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Questions and Answers
What is the treatment of choice for toxic adenomas, toxic multinodular goiter, and most varieties of thyrotoxicosis?
What is the treatment of choice for toxic adenomas, toxic multinodular goiter, and most varieties of thyrotoxicosis?
Why is radioactive iodine contraindicated during pregnancy?
Why is radioactive iodine contraindicated during pregnancy?
What should women of childbearing age be instructed to do following radioactive iodine treatment?
What should women of childbearing age be instructed to do following radioactive iodine treatment?
What is the goal of radioactive iodine therapy (131I)?
What is the goal of radioactive iodine therapy (131I)?
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What is the principal test used for monitoring patients early after radioactive iodine treatment?
What is the principal test used for monitoring patients early after radioactive iodine treatment?
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Which medication is recommended during the first trimester of pregnancy due to teratogenic effects of methimazole?
Which medication is recommended during the first trimester of pregnancy due to teratogenic effects of methimazole?
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What is the purpose of antithyroid medications such as methimazole and propylthiouracil?
What is the purpose of antithyroid medications such as methimazole and propylthiouracil?
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When is thyroid hormone replacement initiated after stopping antithyroid medications?
When is thyroid hormone replacement initiated after stopping antithyroid medications?
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What is the initial effect of an ablative dose of radioactive iodine?
What is the initial effect of an ablative dose of radioactive iodine?
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What condition are patients undergoing radioactive iodine treatment monitored for signs of?
What condition are patients undergoing radioactive iodine treatment monitored for signs of?
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What can happen if antithyroid medications are discontinued before completing therapy?
What can happen if antithyroid medications are discontinued before completing therapy?
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When should baseline blood tests be performed before initiating antithyroid medication therapy?
When should baseline blood tests be performed before initiating antithyroid medication therapy?
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What is the main target of radioactive iodine in the body?
What is the main target of radioactive iodine in the body?
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What happens if patients treated with radioactive iodine contaminate their surroundings?
What happens if patients treated with radioactive iodine contaminate their surroundings?
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How is the therapeutic dose of antithyroid medications determined?
How is the therapeutic dose of antithyroid medications determined?
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When should patients take antithyroid medications to avoid decreased absorption?
When should patients take antithyroid medications to avoid decreased absorption?
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What is the primary purpose of antithyroid drugs?
What is the primary purpose of antithyroid drugs?
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What should patients do if they experience signs and symptoms of acute liver failure?
What should patients do if they experience signs and symptoms of acute liver failure?
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What are the patient teaching guidelines for propylthiouracil?
What are the patient teaching guidelines for propylthiouracil?
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What should patients do before taking over-the-counter drugs while on antithyroid medication?
What should patients do before taking over-the-counter drugs while on antithyroid medication?
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What risk is associated with methimazole use during the first trimester of pregnancy?
What risk is associated with methimazole use during the first trimester of pregnancy?
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Which statement about iodine preparations used in the short-term treatment of hyperthyroidism is true?
Which statement about iodine preparations used in the short-term treatment of hyperthyroidism is true?
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What is a potential consequence of using sodium iodide 131I to treat hyperthyroidism and thyroid cancer?
What is a potential consequence of using sodium iodide 131I to treat hyperthyroidism and thyroid cancer?
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When may the therapeutic benefits of sodium iodide 131I become apparent?
When may the therapeutic benefits of sodium iodide 131I become apparent?
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For which symptoms is propranolol recommended in patients with symptomatic hyperthyroidism?
For which symptoms is propranolol recommended in patients with symptomatic hyperthyroidism?
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In which patient population is propranolol particularly useful?
In which patient population is propranolol particularly useful?
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When should propranolol be tapered and discontinued in patients with hyperthyroidism?
When should propranolol be tapered and discontinued in patients with hyperthyroidism?
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What is the plasma half-life of propylthiouracil?
What is the plasma half-life of propylthiouracil?
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What is the preferred treatment for hyperthyroidism in older adults?
What is the preferred treatment for hyperthyroidism in older adults?
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What is the only contraindication to propylthiouracil?
What is the only contraindication to propylthiouracil?
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What is the main concern highlighted by the FDA's BLACK BOX WARNING for propylthiouracil?
What is the main concern highlighted by the FDA's BLACK BOX WARNING for propylthiouracil?
