A nurse is talking with a client who has been taking levothyroxine to treat hypothyroidism.
The nurse should instruct the client to avoid taking which of the following over-the-counter medications within 4 hr of taking levothyroxine?

Choice A rationale:

“Inject the medication into the subcutaneous tissue of your abdomen.” This is correct because exenatide is a type of medication that needs to be injected subcutaneously for it to be absorbed into the body properly.

Choice B rationale:

“Discard excess medication after 60 days.” This statement is incorrect because exenatide pens are usually good for 30 days after the first use.

Choice C rationale:

“Take the medication at bedtime.” This is incorrect because exenatide should be taken within 60 minutes before the morning and evening meal.

Choice D rationale:

“Contact the provider if you experience unexplained muscle pain.” While this is generally good advice when starting any new medication, muscle pain is not a common side effect of exenatide.

Choice A rationale:

A Positive Chvostek’s sign is a clinical finding associated with hypocalcemia, or low levels of calcium in the blood. It’s not directly related to glyburide usage or symptoms of anxiety and profuse sweating.

Choice B rationale:

Pitting pedal edema occurs when excess fluid builds up in the body, causing swelling. It’s not directly related to glyburide usage or symptoms of anxiety and profuse sweating.

Choice C rationale:

Decreased deep-tendon reflexes or hyporeflexia happens when your skeletal muscles have a decreased or absent reflex response. It’s not directly related to glyburide usage or symptoms of anxiety and profuse sweating.

Choice D rationale:

Decreased blood glucose level or hypoglycemia occurs when your blood sugar (glucose) level falls too low. Glyburide is an oral diabetes medicine that helps control blood sugar levels. Anxiety and profuse sweating are symptoms of low blood sugar.