Med Names
Prototype Med |
Levothyroxine (Synthroid) |
Other Meds |
liothyroxine (Cytomel) |
| |
liotrix (Thyrolar) |
| |
Thyroid USP |
Action: Levothyroxine is a synthetic form of thyroxine or T4 which is then converted to T3 in the body
Adverse Drug Reactions
Thyrotoxicosis, Hyperthyroidism (from excessive doses) |
Headache, irritability, insomnia |
Abdominal cramping, diarrhea |
Tachycardia, arrhythmia |
Heat intolerance, diaphoresis |
Menstrual irregularities |
Nursing Interventions
Monitor thyroid function |
Monitor for indications of hyperthyroidism (anxiety, tachycardia, palpi- tations, tremors, altered appetite, heat intolerance, fever, diaphoresis, weight loss) |
Patient Education
Watch for and report nervousness, rapid heart rate, palpitations, trem- ors, altered appetite, heat intolerance, fever, sweating, weight loss, and chest pain. |
Contraindications
Thyrotoxicosis |
Recent myocardial infarction |
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Precautions
Cardiovascular disorders (hypertension, angina pectoris, ischemic heart disease) |
Renal impairment |
Diabetes mellitus |
Older adults |
Administration
Give orally to treat hypothyroidism and IV to treat myxedema coma. |
Give daily on an empty stomach (at least 30–60 min before breakfast with full glass of water). |
Measure baseline vital signs, weight, and height, and monitor periodical- ly thereafter. |
Monitor for cardiac excitability (angina, chest pain, palpitations, dys- rhythmias). |
Monitor T4 and TSH levels. |
Be aware that the various formulations of thyroxine are not inter- changeable; instruct clients to notify the provider if a pharmacy dispens- es a different levothyroxine product. |
Expect lifelong replacement therapy. |
Interactions
Cholestyramine (Questran), antacids, iron and calcium supplements, and sucralfate (Carafate) reduce absorption, so clients should not take levothyroxine within 4 hr of these drugs |
Food reduces absorption |
Many antiseizure and antidepressant drugs, including carbamazepine (Tegretol), phenytoin (Dilantin), phenobarbital, and sertraline (Zoloft), decrease levels. |
Anticoagulant effects of warfarin (Coumadin) increase. |
Cardiac response to catecholamines (such as epinephrine) increases. |
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