Carbimazole/propyluracil Flashcards
Carbimazole - indications
hyperthyroidism
Pregnant patient with hyperthyroidsm - which medication would they be initiated on to treat their hyperthyroidism?
propyluracil
Do NOT give carbimazole to pregnant women
How long do patients usually have to continue taking carbimazole for?
typically continued for 12-18 months
35 year old patient presents with a sore throat - PMHx includes hyperthyroidism which she currently takes carbimazole for. What is the most likely diagnosis and what should you do next?
AGRANULOCYTOSIS - the major complication of carbimazole therapy is agranulocytosis (low WBC = increased chance of infection)
URGENT A&E - CHECK WCC
warn patients to let GP know if they develop a sore throat, ulcers or random fever
How would you explain to a patient what hyperthyroidism is and how carbimazole will help their symptoms?
Your thyroid controls things like your heart rate and body temperature. When it makes too many hormones, you can have symptoms such as weight loss, mood swings and feeling irritable.
Carbimazole helps to ease these symptoms by reducing the amount of hormones your thyroid produces. It can take up to 3 weeks to see an improvement in your symptoms.
Carbimazole - side effects (common)
Side effects usually only happen in the first 8 weeks and tend not to last long.
- nausea/vomiting
- diarrhoea
- dizzy
- headache
- joint pain
- itchy skin
How would you explain the risk of agranulocytosis to your patient?
One rare side effect of carbimazole can be a sudden drop in your white blood cell count. This makes it harder to fight infections.
Warn patients to let GP know if they develop a sore throat, ulcers or random fever
Carbimazole - Administration
Swallow the tablets whole, with a drink of water. You can take carbimazole with or without food.
When you first start taking carbimazole, you will take it 2 or 3 times a day. Try to space the doses evenly throughout the day.
Carbimazole - Monitoring
When you first start treatment, you’ll have blood tests every 6 weeks or so to check TFT. Once your hormone levels are stable, you’ll have a blood test every 3 months, for as long as you continue to take carbimazole.
Carbimazole - contraindications
- Pregnancy (these pxts will be given propyluracil instead)
How to answer patient question - will i be taking this forever?
Once your thyroid hormone levels are under control, your dose of carbimazole may be gradually lowered and then stopped.
Depending on your condition, you may need to take carbimazole for 12 to 18 months.
