# data[].attributes.body
It is a tablet, given oral route, onset of action happens 12 to 18 hours. The distribution is concentrated in thyroid gland, metabolized by liver, and excreted by kidney. Initial dose is individualized by T4 levels.
Free T4 levels 1 to 1.5 times ULN: 5 to 10 mg once daily
1.5 to 2 times: 10 to 20 mg once daily
more than 2 times: 20 to 40 mg once daily.
Maintenance dose: 5 to 10 mg once daily with 4-6 week total T3 and free T4 assessment.
Image from: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=a57ff449-e3b7-48b6-9acf-c719a9770e8a&type=display

SYC

# data[].attributes.body
Hyperthyroidism associated with
- Graves disease
- Toxic multinodular goiter
- Toxic adenoma
- Iodine-induced thyrotoxicosis
Thyroid Storm
Thyrotoxicosis, type I amodarone-induced
Image from: https://www.ezmedlearning.com/blog/hyperthyroidism-vs-hypothyroidism-symptoms

SYC

# data[].attributes.body
Thyroid hormone synthesis inhibitor that is used for treatment of hyperthyroidism. It blocks the oxidation of iodine in the thyroid gland, and also blocks synthesis of T3, yet does not inactivate circulating T4 and T3 already in blood.
Image from: https://doctorlib.info/pharmacology/pharmacology-examination-board-review/38.html

SYC

# data[].attributes.body
Common:
- Rash
- Arthritis

Serious:
- Hypothyroidism (drowsiness, depression, weight gain, edema, dry skin, etc.)
- Agranulocytosis (sore throat, fever)
- Vasculitis
- Pancreatitis
- Aplastic Anemia
- Hepatotoxicity

SJ

# data[].attributes.body
Pre-administration:
Contraindicated in pregnancy (Category D)
Educate that therapeutic effect can take 1-2 weeks

Administration:
Wear gloves when handling, double gloves if cutting, crushing, or manipulating uncoated tablets

Post administration/Monitoring:
Thyroid function tests should be conducted 2-6 weeks after initiation, 4-6 weeks after dose change, then every 2-3 months once stabilized.
Monitor TSH and T4 levels
Hypothyroidism can occur, routinely monitor and adjust dosage accordingly
Advise patient to report any symptoms of serious adverse reactions
- new rash, hematuria, drug fever, dyspnea, etc.
Medication should be taken at consistent times each day and with meals

SJ

# data[].attributes.body
Should not be used with:
Bupropion
Tegafur

Concurrent use with anticoagulants increases anticoagulation
Concurrent use with digoxin can increase glycoside levels

SJ

# data[].attributes.body
A patient taking Methimazole is preparing for discharge and the nurse is providing discharge education. Which of the following indicates the patient understood the teaching?
A. It's fine if I take this medication at different times each day
B. This medication will help with my hypothyroidism
C. I need to get my thyroid checked every 2-3 months after taking this medication for a while
D. If I get pregnant while on this medication, I can keep taking it.

SJ

# data[].attributes.body
Methimazole Tablets, USP. (n.d.). Lexicomp. Retrieved June 10, 2022, from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=a57ff449-e3b7-48b6-9acf-c719a9770e8a&type=display

Methimazole. Dynamed. Retrieved June 10, 2022, from https://www.dynamed.com/drug-monograph/methimazole#GUID-DA8A5482-0B82-4D4D-8B71-0FBFFF827227

Holman, H. C., Williams, D., Sommer, S., Johnson, J., Ball, B. S., Morris, C., Wheless, L. K., McMichael, M., Roland, P., Leehy, P., & Hertel, R. (2019). RN Pharmacology for Nursing: Review Module 8th Edition. Assessment Technologies Institute.

# data[].attributes.attachment_link.description
Published by EBSCO Information Services. Copyright © 2022, EBSCO Information Services. All rights reserved. No part of this may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, with…