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Questions and Answers
What is the standard of care for long-term treatment of hypothyroidism?
What is the BLACK BOX WARNING issued by the FDA cautioning prescribers about?
What may induce profound somnolence and respiratory depression?
What is the absorption range of levothyroxine after oral administration?
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What does levothyroxine increase in the body's tissues?
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What requires prompt, aggressive management?
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Which medication interacts with oral thyroid hormones?
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What may levothyroxine cause in older adults, especially those with cardiovascular disease?
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What does the hepatic metabolism of levothyroxine in patients with hypothyroidism result in?
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What are adverse effects of levothyroxine?
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What is a contraindication for levothyroxine therapy?
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When should levothyroxine be taken?
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What is a consideration for patients with Addison's disease regarding levothyroxine therapy?
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What is the initial approach to dosing levothyroxine?
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What are the parameters for assessing therapeutic effects of levothyroxine therapy?
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What should patients avoid when taking levothyroxine?
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What are the adverse effects that should be assessed during levothyroxine therapy?
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What is the impact of excessive thyroid hormones on cardiac workload?
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What is a consideration for dosage adjustment of levothyroxine?
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What is a lifelong requirement for patients undergoing levothyroxine therapy?
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What is the general range for the daily dosage of synthetic levothyroxine for the treatment of hypothyroidism?
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What is the recommended starting dose for synthetic levothyroxine treatment?
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What dosage of synthetic levothyroxine is often sufficient to achieve normal TSH levels in older adult patients?
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What may some patients on thyroid hormone replacement complain of despite having normal TSH levels?
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Why does the occurrence of angina and acute coronary syndrome signal a problem when thyroid replacement is initiated?
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What is the consequence of thyroid hormone administration on oxygen demand and delivery in patients with atherosclerosis?
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Why might patients with long-standing hypothyroidism have associated elevated serum cholesterol and atherosclerosis?
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What is the signal that the oxygen needs of the myocardium exceed its blood supply?
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Why can angina or arrhythmias occur when thyroid replacement is initiated?
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What is the drug of choice for the treatment of hypothyroidism?
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What is the general range of synthetic levothyroxine for the treatment of hypothyroidism?
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How is the treatment generally started for synthetic levothyroxine?
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What dose of synthetic levothyroxine is often sufficient for achieving normal TSH levels in older adult patients?
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What might some patients on thyroid hormone replacement complain of despite normal TSH levels?
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Why might angina or arrhythmias occur when thyroid replacement is initiated?
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What is the signal that the oxygen needs of the myocardium exceed its blood supply?
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What occurs when thyroid hormone is given in relation to oxygen demand and delivery?
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What usually occurs as long as metabolism is subnormal and tissues require relatively little oxygen?
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What is the drug of choice for the treatment of hypothyroidism?
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What is the range for the general dose of synthetic levothyroxine for the treatment of hypothyroidism in older adult patients?
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What should patients avoid doing when taking levothyroxine?
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In which patients should caution be exercised when administering levothyroxine?
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What is a contraindication to levothyroxine therapy?
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How should levothyroxine be taken?
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What is the initial approach to dosage adjustment for levothyroxine therapy?
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What should be assessed to determine the therapeutic effects of levothyroxine therapy?
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What are potential adverse effects that should be assessed during levothyroxine therapy?
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What increases tissue metabolism and demands for adrenocortical hormones?
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What factors affect the dosage of levothyroxine?
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What should patients be taught about levothyroxine therapy?
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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.
