Clinical Medication Worksheet

Generic Name Trade Name Classification Dose Route Time/frequency

Levothyroxine Synthroid Hormone 150 mcg PO QD

Peak Onset Duration For IV meds, compatibility with IV drips and /or
solutions:
1 – 3 weeks Unknown 1 – 3 weeks NA
Nursing Implications (what to focus on)
Why Med ordered: Contraindications/warnings/interactions:
Hypersensitivity
Hypothyroidism
Common side effects:

Mechanism of action and indications: Excessive dose may cause hyperthyroidism, nervousness,
and headache
Replacement of or supplementation to endogenous
thyroid hormones. Increases metabolic rate of body
tissues: promotes gluconeogenesis, stimulates protein
synthesis.

Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically):
Take other meds 1 hr before or 2 hrs after.
Lab value alterations caused by medicine:
Monitor TSH concentrations 8 – 12 if brand is changed
Be sure to teach the patient the following about this
medication:

Take at same time daily, take missed dose ASAP. Call Dr. if
heat intolerant, chest pain, weight loss greater than 2 lbs.
per week. Take separate from other meds. Take with water.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration) Why would you hold or not give this Check after giving
med?
Assess apical pulse and BP, Chest pain, Tachycardia, diaphoresis, wt loss Resolution of
tachyarrhythmias hypothyroidism and
normalization of thyroid
hormone lab levels