • What may induce profound somnolence and respiratory depression?

  • Adrenergic agents
  • Levothyroxine
  • Warfarin
  • Hypnotic and sedative agents in small IV doses (correct)

    • What is the absorption range of levothyroxine after oral administration?

    <p>48% to 79%</p> Signup and view all the answers

    What does levothyroxine increase in the body's tissues?

    <p>Metabolic rate</p> Signup and view all the answers

    What requires prompt, aggressive management?

    <p>Severe hypothyroidism and myxedema coma</p> Signup and view all the answers

    Which medication interacts with oral thyroid hormones?

    <p>Warfarin</p> Signup and view all the answers

    What may levothyroxine cause in older adults, especially those with cardiovascular disease?

    <p>Serious adverse effects</p> Signup and view all the answers

    What does the hepatic metabolism of levothyroxine in patients with hypothyroidism result in?

    <p>Slow drug metabolism</p> Signup and view all the answers

    What are adverse effects of levothyroxine?

    <p>Signs and symptoms of hyperthyroidism</p> Signup and view all the answers

    What is a contraindication for levothyroxine therapy?

    <p>Hypersensitivity</p> Signup and view all the answers

    When should levothyroxine be taken?

    <p>In the morning on an empty stomach</p> Signup and view all the answers

    What is a consideration for patients with Addison's disease regarding levothyroxine therapy?

    <p>They require corticosteroids before levothyroxine administration</p> Signup and view all the answers

    What is the initial approach to dosing levothyroxine?

    <p>Start with a small dosage, gradually increasing at 2-week intervals</p> Signup and view all the answers

    What are the parameters for assessing therapeutic effects of levothyroxine therapy?

    <p>Energy levels, pulse rate, bowel regularity, and laboratory values</p> Signup and view all the answers

    What should patients avoid when taking levothyroxine?

    <p>Switching between drug brands</p> Signup and view all the answers

    What are the adverse effects that should be assessed during levothyroxine therapy?

    <p>Tachycardia, cardiac dysrhythmias, chest pain, and signs of heart failure</p> Signup and view all the answers

    What is the impact of excessive thyroid hormones on cardiac workload?

    <p>It increases cardiac workload, leading to myocardial ischemia symptoms when prolonged</p> Signup and view all the answers

    What is a consideration for dosage adjustment of levothyroxine?

    <p>Age, severity of hypothyroidism, and clinical response</p> Signup and view all the answers

    What is a lifelong requirement for patients undergoing levothyroxine therapy?

    <p>Periodic tests of thyroid function</p> Signup and view all the answers

    What is the general range for the daily dosage of synthetic levothyroxine for the treatment of hypothyroidism?

    <p>75 to 150 mcg</p> Signup and view all the answers

    What is the recommended starting dose for synthetic levothyroxine treatment?

    <p>Lower dose</p> Signup and view all the answers

    What dosage of synthetic levothyroxine is often sufficient to achieve normal TSH levels in older adult patients?

    <p>50 mcg per day</p> Signup and view all the answers

    What may some patients on thyroid hormone replacement complain of despite having normal TSH levels?

    <p>Continued clinical manifestations</p> Signup and view all the answers

    Why does the occurrence of angina and acute coronary syndrome signal a problem when thyroid replacement is initiated?

    <p>Thyroid hormones enhance the cardiovascular effects of catecholamines</p> Signup and view all the answers

    What is the consequence of thyroid hormone administration on oxygen demand and delivery in patients with atherosclerosis?

    <p>Oxygen demand increases, but delivery may not improve</p> Signup and view all the answers

    Why might patients with long-standing hypothyroidism have associated elevated serum cholesterol and atherosclerosis?

    <p>Metabolism is subnormal and tissues require relatively little oxygen</p> Signup and view all the answers

    What is the signal that the oxygen needs of the myocardium exceed its blood supply?

    <p>Occurrence of angina and acute coronary syndrome</p> Signup and view all the answers

    Why can angina or arrhythmias occur when thyroid replacement is initiated?

    <p>Thyroid hormones enhance the cardiovascular effects of catecholamines</p> Signup and view all the answers

    What is the drug of choice for the treatment of hypothyroidism?

    <p>Synthetic levothyroxine</p> Signup and view all the answers

    What is the general range of synthetic levothyroxine for the treatment of hypothyroidism?

    <p>75 to 150 mcg per day</p> Signup and view all the answers

    How is the treatment generally started for synthetic levothyroxine?

