Drug name and Action
Levothyroxine
Thyroid hormones are a synthetic form of thyroxine (T4), a form of liothyronine (T3), increase Metabolic rate, protein synthesis, cardiac output, renal perfusion, oxygen use, body temperature, blood volume, and growth processes
What are the side/ adverse effects of Levothyroxine?
Nausea and decreased appetite, abdominal cramps and diarrhea, weight loss, Nervousness and tremors, insomnia,SWEATING, heat intolerance, TACHYCARDIA, Dysrhythmia, PALPITATIONS, CHEST PAIN, Hypertension, HYPERTHYROIDISM
What are the nursing interventions for Levothyroxine?
Assessed patient history of medications currently taken, Monitored vitals, Monitored weight, Monitor triiodothyronine, thyroxine, and TSH levels, TAKE IN THE MORNING WITHOUT FOOD, SAME TIME EVERY DAY, instruct client how to monitor their pulse rate, DISCUSS DIET/ WHICH FOOD CLIENT CAN NOT HAVE WHILE TAKING THIS MED, AVOID OVER THE COUNTER MEDS, WEAR MEDICAL ALTER BRACELET
How often should thyroid hormones be given with other medications?
TH need to be given at least 4 hours apart from multivitamins, calcium, etc because these medications decrease the absorption of TH replacements.
Client teaching for Levothyroxine
Take daily on empty stomach 30-60mins before breakfast
Do not discontinue without checking with your PCP (life-long medication)
Check with a provider before switching to a different brand of levothyroxine
Methimazole
Blocks the synthesis of TH, prevents the oxidation of iodide, and blocks the conversion of T4 into T3.....Treatment of Graves' disease, used in the emergency treatment of thyrotoxicosis, first-line therapy
What are the side effects of Methimazole?
Nausea and Vomiting, Diarrhea, drowsiness, headache, fever, hypersensitivity with skin rash, Agranulocytosis with leukopenia and thrombocytopenia, Alopecia, and Hyperpigmentation, hypothyroidism, IODISM: VOMITING, ABDOMINAL PAIN, METALLIC OR BRASSY TASTE IN THE MOUTH, RASH, SORE GUMS, AND SALIVARY GLANDS, MONITOR FOR JAUNDICE, DARK URINE, LIGHT COLORED STOOLS, AND ELEVATED LIVER FUNCTION TESTS
what are the Nursing interventions for methimazole?
Monitor Vitals, Monitor triiodothyronine, thyroxine, and TSH levels, monitor weight, TAKE MEDS WITH MEALS TO AVOID GI UPSET, monitor pulse rate, REPORT ANY SIGNS OF HYPOTHYROIDISM, DO NOT ABRUPTLY STOP MEDS, monitor for signs/symptoms of THYROID STROM (FEVER, FLUSHED SKIN, CONFUSION, AND BEHAVIORAL CHANGES, TACHYCARDIA, DYSRHYTHMIAS, AND SIGNS OF HEART FAILURE), MONITOR FOR SIGNS OF IODISM, consult PCP before eating iodized salt and iodine-rich foods, DO NOT TAKE ASPIRIN AND MEDICATIONS CONTAINING IODINE
Take precautions with Methimazole
caution in clients who are pregnant (can use during the second and third trimester), have bone marrow depression/ or immunosuppression and in clients at risk for liver failure
Patient teaching for methimazole
Report fever, chills, headache, malaise, and weakness, meds take 1-2 weeks to be evident while full benefits take 3-12 weeks, take with food at the same time to decrease GI upset, DO NOT ABRUPTLY STOP THIS MED, DO NOT USE OVER THE COUNTER MEDS, AVOID CONSUMPTION OF SHELLFISH, AND OTHER IODINE PRODUCT
Glucocorticoids (Prednisone) (ending in one)
Memic the effect of natural steroid hormones, an acute and chronic replacement for Addison's disease, adrenal crisis
What are the side effects of Glucocorticoids?
Hyperglycemia, Hypokalemia, Hypocalcemia, osteoporosis, sodium and fluid retention, weight gain, and edema, mood swings, moon face, buffalo hump, truncal obesity, increased susceptibility to infection and masking of the signs and symptoms of infection, cataracts, Hirsutism, acne, fragile skin, bruising, growth retardation in children, GI irritation, peptic ulcer, pancreatitis, seizure, psychosis, Addison disease
what are the Nursing interventions for Glucocorticoids?
Monitor vitals, serum electrolytes, and blood glucose levels, hypokalemia, hyperglycemia, I&Os, weight, and for edema, and hypertension...check medical history for glaucoma, cataracts, peptic ulcer, mental health disorders, diabetes mellitus, monitor the older client for signs and symptoms of increased osteoporosis, check for any change in muscle strength, TAKE EARLY MORNING WITH FOOD OR MILK, EAT FOODS HIGH IN POTASSIUM, AVOID INDIVIDUALS WITH INFECTIONS
Glucocorticoids precautions
Use is contraindicated in clients who have an active infection not controlled by antibiotics, use with caution in clients who have had a recent MI, gastric ulcer, hypertension, kidney disorder, osteoporosis, diabetes mellitus, cirrhosis, hypothyroidism, myasthenia gravis, glaucoma, or seizure disorder, DO NOT USE ALCOHOL, NSAIDs, ACETAMINOPHEN
Client teaching for Glucocorticoids
Teach the patient to observe for manifestations of peptic ulcer ( coffee-ground emesis, bloody or tarry stools, abdominal pain) and notify PCP if these symptoms occur, notify PCP of manifestations of acute adrenal insufficiency (fever, muscle, and joint pain, weakness, fatigue), DO NOT ABRUPTLY STOP THIS MEDICATION, TALK WITH PCP BEFORE GETTING VACCINATIONS, WEAR A MedicAlert BRACELET, MAY NEED ADDITIONAL DOSE IN TIMES OF STRESS