A patient has been taking levothyroxine for several years and ...

[londonang]

A patient has been taking levothyroxine for several years and reports that for the past 2 weeks, the drug doesn't seem to work as well as before. What will the nurse do?
 
  a. Ask the patient when the prescription was last refilled.
  b. Expect the patient to have an elevated temperature and tachycardia.
  c. Suggest that the patient begin taking calcium supplements.
  d. Tell the patient to try taking the medication with food.

Question 2

A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching?
 
  a. I should not take heartburn medication without consulting my provider.
  b. I should report insomnia, tremors, and an increased heart rate to my provider.
  c. If I take a multivitamin with iron, I should take it 4 hours after the Synthroid.
  d. If I take calcium supplements, I may need to decrease my dose of Synthroid.

[flannelavenger]

Answer to Question 1

ANS: A
Not all levothyroxine preparations have the same drug bioavailability; therefore, if a patient is experiencing differing effects, the pharmacist may have switched brands. Asking a patient about a recent refill may help to explain why the drug has different effects. An elevated temperature and tachycardia would be signs of toxicity, not of a decrease in effectiveness. Calcium supplements and food would only interfere with absorption and further reduce the drug's effectiveness.

Answer to Question 2

ANS: D
Patients taking calcium supplements should take these either 4 hours before or after taking levothyroxine, because they interfere with levothyroxine absorption. Many heartburn medications contain calcium, so patients should consult their provider before taking them. Insomnia, tremors, and tachycardia are signs of levothyroxine toxicity and should be reported. Iron also interferes with levothyroxine absorption, so dosing should be 4 hours apart.

[londonang]

TYSM

[komodo7]

Gracias!