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NABP Exam NAPLEX Topic 2 Question 105 Discussion

Actual exam question for NABP's NAPLEX exam
Question #: 105
Topic #: 2
[All NAPLEX Questions]

LN is 84 YOM who is in hospital for a back surgery. His height is 5 feet and 4 inches, weight 85 kg and NKDA.

His past medical history includes hypertension, diabetes mellitus, major depression, hypothyroidism and chronic back pain. Post-op day 1, LN's medication includes Dexamethasone 8mg iv q6h with taper dosing, Ondansetron 4mg iv q6h prn for N/V, Levothyroxine 0.075mg po daily, Lisinopril 10mg po daily, Citalopram 20mg po daily, Docusate sodium / Senna 1 tab po twice a day, Bisacodyl 10mg suppository daily prn for constipation, Famotidine 20mg iv q12hr, Metoclopramide 10mg iv q6h, Metformin 500mg po bid, D51/2NS with 20K at 125mls/hour and Hydromorphone PCA at 0.2mg/hour of basal rate, demand dose 0.1mg. lock-out

every 6min, one hour limit 2.2mg/hour. Pertinent morning labs includes serum creatinine 1.4mg/dl, Mg 1.5mg/ dl, K 5.0mmol/L, Na 135mmol/L. The bioavailability of levothyroxine is roughly 50%.

The physician requests you for a dose recommendation to convert her home dose of 75mcg po daily to intravenous.

What would be the appropriate intravenous dose?

Show Suggested Answer Hide Answer
Suggested Answer: A

Since the bioavailability of levothyroxine is roughly 50% (given in the Question:). To convert

the home dose to intravenous, it would be 50% of the oral dose. So 50% of oral 75 mcg would be 37.5 mcg intravenously.


Contribute your Thoughts:

Veronika
12 days ago
Okay, let's see... 75mcg it is! I'm not about to give this poor guy a massive overdose of thyroid medication. Although, a dose of 150mcg might just give him the superpower he needs to lift that hospital bed with one hand.
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Artie
15 days ago
Ah, the good old levothyroxine conversion trick! I bet the patient would love a 37.5mg dose, that's sure to keep their thyroid in check. Who needs a functioning metabolism anyway?
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Izetta
8 days ago
User 1: I think the appropriate intravenous dose would be 37.5mcg.
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Georgeanna
23 days ago
I'm not sure about that. I think the correct intravenous dose should be 75mcg to maintain the same therapeutic effect.
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Jenelle
29 days ago
I agree with you. Since the bioavailability of levothyroxine is roughly 50%, we should halve the dose to 37.5mcg.
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Casandra
1 months ago
I think the appropriate intravenous dose would be 37.5mcg.
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Melvin
2 months ago
Hmm, this is a tricky one. I think the answer is B) 75mcg, since the bioavailability of levothyroxine is roughly 50%. Can't go with the mg option, that's just silly.
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Reita
5 days ago
Correct, B) 75mcg is the appropriate intravenous dose based on the bioavailability of levothyroxine.
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Sanda
8 days ago
Yeah, definitely not the mg option, that would be way too high.
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Bong
1 months ago
I agree, the answer is B) 75mcg because of the bioavailability of levothyroxine.
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