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Questions and Answers
Which form of pharmacotherapy is considered the treatment of choice for toxic adenomas, toxic multinodular goiter, and most varieties of thyrotoxicosis?
Why is radioactive iodine therapy contraindicated during pregnancy?
What should women of childbearing age be instructed to do before administration of radioactive iodine?
How long should women of childbearing age wait to conceive following radioactive iodine treatment?
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What is the goal of radioactive iodine therapy (131I)?
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What percentage of cases is a single dose of radioactive iodine effective in treating?
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What is the primary function of antithyroid medications in treating hyperthyroidism?
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What is the principal test for monitoring thyroid function after radioactive iodine treatment?
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When is thyroid hormone replacement started after stopping antithyroid medications?
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What is the recommended medication during the first trimester of pregnancy due to teratogenic effects of methimazole?
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How do antithyroid medications work?
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What happens if antithyroid medications are discontinued before therapy is complete?
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When are baseline blood tests performed before initiating antithyroid medications?
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What should patients treated with radioactive iodine be informed about?
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What is the usual dosage for propylthiouracil?
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How does propylthiouracil affect thyroid hormone production?
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What is the only contraindication to propylthiouracil?
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What has the FDA issued a BLACK BOX WARNING for regarding propylthiouracil?
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How should patients take propylthiouracil?
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What should patients be monitored for due to evidence suggesting a potential effect of propylthiouracil?
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Why is close monitoring necessary in older adults and patients with hepatic impairment?
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What is the recommended treatment for all patients with symptomatic hyperthyroidism, particularly in older adults with resting heart rates over 90 beats/min or with a history of cardiovascular conditions?
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Which medication should be used cautiously by women of childbearing age due to the risk of fetal abnormalities during the first trimester?
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What is the potential disadvantage of using radioactive iodine therapy for hyperthyroidism?
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What should patients be educated about regarding the signs and symptoms of acute liver failure while taking propylthiouracil?
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What is the purpose of sodium iodide 131I in the treatment of hyperthyroidism?
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What is the timeframe for achieving a euthyroid state with propylthiouracil treatment?
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What are the adverse effects that should be monitored in patients taking propylthiouracil?
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What is the primary function of propranolol in the treatment of hyperthyroidism?
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What is the purpose of strong iodine solution and saturated solution of potassium iodide in the treatment of hyperthyroidism?
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What is the primary cause of hypothyroidism?
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Which symptom is not commonly associated with hypothyroidism?
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What is the effect of low thyroid hormone levels on the body's processes?
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What is a common effect of hypothyroidism on the menstrual cycle?
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What is a potential consequence of untreated hypothyroidism during pregnancy?
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What is the most common symptom of hypothyroidism?
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What is the main function of the thyroid hormone in the body?
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What is a potential symptom of hypothyroidism related to the skin?
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What is the term for an enlarged thyroid gland due to hypothyroidism?
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What is a potential effect of hypothyroidism on muscle and joint health?
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What is the primary treatment for hypothyroidism?
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What can lead to hypothyroidism?
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What is the purpose of routine laboratory testing for patients on levothyroxine therapy?
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What are people with hypothyroidism at risk of when taking opioid analgesics and sedating drugs?
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How is hyperthyroidism diagnosed?
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What are symptoms of hyperthyroidism?
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What is the recommended treatment for hyperthyroidism?
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What is the timeframe for achieving a euthyroid state with propylthiouracil treatment?
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What should women of childbearing age be instructed to do before administration of radioactive iodine?
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Why is radioactive iodine therapy contraindicated during pregnancy?
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Which medication is considered the treatment of choice for toxic adenomas, toxic multinodular goiter, and most varieties of thyrotoxicosis?
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What is the principal test for monitoring thyroid function after radioactive iodine treatment?
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What has the FDA issued a BLACK BOX WARNING for regarding propylthiouracil?
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What is the usual dosage for propylthiouracil?
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What is the purpose of strong iodine solution and saturated solution of potassium iodide in the treatment of hyperthyroidism?
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When are baseline blood tests performed before initiating antithyroid medications?
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What is the potential disadvantage of using radioactive iodine therapy for hyperthyroidism?
