Hyperthyroidism Treatment Flashcards
what is the mechanism for antithyroid drugs(ATDs)
inhibition of TPO, thereby blocking thyroid hormone synthesis
what type of drug is Carbimazole and when would it be used
ATD, first line, once daily dose
what type of drug is Propylthiouracil(PTU) and when would it be used
ATD, first line only in 1st trimester of pregnancy, twice daily dose
(inhibits DIO1, ie decreases T4 to T3 conversion)
how does Carbimazole compare to PTU
carbimazole lower rate of side effects, 10x more potent, but risk of complication on early pregnancy
what are the general side effects of ATDs
generally well tolerated, 1-5% develop allergic reaction(eg rash), agranulocytosis(0.1-0.5% patients, ATDs can’t be used again)
what are the possible side effects of PTU
cholestatic jaundice, increased liver enzymes, fulminant hepatic failure
what different treatment options are there for hyperthyroidism
antithyroid drugs(ATDs), beta-blockers, radioiodine, thyroidectomy
what type of beta-blocker is the drug of choice, and what benefits does it have
propanolol, additional benefit of inhibiting DIO1, useful for immediate relief of symptomatic relief of thyrotoxic symptoms
(caution use in asthma)
what is the first line treatment for relapsing Graves’ disease and nodular thyroid disease
radioiodine
what are the contraindications/risks of radioiodine
contraindicated in pregnancy and in some eye disease
high risk of hypothyroidism in Graves’
when would a thyroidectomy be considered
if radioiodine contraindicated
what risks are associated with thyroidectomy
recurrent laryngeal nerve palsy, hypothyroidism, hypoparathyroidism
