The Rx Consultant

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The Hypothyroid Patient

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Overview

About 12% of the US population has some form of thyroid disease, and more than half of them are unaware of their condition. Hypothyroidism is the most common thyroid condition. It affects about 2% of women and 0.1-0.2% of men; however, in adults over 60 years old, 6% of women and 2.5% of men have the condition.

Hypothyroidism is a chronic disease that requires lifelong treatment; fortunately, it can be easily managed with thyroid hormone replacement medication. The recommended treatment is levothyroxine, which was the most frequently prescribed drug in the US in 2019. Other thyroid hormone replacement medications are available in various products and strengths, which can be cause of confusion for healthcare providers and patients. Choosing the correct product and dose requires a full understanding of the disease and the treatments. Healthcare providers should be able to provide evidence-based recommendations, taking into consideration a patient's age, concurrent medical conditions, and other medications. This issue will review the pathophysiology and clinical features of hypothyroidism, as well as drug therapy considerations. Treatment strategies for older adults, children, and pregnant women are summarized. Subclinical hypothyroidism is also discussed.

Details

Publication Date: 10/22/2019
Expiration Date: 10/22/2022
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Michelle Chu, PharmD, BCACP, APh is Assistant Professor of Clinical Pharmacy at the University of Southern California (USC), School of Pharmacy. Dr. Chu is also a primary care clinical pharmacist at Los Angeles County USC Medical Center and the Director of the Ambulatory Care Pharmacy Residency Program in Los Angeles.

Disclosure Statement

Dr. Chu reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists .

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe the pathophysiology of hypothyroidism; list common signs and symptoms.
    2. Discuss thyroid hormone replacement products, their advantages and disadvantages, and their interchangeability.
    3. Describe the risks of thyroid hormone replacement therapy and recommended monitoring parameters. Discuss the current recommendations for special populations (eg, subclinical hypothyroidism, pregnancy, congenital hypothyroidism).
    4. Counsel a patient who requires thyroid hormone replacement on proper administration, and potential drug interactions.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-19-013-H01-P


Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


Tracy Farnen, PharmD

Associate Editors


James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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