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Central nervous system
Tremor, sedation, headache
Use a slow-release formulation; dose twice daily.
Collaborate with primary care physician for management
Consult with endocrinologist; augment with triiodothyronine.
Split into 2–3 daily doses. Use a slow-release formulation.
Encourage diet and exercise. Consider a trial of metformin
(Klein et al. 2006Klein et al. 2006).
Polyuria, decreases in renal function
Write note to school that allows the patient to go to
the bathroom as needed during school; monitor serum creatinine or
creatinine clearance, serum urea nitrogen, and urine osmolality
every 6 months.