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What is the goal of radioactive iodine therapy ($^{131}I$)?
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What should women of childbearing age be instructed to do before administration of radioactive iodine?
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What is the purpose of sodium iodide $^{131}I$ in the treatment of hyperthyroidism?
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Study Notes
Treating Hyperthyroidism with Propylthiouracil
- Therapeutic effects of propylthiouracil may take 1 to 2 weeks to become apparent, but achieving a euthyroid state could take 6 to 8 weeks.
- Adverse effects should be monitored, including heart rate, peripheral pulses, lung sounds, heart sounds, speech, emotional status, rest periods, weight, constipation, skin changes, CNS depression, gastric irritation, fever, sore throat, and white blood count for leukopenia.
- Patients should be educated about the signs and symptoms of acute liver failure and seek immediate medical treatment if these symptoms occur.
- Patient teaching guidelines for propylthiouracil include periodic tests of thyroid and liver function, avoiding seafood or iodized salt, taking the drug at regular intervals, reporting adverse effects, consulting a healthcare provider before taking over-the-counter drugs, monitoring pulse and weight, and seeking medical attention for rash symptoms.
- Methimazole is similar to propylthiouracil and should be used cautiously by women of childbearing age due to the risk of fetal abnormalities during the first trimester.
- Strong iodine solution and saturated solution of potassium iodide are short-term treatments for hyperthyroidism, used to inhibit the release of thyroid hormones.
- Sodium iodide 131I is a radioactive isotope used for diagnostic tests of thyroid function and therapeutic treatment of hyperthyroidism and thyroid cancer.
- Disadvantages of using radioactive iodine therapy include the development of hypothyroidism and delayed therapeutic benefits.
- Propranolol is recommended for all patients with symptomatic hyperthyroidism, particularly in older adults with resting heart rates over 90 beats/min or with a history of cardiovascular conditions.
- Propranolol blocks beta-adrenergic receptors to control symptoms of hyperthyroidism such as tachycardia, palpitations, excessive sweating, tremors, and nervousness.
- Propranolol is useful for controlling symptoms during the delayed response to thioamide drugs and radioactive iodine, before thyroidectomy, and in treating thyrotoxic crisis.
- Propranolol should be tapered and discontinued when patients become euthyroid and definitive treatment has controlled hyperthyroid symptoms.
Hypothyroidism and Hyperthyroidism: Causes, Diagnosis, and Treatment
- Hypothyroidism can be caused by Hashimoto’s disease, congenital hypothyroidism, surgical removal of the thyroid, radiation treatment, and certain medications.
- Symptoms of hypothyroidism develop slowly and can go unnoticed for months or years.
- There is no cure for hypothyroidism, and most patients have it for life, but some exceptions exist, such as viral thyroiditis or thyroiditis after pregnancy.
- Hypothyroidism is treated by replacing the hormone the thyroid can no longer make, typically with synthetic thyroxine pills.
- Certain medications and conditions, such as amiodarone, interferon alpha, lithium, and iodine levels, can lead to hypothyroidism.
- Surgical removal of part or all of the thyroid can result in hypothyroidism, and radiation treatment for hyperthyroidism often leads to hypothyroidism.
- Treatment for hypothyroidism involves the administration of synthetic thyroxine, such as levothyroxine, which should be taken on an empty stomach.
- Levothyroxine therapy is for life and requires routine laboratory testing to review thyroid-stimulating hormone (TSH) levels.
- Levothyroxine rarely causes adverse effects when administered at appropriate doses.
- Replacement therapy for hypothyroidism is lifelong, and no clear-cut guidelines exist regarding duration of antithyroid drug therapy.
- People with hypothyroidism are at risk of respiratory depression and myxedema coma with opioid analgesics and sedating drugs.
- Hyperthyroidism can be diagnosed through blood tests measuring thyroid hormone and TSH levels, and symptoms include heat intolerance, palpitations, anxiety, fatigue, weight loss, and irregular menses in women.
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Description
Test your knowledge on the treatment of hyperthyroidism with propylthiouracil and related medications. This quiz covers therapeutic effects, adverse effects monitoring, patient teaching guidelines, and other treatment options for hyperthyroidism management.
