Posted: February 26th, 2022

It is important that you know your PO medications from IV medications. Does Keflex or Cephalexin really comes in an injectable form?

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Alejandra,
It is important that you know your PO medications from IV medications. Does Keflex or Cephalexin really comes in an injectable form?
The starting dose of prescription for Synthroid is too low. This patient is 40 years old and will need a full replacement, she does have some co-morbidities but cardiac disease is not yet diagnosed. You may start with 50 micrograms or 75 micrograms. Ask her to come back to the office 4-6 weeks later and recheck her TSH levels. If the TSH is still high, you may increase her Synthroid dosage in the increments of 12.5 micrograms, once you reach 100 micrograms, it would be wise to refer her to an endocrinologist to manage her thyroid disease.
Your prescription for lansoprazole is appropriate. However, i don’t believe that they make pills in 14 mg. Lansoprazole is only available in two strengths, 15 mg or 30 mg. For an adult without erosive GERD,  you may start with 30 mg PO daily for up to 8 weeks.
Clomiphene is considered a first-line drug for inducing ovulation. It may be used alone or in combination with metformin. Metformin, a drug for type 2 diabetes, increases insulin sensitivity and decreases insulin levels, which lowers androgen levels through an indirect mechanism. The net result is improved glucose tolerance, improved ovulation, and increased pregnancy rates. Pioglitazone, another drug for type 2 diabetes, can harm the fetus and hence should not be used by women trying to become pregnant.
Reference:
Rosenthal, L. D., & Burchum, J. R. (2021). Lehnespharmacotherapeutics for Advanced Practice Nurses (2nd ed.). Elsevier.
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