Alternative uses for Synthroid?

Nurses General Nursing

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Hi AllNurses,

I just had my second day of clinicals on the med surg unit and my patient had been in for 11 days. Pt was admitted to have a rectal mass removed, and received a new ileostomy. The surgical wound became infected by a leaking ostomy appliance, so pt was being treated for that. I'm now working on the care plan, and I am perplexed by the order for IV Synthroid. I did not see anything in his history indicating hypothyroid, nor that he was on Synthroid prior to this hospitalization. Are there unlabeled uses for Synthroid that might be related to this condition? A little more on pt's diagnoses... pt is recovering from post-op pneumonia, is bipolar and autistic. Labs normal except for the hematology labs being slightly below normal. Any thoughts would be greatly appreciated!

Did you check the thyroid function labs?

Oddly, I could not find thyroid function labs in the chart anywhere, and I scoured the Labs tab and the pt's history!

Specializes in Emergency.

Is the pt overweight? I read an article recently about using it for weight loss. If this is for the pt you are caring for, you should ask the nurse you are working with because he/she will have all of the information or just ask the doctor, I used to be petrified of doctors but if you are giving a med or if the pt you are caring for is receiving it, they should answer your questions.

Thanks for your reply, PacificNWNurse. No, the pt wasn't overweight at all, and was in quite good health prior to this hospital visit. I definitely understand the importance of knowing why a patient is receiving a med if I am giving it. I was not passing meds that day, and it was a question I didn't get to ask while I was at the hospital and now I'm home and kicking myself for it!

Increasing the level of thyroid hormone can increase peristalsis without causing diarrhea. Since your patient had a rectal mass, it is possible the physician is prophylaxing for future bowel issues.

Specializes in CMSRN.

I can't seem to think of any reason why iv synthroid was ordered except as an error. Weight would not be a good indication unless low levels of thryoid hormone are the cause. Besides, an acute care setting (I am assuming it is a hospital) would not be the place to implement weight loss.

In regards to increasing peristalsis I would be concerned if it was used for this.

Over abundance of thyroid hormone would increase overall metabolism.

HR and BP would increase also. It would be an increase in risk for stroke.

Without knowing a persons baseline thyroid levels I would be concerned to order synthryoid even if for issues mentioned.

Specializes in TCU, Post-surgical, Infection Prevention.

Bipolar patients get prescribed synthyroid... Hth

I think Bipolar patients are prescribe synthroid because Lithium blocks a step of thyroid hormone synthesis.

IV Synthroid? I wasn't aware it was given IV. Where have I been????

Specializes in ER.
Is the pt overweight? I read an article recently about using it for weight loss. If this is for the pt you are caring for, you should ask the nurse you are working with because he/she will have all of the information or just ask the doctor, I used to be petrified of doctors but if you are giving a med or if the pt you are caring for is receiving it, they should answer your questions.

Synthroid has a black box warning for use in patients for weight loss. It is an absolute contraindication in the euthyroid patient related to toxicities.

Like others, I'm at a loss for why this would be prescribed in this situation with all the S/E of the drug. Bipolar patients on Lithium have a 20-30% chance of developing hypothyroidism within the 1st 2 years of therapy but,you not finding a history of previous of synthroid use, does leave to question why it's being used. Without PMHx of hypothyroidism and without recent TSH T3 and free T4 I'd really have to question use of this drug. I'd go as far as go though the admit orders to verify drug order, ask staff why and if need be ask the doctor.

IV synthoid is an acceptable route of administration in the patient unable to take/tolerate po meds and usually started off at half the PO dose and adjusted.

Specializes in Post Anesthesia.
Increasing the level of thyroid hormone can increase peristalsis without causing diarrhea. Since your patient had a rectal mass, it is possible the physician is prophylaxing for future bowel issues.

Interesting- Has anyone seen it used for this purpose regularly? I would think if the thyroid functoin was normal, giving a suppliment would end up inhibiting the thyroid over time?

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