Hypothyroidism Treated With Levothyroxine

Hypothyroidism Treated With Levothyroxine0

Hypothyroidism Treated With Levothyroxine4

Patient Details4

Age4

Sex4

Past Medical History of Mary4

Diagnosis4

Renal-Hepatic Function5

Treatment with Other Medicines6

Pregnant or Breast Feeding6

Allergies6

Levothyroxine7

Brand names of Levothyroxine7

Product License7

Product Levothyroxine licensed7

Dose/ Route8

Dose8

Route8

Why this Route/Dose?8

Was an Adjustment Required?9

What Preparations are required?9

Diluents9

Concentration9

Pharmacodynamics of Levothyroxine10

Action of the Drug10

Working of Drug10

Contraindications of Levothyroxine11

Contraindications11

Cautions for the Use of Levothyroxine11

Does Mary have any Contraindications?12

Reason12

Drug Interactions13

Main Interactions of Drugs13

Does Mary is at High Risk14

Does Drug is at High Risk14

Does any Other Drug "which Mary is using" has Interactions with Levothyroxine16

How to Minimize the Risk of Interaction17

Side effects of Levothyroxine18

Main Side Effects of Drug18

How the Side Effects of Levothyroxine can be minimized20

Counseling for the Patient21

Patient Monitoring while the Administration of Levothyroxine21

Monitoring of Patient21

Patient Monitoring and Link with the Side Effects22

Medication Incidents22

Due to Medicine Itself22

Due to Route23

Medication Errors Associated with Mary23

Any existing NPSA/MHRA reports23

Conclusion24

References25

Hypothyroidism Treated With Levothyroxine

Patient Details

Age

Mary is 45 years old

Sex

Female

Past Medical History of Mary

Mary's past Medical History revealed excessive alcohol intake. She was apparently healthy and fit. Mary lives in nursing Home for rehabilitation of excessive alcohol use and overdosing of paracetamol. Mary does not take any medication previously.

Diagnosis

Mary is diagnosed with Hypothyroidism when she informed her physician that she put 31kgs of weight in three months. She is unable to tolerate coldness; she feels weakness and fatigue accompanied by Constipation and heavy menstrual flow.

General Practitioner of Mary has taken blood tests which resulted in 4.1-5.0mu/l of thyroid hormone levels "in the blood". TSH levels are also abnormal in the blood. According to British Thyroid Association, normal range of thyroid functions in the blood of adults is 0.4-2.5mu/l. The results of the blood reports of Mary revealed that she is likely to develop Hypothyroidism. The Thyroid stimulating Hormone test is widely used in United Kingdom to test the function of thyroid glands (BTA, 2010). Mary is now treated with Levothyroxine (50mcg) to overcome the deficiency of thyroid hormones (NPC, 2012).

Renal-Hepatic Function

The renal functioning of Mary appears to be normal before the start of treatment with l-thyroxine. It is truly necessary to monitor the renal functions in the body of patient as the thyroid abnormalities adversely affect the renal function. Hypothyroidism develops diuresis in hypothyroid patients because the thyroid hormone increases the flow of blood to kidneys and also promotes a rise in the amount of plasma level, which is filtered by kidneys. Thyroid diseases influence the renal functioning by creating alterations in the renal elimination of drugs which are excreted in urine. Patients with abnormal renal functioning needs close monitoring.

National Patient Safety Agency (NPSA) suggests that precautions are necessary in patients with Hepatitis B and cirrhosis. Such patients "when treated with Levothyroxine" should be specially monitored. Levothyroxine promotes the hepatic gluconeogenesis in the patients. The nurses should monitor in the affected patients signs of jaundice, pale stools, dark urine and abdominal pain. All these symptoms should be monitored in Mary. Blood sugar levels of Mary should also be checked weekly (Griffiths, et al, 2006).

Thyroid hormones increase the production of glucose ...