Drug Therapy Assignment: Grave's Disease and Pregnancy Concerns

This assignment focuses on drug therapy in the context of Grave's disease, specifically addressing the use of beta blockers and their implications. The student analyzes a case involving a patient, Jolene, diagnosed with Grave's disease, who is prescribed anti-thyroid drugs and beta blockers to manage her hyperthyroidism symptoms, such as palpitations, anxiety, and tachycardia. The assignment explains the mechanism of action of beta blockers in controlling these symptoms and discusses the potential risks associated with the concurrent use of beta blockers and bronchodilators. Furthermore, the assignment addresses Jolene's concerns about conceiving, emphasizing the risks of pregnancy during anti-thyroid drug treatment, including potential birth defects and maternal complications. It highlights the importance of advising the patient to delay pregnancy until her condition is stable to ensure the health of both the mother and the fetus, citing relevant research and studies to support the recommendations.

Running Head: DRUG THERAPY
DRUG THERAPY
Name of the Student
Name of the University
Author’s Note

1DRUG THERAPY
Question 7
Jolene was suffering from Grave’s disease, which is caused due to hyperactive thyroid glands.
She was prescribed anti-thyroid drug treatment with beta blockers. The reason beta blockers are
used for thyroid treatment is due to the fact that they control the symptoms of thyroid
hyperactivity that happens due to increased beta-adrenergic tone. Hyperthyroidism increases beta
adrenergic receptors in many tissues and it is the reason for elevating the symptoms such as
palpitations, anxiety, tachycardia and heat tolerance. A symptom of lower heart rate and decrease
in fatigue, shortness of breath and physical movement is seen in patients who have been under
the treatment of beta blockers (Ross 2017).
Bronchodilators are a class of drugs that help in breathing by relaxing the lung muscles and
widening the airways, which is the bronchi. However, it causes an increase in the effects of
cardiovascular diseases including arrhythmias and ischaemic events and the beta blockers
elevates the response of bronchodilators on the respiratory system. This increases the
complication in cardiovascular system and makes it susceptible to cardiopulmonary issues and
heart failures. Bronchodilators have been useful for conditions such as asthma, chronic
obstructive pulmonary disease and other respiratory distress. Cardio-selective beta blockers that
maintain cardio-selectivity have been found to be safer for people with cardiopulmonary issues
(Corrao et al. 2017).
Question 8
Jolene has been asking me about conceiving as she and her husband wants a baby. Her existing
condition is making her feel skeptical and she wants to know if having a baby right now is save
for her and her child.

2DRUG THERAPY
As a nurse, I explained to her about her current condition because she is under anti-thyroid drug
treatment with beta blockers due to her diagnosis of grave disease, hypertension, tachycardia and
tremor. She might be worried but it is my duty to tell her that it is not safe for her to conceive
during this time because thyroid medications given during pregnancy for hyperthyroidism can
lead to birth defects in the foetus and other anomalies such as threatening fetal survival. Not only
for the foetus but hyperthyroidism also hampers the condition of the pregnant woman (Laurberg
and Andersen 2015). Similarly, beta blockers are a class of drugs that are prescribed in the first
trimester of pregnancy if the woman has hypertension. It is reported that beta blockers can lead
to growth restrictions in the foetus and maternal cardiac complications such as decreased cardiac
systolic function (Ersbøll et al. 2014). It is recommended for Jolene to recover and then consider
getting pregnant because it can increase the complications in the health of the foetus and also
her.

3DRUG THERAPY
References
Corrao, S., Brunori, G., Lupo, U. and Perticone, F., 2017. Effectiveness and safety of concurrent
beta-blockers and inhaled bronchodilators in COPD with cardiovascular
comorbidities. European Respiratory Review, 26(145), p.160123.
Ersbøll, A.S., Hedegaard, M., Søndergaard, L., Ersbøll, M. and Johansen, M., 2014. Treatment
with oral beta‐blockers during pregnancy complicated by maternal heart disease increases the
risk of fetal growth restriction. BJOG: An International Journal of Obstetrics &
Gynaecology, 121(5), pp.618-626.
Laurberg, P. and Andersen, S.L., 2015. Antithyroid drug use in pregnancy and birth defects: why
some studies find clear associations, and some studies report none. Thyroid, 25(11), pp.1185-
1190.
Ross, D., 2017. Beta blockers in the treatment of hyperthyroidism. UpToDate, Cooper, D (Ed),
UpToDate, Waltham, MA. Accessed October, 12.