Propylthiouracil
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Questions and Answers

What is the primary goal of radioactive iodine therapy (131I)?

  • To stimulate the production of thyroid hormones for long-term balance
  • To eliminate the hyperthyroid state with the administration of sufficient radiation in a single dose (correct)
  • To prevent the synthesis of thyroid hormones using a series of radiation doses
  • To reduce the size of the thyroid gland through continuous low-dose radiation

    • Why is radioactive iodine therapy contraindicated during pregnancy?

  • Because it leads to increased fertility and risk of multiple pregnancies
  • Because it causes allergic reactions in pregnant women
  • Because it reduces the effectiveness of prenatal vitamins
  • Because it crosses the placenta and can affect the fetus (correct)

    • What should women of childbearing age be advised to do before receiving radioactive iodine therapy?

  • Undergo a series of fertility treatments
  • Take a pregnancy test 48 hours before administration of radioactive iodine (correct)
  • Start taking prenatal vitamins 6 weeks before treatment
  • Avoid consuming iodine-rich foods for 6 months before treatment

    • Where does almost all of the iodine that enters and is retained in the body become concentrated?

    <p>In the thyroid gland</p> Signup and view all the answers

    What is the purpose of radioactive iodine in the treatment of hyperthyroidism?

    <p>To destroy thyroid cells and reduce hyperthyroid state</p> Signup and view all the answers

    What can be the initial effect of an ablative dose of radioactive iodine?

    <p>Acute release of thyroid hormone and increased symptoms</p> Signup and view all the answers

    What should patients treated with radioactive iodine be observed for?

    <p>Signs of thyroid storm</p> Signup and view all the answers

    What are beta-blockers used for in the context of hyperthyroidism treatment?

    <p>To control symptoms of thyroid storm</p> Signup and view all the answers

    When is thyroid hormone replacement started after stopping antithyroid medications?

    <p>4 to 18 weeks after stopping antithyroid medications</p> Signup and view all the answers

    What is the principal test measured following treatment with radioactive iodine?

    <p>Serum free T4</p> Signup and view all the answers

    What should patients treated with radioactive iodine be informed about?

    <p>The potential for contaminating their household and others</p> Signup and view all the answers

    What is the mechanism of action of antithyroid medications?

    <p>Inhibit stages in thyroid hormone synthesis or hormone release</p> Signup and view all the answers

    Which are the most commonly used antithyroid drugs in the United States?

    <p>Methimazole or propylthiouracil</p> Signup and view all the answers

    When should antithyroid medications be taken?

    <p>In the morning on an empty stomach</p> Signup and view all the answers

    What is recommended for hyperthyroid pregnant patients during the first trimester?

    <p>Propylthiouracil</p> Signup and view all the answers

    Why is methimazole recommended for the remainder of pregnancy and breastfeeding?

    <p>Due to teratogenic effects and hepatotoxicity, respectively</p> Signup and view all the answers

    What is the clinical use of propylthiouracil?

    <p>Treatment of hyperthyroidism and related conditions</p> Signup and view all the answers

    How is propylthiouracil metabolized in the body?

    <p>In the liver and excreted in urine</p> Signup and view all the answers

    What is the BLACK BOX WARNING for propylthiouracil?

    <p>Severe liver injury</p> Signup and view all the answers

    When is propylthiouracil used in the treatment of hyperthyroidism?

    <p>Preoperative preparation for thyroidectomy</p> Signup and view all the answers

    What adverse effect may be associated with propylthiouracil use in older adults?

    <p>Severe liver injury</p> Signup and view all the answers

    What is the only contraindication to propylthiouracil?

    <p>Known hypersensitivity reaction to the medication</p> Signup and view all the answers

    Which clinical evidence suggests a potential association with propylthiouracil?

    <p>Vasculitis</p> Signup and view all the answers

    What should be monitored when propylthiouracil interacts with anticoagulants?

    <p>Coagulation parameters</p> Signup and view all the answers

    What should be assessed in patients receiving propylthiouracil?

    <p>Thyroid function</p> Signup and view all the answers

    How long does it take for the onset of therapeutic effects of propylthiouracil?

    <p>Days to weeks</p> Signup and view all the answers

    What is the preferred alternative to propylthiouracil in older adults?

    <p>Radioactive iodine</p> Signup and view all the answers

    What is the plasma half-life of propylthiouracil?

    <p>1 to 2 hours</p> Signup and view all the answers

    What should patients be instructed to do with antithyroid drugs?

    <p>Take the drug at regular intervals around the clock</p> Signup and view all the answers

    Which drug is recommended in all patients with symptomatic hyperthyroidism, particularly in older adults with cardiovascular conditions?

    <p>Propranolol</p> Signup and view all the answers

    What are strong iodine solution and saturated solution of potassium iodide used for?

    <p>Short-term treatment of hyperthyroidism</p> Signup and view all the answers

    What should patients consult a healthcare provider before taking?

    <p>Over-the-counter drugs</p> Signup and view all the answers

    How is methimazole related to propylthiouracil?

    <p>Methimazole is similar to propylthiouracil in action, use, and adverse effects</p> Signup and view all the answers

    What is the primary action of propranolol in controlling symptoms of hyperthyroidism?

    <p>Blocking beta-adrenergic receptors</p> Signup and view all the answers

    What should patients be taught about signs and symptoms of?

    <p>Acute liver failure</p> Signup and view all the answers

    What is sodium iodide 131I used for?

