A patient with a history of heart failure has been diagnosed with hypothyroidism. The drug interaction with glycosides and thyroid replacement therapy will most likely require which change in therapy?
a. Decrease in the daily digoxin dosage
b. Gradual increase in the daily glycoside dosage
c. Inability to begin thyroid replacement therapy because of the underlying heart condition
d. Increased thyroid replacement dosage
ANS: B
If thyroid replacement therapy is started while receiving digoxin, a gradual increase in the glycoside will also be necessary to maintain adequate therapeutic activity. Decreasing the digoxin would put the patient at risk for cardiovascular complications. The two treatments can be coordinated. The thyroid medication does not need to be increased.
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