This episode CONTAINS NO EDUCATIONAL MATERIAL. This episode details how the subjects are set up.

Season 1= Health Assessment

Season 2- Medical Surgical

Season 3- Pharmacology

💊 HIGH-YIELD PHARM REVIEW: LEVOTHYROXINE (Synthroid, Levoxyl, Euthyrox)

Levothyroxine sodium is a synthetic T4 thyroid hormone—the body’s inactive form that converts to T3, the active hormone responsible for regulating metabolism, energy use, cardiac output, and CNS development. 🧠❤️

🔹 Mechanism of Action (MoA): Mimics natural thyroxine (T4) → converted to triiodothyronine (T3) in tissues → restores normal metabolism and energy balance.

🔹 Primary Uses: • Hypothyroidism (all causes) • Myxedema coma (IV form – emergency use)

🔹 Therapeutic Goal: Normalize TSH and T4 → relieve fatigue, weight gain, bradycardia, cold intolerance, and cognitive slowing.

⚠️ Toxicity / Overdose = Hyperthyroidism Symptoms: • Cardiac: Tachycardia, palpitations, arrhythmias, angina, HF, cardiac arrest 🚨 • Neuro: Tremor, insomnia, seizures, anxiety, pseudotumor cerebri • Metabolic: Heat intolerance, weight loss, hyperthermia • Other: Emotional lability, diaphoresis, weakness

👩‍⚕️ Nursing Management & Dosing Pearls • Start low, go slow—especially in older adults or cardiac pts (12.5–25 mcg/day) 💗 • Myxedema coma: IV 200–400 mcg bolus + glucocorticoids to prevent adrenal crisis • Pediatrics: Start with 25% of full dose and titrate weekly to avoid hyperactivity • Never use for weight loss in euthyroid pts ❌

🍽️ Administration Tips (Oral): • Take on an empty stomach, 30–60 min before breakfast ☀️ • Avoid taking with coffee, fiber, soy, calcium, iron, or antacids—space 4 hours apart • Swallow capsules whole; crush tablets only if allowed and give immediately • Give separately from enteral feedings

💉 IV Administration: • Preferred over IM; reconstitute only with 0.9% NaCl • Stable 4 hours—discard remainder • Push slowly (≤100 mcg/min) via Y-site • IV → PO conversion: increase PO dose by 20–25%

⚠️ Major Drug Interactions (Must-Know!) • Warfarin: ↑ anticoagulant effect → monitor INR closely 🩸 • PPIs, Antacids, Calcium, Iron: ↓ absorption → separate by 4 hrs • Antidiabetics: ↓ glucose control → monitor blood sugars • Amiodarone: may cause hypo- or hyperthyroidism → monitor TSH/T4 • Semaglutide (oral): ↑ T4 exposure by 33% → monitor for hyperthyroid sx

📚 Clinical Pearls: • Absorption: 40–80% (best fasting). • Half-life: ~9–10 days → steady-state 4–6 weeks; re-check TSH after any dose change. • Pregnancy: Safe and essential—dose often ↑ 30–50%; revert postpartum 👶 • Growth: Overuse + GH → early epiphyseal closure in kids. • Gastric Acidity: Required for absorption—watch PPI users!

💡 NCLEX Tip: If a hypothyroid patient reports nervousness, palpitations, or heat intolerance → sign of overdose! Hold dose and notify provider immediately.

🧩 Summary Mnemonic: L-E-V-O = Low → start low dose Early AM on empty stomach Vitals (esp HR) monitor Overdose = hyperthyroid signs 🚨

This is everything 1st Gen Ceph Drugs. For my RN Program this class includes Cephalexin.

First-Generation Cephalosporins

Examples: Cefadroxil, Cefazolin, Cephalexin Class: Anti-infective | Pharmacologic: Cephalosporin (1st Gen) MOA: Binds to bacterial cell-wall membrane → cell death (bactericidal).

Top Indications

1️⃣ Skin & soft-tissue infections. 2️⃣ UTIs. 💉 Cefazolin: peri-operative surgical prophylaxis.

Therapeutic Effect

Resolution of infection — ↓ redness, swelling, discharge, pain, fever.

Contraindications / Cautions

• Allergy: Cephalosporin or serious PCN reaction → risk of anaphylaxis.
• Renal impairment: Drug is renally cleared → dose-adjust to avoid toxicity.
• GI disease / Colitis: ↑ risk for C. diff-associated diarrhea (CDAD).

Red-Flag Adverse Effects

🚨 Anaphylaxis / Severe Allergy: Stop drug → maintain airway → notify provider → prepare for epi/O₂/resus. 🚨 C. diff Diarrhea: Watery, foul stool (can occur weeks later) → discontinue, report immediately. ⚠️ Stevens-Johnson / TEN: Blistering rash ± fever → stop drug → seek emergency care. Common: Nausea, vomiting, diarrhea → give with food/milk. IV: Phlebitis → monitor site; rotate every 48–72 h.

Nursing Priorities

1️⃣ Always check allergy history (ceph ↔ PCN cross-sensitivity). 2️⃣ Monitor renal function (BUN/Cr). 3️⃣ Watch bowel pattern for CDAD. 4️⃣ Observe for rash or respiratory distress during first doses. 5️⃣ Teach: report rash, diarrhea, or SOB immediately.

💊 Quick Recall: “1st Gen = 1st Line for Skin & Surgery.” Kills by breaking the wall; watch for Allergy, Abdomen, and Airway.