E. is a 29-year-old woman with a 7-month history of heavy, irregular menses, a 5-lb weight gain, constipation, and decreased energy. her past history is unremarkable. she takes no prescription medications but uses iron and calcium supplements. she has a family history of thyroid disease. on examination, her weight is 152 lbs, her heart rate is 64 bpm, and her blood pressure is 138/86. her thyroid gland is mildly enlarged, without nodularity. she has trace edema in her lower extremities, and her reflexes are slow. laboratory studies are as follows: tsh is 15.3 miu/ml (elevated), free t4 is 0.3 miu/ml, and total cholesterol is 276 mg/ml.

diagnosis: primary hypothyroidism answer the following questions. include two references, cited in apa style.

list specific goals of treatment for m. e. what drug therapy would you prescribe? why?
what are the parameters for monitoring the success of the therapy?
discuss specific patient education based on the prescribed therapy.
list one or two adverse reactions for the selected agent that would cause you to change therapy.
what would be the choice for second-line therapy?
what over-the-counter and/or alternative medications would be appropriate for m. e.?
what lifestyle changes would you recommend to m. e.?
describe one or two drug–drug or drug–food interactions for the selected agent.

Cj is a 53 year old african american female presenting to pharmacy for first-time certification and cmr so that she may start getting her medications at no cost. cj states that her main concern about her health is her diabetes. pmh: t2dm, htn, hyperlipidemia sh: denies tobacco and illicit drug use, occasional alcohol use (1-2 drinks/month) fh: unknown allergies: penicillin (unknown reaction; had reaction when young). medications: lisinopril 5 mg daily aspirin 81 mg daily simvastatin 20 mg daily wt 231 lbs (105 kg), ht 5’6”, bmi 37.3 (obese), ibw 59.3 kg, bp 145/80, hr 98, random blood glucose 395, a1c 11.2%, estimated 10-year ascvd risk 9.5% drug-related problems: 1. uncontrolled t2dm 2. uncontrolled htn 3. suboptimal statin intensity 1) identify two pieces of objective data included in this case: 2) what kind of monitoring needs performed for the new prescription for this patient? 3) based on your case how would you counsel the patient on the new prescription medication? provide examples of specific aspects you would include in your patient education. 4) review your patient case. identify any medications that do not have a corresponding disease state. 5) review your patient case. identify any disease states are not treated by current medications. 6) what otc (over the counter) product would you recommend for this patient (based on the patient request for an otc product? include dose, frequency of administration, route of administration, and critical counseling points.