    <p>Treating hyperthyroidism and thyroid cancer</p> Signup and view all the answers

    What should iodine preparations not be followed by?

    <p>Propylthiouracil</p> Signup and view all the answers

    What should women of childbearing age have before starting methimazole?

    <p>Pregnancy test</p> Signup and view all the answers

    What is the mechanism of action of strong iodine solution and saturated solution of potassium iodide?

    <p>Inhibiting iodine uptake</p> Signup and view all the answers

    What is the purpose of using radioactive iodine therapy in the treatment of hyperthyroidism?

    <p>To reduce thyroid hormone production</p> Signup and view all the answers

    What should patients be instructed to do when taking antithyroid drugs?

    <p>Take the drug at regular intervals around the clock and report any adverse effects to the prescriber</p> Signup and view all the answers

    What is the recommended action for women of childbearing age before starting methimazole?

    <p>Have a pregnancy test</p> Signup and view all the answers

    What is the purpose of using propranolol in patients with symptomatic hyperthyroidism?

    <p>To control symptoms by blocking beta-adrenergic receptors</p> Signup and view all the answers

    What is the use of strong iodine solution and saturated solution of potassium iodide in the context of hyperthyroidism treatment?

    <p>Short-term treatment of hyperthyroidism</p> Signup and view all the answers

    What should patients be cautious about when taking over-the-counter drugs alongside antithyroid medications?

    <p>Some over-the-counter drugs may contain iodide</p> Signup and view all the answers

    Which radioactive isotope is used to treat hyperthyroidism and thyroid cancer?

    <p>Sodium iodide 131I</p> Signup and view all the answers

    What is the recommended action for patients experiencing signs of acute liver failure during antithyroid drug treatment?

    <p>Seek immediate medical treatment</p> Signup and view all the answers

    What is the similarity between methimazole and propylthiouracil?

    <p>They are similar in action, use, and adverse effects</p> Signup and view all the answers

    What is the mechanism by which propranolol controls symptoms of hyperthyroidism?

    <p>By blocking beta-adrenergic receptors</p> Signup and view all the answers

    What should iodine preparations not be followed by?

    <p>Propylthiouracil, methimazole, or radioactive iodine</p> Signup and view all the answers

    What is the clinical use of sodium iodide 131I?

    <p>Treating hyperthyroidism and thyroid cancer</p> Signup and view all the answers

    Study Notes

    Propylthiouracil: Clinical Use and Nursing Implications

    • Propylthiouracil is an FDA-approved thioamide antithyroid drug used to treat hyperthyroidism and related conditions.
    • It inhibits thyroid hormone production and peripheral conversion of T4 to T3, with onset of therapeutic effects taking days to weeks.
    • The drug is metabolized in the liver and excreted in urine, with a plasma half-life of 1 to 2 hours.
    • Propylthiouracil is used in preoperative preparation for thyroidectomy, before or after radioactive iodine therapy, and in the treatment of thyroid storm.
    • In hyperthyroidism, drug metabolism may be rapid, requiring higher doses of medications, which may need adjustment as the patient becomes euthyroid.
    • It may be used in older adults, but radioactive iodine is often preferred due to fewer adverse effects.
    • Propylthiouracil has a BLACK BOX WARNING for severe liver injury, necessitating routine liver function testing.
    • Adverse effects may include signs of hypothyroidism, hematologic effects, dermatologic effects, CNS effects, GI effects, and other reported effects.
    • The only contraindication to propylthiouracil is a known hypersensitivity reaction to the medication.
    • Clinical evidence suggests that propylthiouracil may be associated with vasculitis, requiring close monitoring and aggressive wound care.
    • Propylthiouracil may interact with anticoagulants, amiodarone, potassium iodide, sodium iodide, and lithium, requiring careful administration and monitoring.
    • Nursing implications include administering the drug in evenly divided doses, assessing for therapeutic effects, and monitoring for adverse effects such as heart failure symptoms and signs of hypothyroidism.

    Antithyroid Drug Patient Teaching and Guidelines

    • Patients should be taught about signs and symptoms of acute liver failure and to seek immediate medical treatment if they occur
    • Periodic tests of thyroid and liver function are necessary during treatment with antithyroid drugs
    • Patients should be instructed to take the drug at regular intervals around the clock and to report any adverse effects to the prescriber
    • Patients should consult a healthcare provider before taking over-the-counter drugs, as some may contain iodide
    • Methimazole is similar to propylthiouracil in action, use, and adverse effects
    • Safety alert: women of childbearing age should have a pregnancy test before starting methimazole
    • Strong iodine solution and saturated solution of potassium iodide are iodine preparations used in short-term treatment of hyperthyroidism
    • Iodine preparations should not be followed by propylthiouracil, methimazole, or radioactive iodine
    • Sodium iodide 131I is a radioactive isotope of iodine used to treat hyperthyroidism and thyroid cancer
    • Propranolol is recommended in all patients with symptomatic hyperthyroidism, particularly in older adults with cardiovascular conditions
    • Propranolol controls symptoms of hyperthyroidism by blocking beta-adrenergic receptors
    • Propranolol is useful for controlling symptoms during the delayed response to thioamide drugs and radioactive iodine

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    Description

    Test your knowledge on propylthiouracil, a thioamide antithyroid drug used in the treatment of hyperthyroidism. Learn about its clinical use, nursing implications, patient teaching, and interactions with other drugs. This quiz covers essential information for healthcare professionals and students in the field.

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