Endocrine Medications: Antithyroid

Question 1

What is another name for antithyroid drugs?

Answer 1

Thyroid antagonists

Question 2

What conditions do antithyroid medications treat?

Answer 2

Hyperthyroidism

Question 3

What is another term for hyperthyroidism?

Answer 3

Thyrotoxicosis

Question 4

What type of medications are used to treat hyperthyroidism?

Answer 4

1. Thioamides

2. Beta Blockers

Question 5

What are the generic and brand names of thioamides medications that treat hyperthyroidism?

Answer 5

1. Methimazole (Tapazole)

2. Propylthiouracil

Question 6

How do Beta Blockers treat hyperthyroidism?

Answer 6

To treat symptoms

Question 7

Where are Thioamides absorbed?

Answer 7

GI tract

Question 8

Where are Thioamides concentrated?

Answer 8

Thyroid

Question 9

How are Thioamides metabolized?

Answer 9

Conjunction

Question 10

How are Thioamides excreted?

Answer 10

In urine

Question 11

How do Thioamides work to treat hypertyroidism?

Answer 11

1. Block iodine’s ability to combine with tyrosine

2. Thereby preventing thyroid hormone synthesis.

Question 12

What is the most common condition that causes hyperthyroidism? What percentage of hyperthyroid patients have this condition?

Answer 12

1. Graves disease

2. 85%

Question 13

Why would a provider choose Methimazole (Tapazole) over Propylthiouracil (or visa versa)

Answer 13

1. Propylthiouraci lowers serum T3 levels faster

2. Propylthiouraci is usually used for rapid improvement of severe hyperthyroidism

Question 14

What pregnancy category are Methimazole (Tapazole) and Propylthiouracil?

Answer 14

D

Question 15

Are Methimazole (Tapazole) and Propylthiouracil okay to take during pregnancy?

Answer 15

1. Propylthiouracil is preferred in the first trimester

2. Methimazole is used in the second and third trimesters

Question 16

Why is Propylthiouracil preferred during pregnancy?

Answer 16

1. Its rapid action reduces transfer of the drug across the placenta
2. No risk of aplasia cutis

Question 17

Are Methimazole (Tapazole) and Propylthiouracil excreted in breast milk?

Answer 17

Yes

Question 18

How often is methimazole dosed?

Answer 18

1. Once a day for mild to mod hyperthyroidism

2. More often for severe hyperthyroidism

Question 19

Why is methimazole better when dosed once per day?

Answer 19

Blocks thyroid hormone formation for a longer

time

Question 20

Methimazole therapy may continue for how many months before remission occurs?

Answer 20

12 to 24 mo

Question 21

Other than pharmacologic therapy how else is hyperthyroidism treated?

Answer 21

1. Surgical removal of Thyroid

2. Destroy thyroid by radiation

Question 22

What drugs interact with thioamides?

Answer 22

None

Question 23

What adverse reactions may occur with thioamide therapy?

Answer 23

1. Granulocytopenia

2. Hypersensitivity

Question 24

What should be monitored when a patient is receiving thioamide therapy?

Answer 24

1. Watch for signs of hypothyroidism
2. CBC
3. Hydration status
4. Fever, sore throat, or mouth sores
5. Severe rash or enlarged cervical lymph nodes

Question 25

What signs of hypothyroidism should be monitored for when a patient is receiving thioamide therapy? What actions should be taken if these are observed?

Answer 25

1. Depression 2. Cold intolerance 3. Hard, nonpitting edema 4. Adjust the dosage

Question 26

Why should CBC be monitored when a patient is receiving thioamide therapy?

Answer 26

To detect impending: 1. Leukopenia 2. Thrombocytopenia 3. Agranulocytosis

Question 27

Why should Hydration status be monitored when a patient is receiving thioamide therapy?

Answer 27

This is a symptom of a GI related reaction

Question 28

Why should patient is receiving thioamide therapy be monitored for Fever, sore throat, or mouth sores?

Answer 28

These are early signs of agranulocytosis

Question 29

Why should patient is receiving thioamide therapy be monitored for Severe rash or enlarged cervical lymph nodes?

Answer 29

Indication of hypersensitivity

Question 30

What should a patient do if they are experiencing Severe rash or enlarged cervical lymph nodes with thioamide therapy?

Answer 30

1. Call MD | 2. D/c use

Question 31

What should be monitored when a patient is receiving propylthiouracil therapy?

Answer 31

Thyroid function tests

Question 32

How often should Thyroid function tests be monitored in a patient is receiving propylthiouracil therapy?

Answer 32

1. Before therapy | 2. Regularly thereafter

Question 33

Why should be Thyroid function tests be monitored when a patient is receiving propylthiouracil therapy?

Answer 33

Euthyroid state may not be reached until after 3 to 12 weeks of treatment with propylthiouracil.

Question 34

How often should propylthiouracil be dosed?

Answer 34

Several times a day

Question 35

Why is propylthiouracil dosed several times a day?

Answer 35

Short half-life

Question 36

What should a pateint taking thioamides avoid eating?

Answer 36

1. Iodized salt | 2. Eating shellfish

Question 37

What should NOT occur if a stable response has been achieved when taking antithyroid medications?

Answer 37

Switching to a different brand name

Question 38

What adverse reaction can occur in children taking thioamides?

Answer 38

May lose hair

Question 39

How long does the adverse effect of hair loss in children last when taking thioamides?

Answer 39

Temporary

Question 40

What circumstance should prompt a patient receiving thioamides therapy to notify their MD?

Answer 40

Unusual bleeding or bruising