A patient who has been taking methimazole (Tapazole) for 3 weeks ...

[vinney12]

A patient who has been taking methimazole (Tapazole) for 3 weeks has all of the following laboratory blood test results. Which result does the nurse report immediately to the prescriber?
 
  a. White blood cell count 3500 cells/mm3
  b. Lactate dehydrogenase 990 IU/L
  c. Sodium 132 mEq/L
  d. Hematocrit 32

Question 2

Why does a patient who is taking drugs for thyroid suppression continue to have symptoms of hyperthyroidism for 3 weeks (or longer) after drug therapy is started?
 
  a. Thyroid hormones are stored and thyroid suppressing drugs only stop the synthe-sis of new hormones.
  b. At first, the patient's metabolism is so high that the thyroid cells continue to syn-thesize thyroid hormones.
  c. The activity of the intestinal tract is increased and the drug is eliminated before complete suppression can occur.
  d. The side effects of thyroid suppression drugs are so uncomfortable that most pa-tients do not take the full dose of the drug that is needed to prevent further hor-mone secretion.

[alexanderhamilton]

Answer to Question 1

B
All of these blood values are abnormal; however, only the lactate dehydrogenase level is very high (four times normal). This value indicates liver impairment. Methimazole can cause liver impairment. This value must be reported immediately so that liver function can be explored and any needed changes in drug therapy made before irreversible liver damage occurs.

Answer to Question 2

A
Thyroid-suppressing drugs enter the thyroid gland and combine with the enzyme responsible for connecting iodine (iodide) with tyrosine to make active thyroid hormones, preventing further thyroid hormone synthesis. These drugs do not affect the hormones already formed and stored in the thyroid gland, so it may take as long as 3 or 4 weeks for the person to use up all the thyroid hormones made before the drug was started. Until that time, the person continues to have symp-toms of hyperthyroidism.

[vinney12]

Thank you!

[alexanderhamilton]

Always glad to help...