Thyroid Medications (Levothyroxine, Methimazole, PTU) on the NCLEX
Levothyroxine for hypothyroidism, methimazole and PTU for hyperthyroidism. Teaching, monitoring.
Thyroid meds: replacement for hypo, suppression for hyper. NCLEX tests timing, TSH monitoring, and pregnancy-specific use.
Levothyroxine (Synthroid)
Replacement T4 for hypothyroidism. Take on empty stomach (60 min before food, 4h before calcium/iron). Lifelong. TSH monitored to titrate. Signs of overdose: hyperthyroid symptoms (tachy, anxiety, weight loss).
Methimazole (Tapazole)
First-line for hyperthyroidism. Side effects: agranulocytosis, hepatotoxicity. Teratogenic in 1st trimester, use PTU instead.
PTU (propylthiouracil)
Used in 1st trimester pregnancy, thyroid storm. Hepatotoxic (black box). Switch to methimazole after 1st trimester if possible.
Radioactive iodine I-131
Ablative treatment. Contraindicated in pregnancy and breastfeeding. Avoid close contact with pregnant women/children for several days post-treatment.
Frequently asked
Levothyroxine when to take?
Morning, empty stomach, water only. Wait 60 min before food/coffee.
Pregnant patient with Graves?
PTU in 1st trimester, switch to methimazole 2nd/3rd.
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