A nurse is providing education for a patient recently started on levothyroxine (Levothroid)
To evaluate the patient's knowledge of the drug-drug interactions explained in the patient's educational session, the nurse asks the patient which drugs should not be taken concurrently with levothyroxine. Which statement made by the patient best demonstrates the need for further teaching?
a. "I should avoid taking iron supplements."
b. "I should take only Maalox and Mylanta for indigestion."
c. "I should anticipate an increase in the dose of levothyroxine if I start taking sertraline (Zoloft) again."
d. "I should anticipate a decrease in my dose of warfarin (Coumadin)."
ANS: B
The statement that only Maalox and Mylanta should be taken for indigestion demonstrates a need for further teaching, because these medications are contraindicated with levothyroxine.
The patient should avoid taking iron supplements; no further teaching is necessary.
The interaction of sertraline and levothyroxine results in accelerated metabolism of levothyroxine and would require an increase in the dose of levothyroxine. Levothyroxine accelerates the degradation of warfarin and enhances its effects, therefore the dose may need to be reduced.
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