Problem
Case Study Thyroid Disorder
Maria is a 29-year-old woman with a seven-month history of heavy, irregular menses, a 5-lb weight gain, constipation, and decreased energy. Her past history is unremarkable. She takes no prescription medications but uses iron and calcium supplements. She has a family history of thyroid disease. On examination, her weight is 152 lbs, her heart rate is 64 bpm, and her blood pressure is 138/86. Her thyroid gland is mildly enlarged, without nodularity. She has trace edema in her lower extremities, and her reflexes are slow.
Laboratory studies are as follows:
TSH is 15.3 mIU/mL (elevated), free T4 is 0.3 mIU/mL (decreased), and total cholesterol is 276 mg/mL.
Diagnosis: Primary Hypothyroidism
• List specific goals of treatment for Maria.
• What drug therapy would you prescribe? Why?
• What are the parameters for monitoring the success of the therapy?
• Discuss specific patient education based on the prescribed therapy.
• List one or two adverse reactions for the selected agent that would cause you to change therapy.
• What would be the choice for second-line therapy?
• What over-the-counter and/or alternative medications would be appropriate for Maria?
• What lifestyle changes would you recommend to Maria?
• Describe one or two drug-drug or drug-food interactions for the selected agent.
The response must include a reference list. Using one-inch margins, double-space, Times New Roman 12 pnt font and APA style of writing and citations.