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What is the evidence-based link between propylthiouracil and a specific condition, necessitating close monitoring and aggressive wound care?
What is the evidence-based link between propylthiouracil and a specific condition, necessitating close monitoring and aggressive wound care?
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With which of the following medications may propylthiouracil potentially interact?
With which of the following medications may propylthiouracil potentially interact?
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What is the primary purpose of administering propylthiouracil around the clock?
What is the primary purpose of administering propylthiouracil around the clock?
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What is the most common adverse effect associated with propylthiouracil use?
What is the most common adverse effect associated with propylthiouracil use?
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When is propylthiouracil used in the management of hyperthyroidism?
When is propylthiouracil used in the management of hyperthyroidism?
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What is the preferred treatment for hyperthyroidism in older adults?
What is the preferred treatment for hyperthyroidism in older adults?
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What is the primary action of propylthiouracil in the treatment of hyperthyroidism?
What is the primary action of propylthiouracil in the treatment of hyperthyroidism?
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What is the preferred treatment for hyperthyroidism in older adults?
What is the preferred treatment for hyperthyroidism in older adults?
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Study Notes
Antithyroid Drug Patient Teaching and Other Drugs
- Antithyroid drugs are used to treat an overactive thyroid gland by decreasing the production of thyroid hormone.
- Patients should receive instructions about signs and symptoms of acute liver failure and seek immediate medical treatment if these symptoms occur.
- Patient teaching guidelines for propylthiouracil include regular thyroid and liver function tests, avoiding seafood or iodized salt, and taking the drug at regular intervals.
- Patients should report adverse effects to the prescriber and consult a healthcare provider before taking over-the-counter drugs.
- Methimazole is similar to propylthiouracil and carries a risk of fetal abnormalities, requiring a pregnancy test before use during the first trimester.
- Strong iodine solution and saturated solution of potassium iodide are iodine preparations used in short-term treatment of hyperthyroidism, but should not be followed by certain antithyroid drugs.
- Sodium iodide 131I is a radioactive isotope used to treat hyperthyroidism and thyroid cancer, but can lead to hypothyroidism and requires lifelong hormone replacement therapy.
- The therapeutic benefits of sodium iodide 131I may not be apparent for 3 months or longer, and patients should avoid expectorating or coughing freely for 24 hours after therapy.
- Propranolol is a beta-adrenergic–blocking agent recommended for all patients with symptomatic hyperthyroidism to control symptoms such as tachycardia, palpitations, excessive sweating, and nervousness.
- Propranolol is particularly useful in older adults with resting heart rates greater than 90 beats/min or a history of cardiovascular conditions.
- Propranolol is used to control symptoms during the delayed response to other hyperthyroidism treatments, before thyroidectomy, and in treating thyrotoxic crisis.
- Once patients become euthyroid and definitive treatment has controlled hyperthyroid symptoms, propranolol should be tapered and discontinued.
Propylthiouracil: Pharmacokinetics, Action, and Use
- Propylthiouracil is a thioamide antithyroid drug used to treat hyperthyroidism
- It inhibits thyroid hormone production and peripheral conversion of T4 to T3
- Propylthiouracil is well absorbed orally, with a plasma half-life of 1-2 hours
- It is used alone for hyperthyroidism, preoperative thyroidectomy preparation, and in thyroid storm treatment
- Hyperthyroidism affects drug metabolism, requiring close monitoring and potential dose adjustments
- In older adults, radioactive iodine is preferred over propylthiouracil due to fewer adverse effects
- A BLACK BOX WARNING by the FDA highlights the risk of severe liver injury with propylthiouracil
- Adverse effects of propylthiouracil include hypothyroidism signs, hematologic, dermatologic, CNS, GI effects, and more
- The only contraindication to propylthiouracil is known hypersensitivity
- Evidence-based practice shows a link between propylthiouracil and vasculitis, requiring close monitoring and aggressive wound care
- Propylthiouracil may interact with anticoagulants, amiodarone, potassium iodide, sodium iodide, and lithium
- Nursing implications include administering the drug around the clock, assessing for therapeutic and adverse effects, and preventing interactions
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Description
Test your knowledge on antithyroid drugs and patient teaching with this quiz. Explore essential information on propylthiouracil, methimazole, iodine preparations, and propranolol. Brush up on pharmacokinetics, actions, uses, adverse effects, and nursing implications for propylthiouracil.