    <p>At the lower dose and titrated slowly</p> Signup and view all the answers

    What dose of synthetic levothyroxine is often sufficient for achieving normal TSH levels in older adult patients?

    <p>50 mcg per day</p> Signup and view all the answers

    What might some patients on thyroid hormone replacement complain of despite normal TSH levels?

    <p>Continued clinical manifestations</p> Signup and view all the answers

    Why might angina or arrhythmias occur when thyroid replacement is initiated?

    <p>Thyroid hormones enhance the cardiovascular effects of catecholamines</p> Signup and view all the answers

    What is the signal that the oxygen needs of the myocardium exceed its blood supply?

    <p>The occurrence of angina and acute coronary syndrome</p> Signup and view all the answers

    What occurs when thyroid hormone is given in relation to oxygen demand and delivery?

    <p>Oxygen demand increases, but delivery cannot be increased unless atherosclerosis improves</p> Signup and view all the answers

    What usually occurs as long as metabolism is subnormal and tissues require relatively little oxygen?

    <p>A reduction in blood supply is tolerated without overt symptoms of coronary artery disease</p> Signup and view all the answers

    What is the drug of choice for the treatment of hypothyroidism?

    <p>Synthetic levothyroxine</p> Signup and view all the answers

    What is the range for the general dose of synthetic levothyroxine for the treatment of hypothyroidism in older adult patients?

    <p>Lower dose</p> Signup and view all the answers

    What should patients avoid doing when taking levothyroxine?

    <p>Switching between different drug brands</p> Signup and view all the answers

    In which patients should caution be exercised when administering levothyroxine?

    <p>Patients with Addison's disease</p> Signup and view all the answers

    What is a contraindication to levothyroxine therapy?

    <p>Hypersensitivity</p> Signup and view all the answers

    How should levothyroxine be taken?

    <p>In the morning on an empty stomach</p> Signup and view all the answers

    What is the initial approach to dosage adjustment for levothyroxine therapy?

    <p>Start with a small dosage, gradually increasing at 2-week intervals</p> Signup and view all the answers

    What should be assessed to determine the therapeutic effects of levothyroxine therapy?

    <p>Energy levels, pulse rate, and laboratory values</p> Signup and view all the answers

    What are potential adverse effects that should be assessed during levothyroxine therapy?

    <p>Tachycardia and signs of heart failure</p> Signup and view all the answers

    What increases tissue metabolism and demands for adrenocortical hormones?

    <p>Thyroid hormones</p> Signup and view all the answers

    What factors affect the dosage of levothyroxine?

    <p>Drug choice, age, severity of hypothyroidism, and clinical response</p> Signup and view all the answers

    What should patients be taught about levothyroxine therapy?

    <p>The lifelong nature of therapy and the need for periodic tests of thyroid function</p> Signup and view all the answers

    Study Notes

    Levothyroxine Therapy Considerations

    • Excessive thyroid hormones increase cardiac workload, leading to myocardial ischemia symptoms when prolonged
    • Elderly and heart disease patients are more prone to cardiovascular problems
    • Contraindications to levothyroxine include hypersensitivity, thyrotoxicosis, and acute myocardial infarction related to hypothyroidism
    • Caution is warranted in Addison's disease, as patients require corticosteroids before levothyroxine administration
    • Thyroid hormones increase tissue metabolism and demands for adrenocortical hormones
    • Dosage of levothyroxine is affected by drug choice, age, severity of hypothyroidism, and clinical response
    • Initial dosage is small, gradually increasing at 2-week intervals until symptoms are relieved and a normal serum TSH level is reestablished
    • Levothyroxine should be taken in the morning on an empty stomach and not changed between brands
    • Assessment for therapeutic effects includes energy levels, pulse rate, bowel regularity, and laboratory values
    • Adverse effects assessment involves tachycardia, cardiac dysrhythmias, chest pain, and signs of heart failure
    • Patient teaching includes the lifelong nature of levothyroxine therapy and the need for periodic tests of thyroid function
    • Patients should avoid switching between drug brands and consult a healthcare provider before taking over-the-counter drugs that stimulate the heart or cause nervousness

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    Description

    Test your knowledge of levothyroxine therapy with this quiz. Covering key facts, considerations, and therapy guidelines, this quiz will help you understand the administration, interactions, contraindications, and adverse effects of levothyroxine.

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