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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 therapy contraindicated during pregnancy?
Why is radioactive iodine therapy contraindicated during pregnancy?
What precaution should women of childbearing age take before administration of radioactive iodine?
What precaution should women of childbearing age take before administration of radioactive iodine?
Why should women be instructed to not conceive for at least 6 months following radioactive iodine treatment?
Why should women be instructed to not conceive for at least 6 months following radioactive iodine treatment?
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Where does almost all of the iodine that enters and is retained in the body become concentrated?
Where does almost all of the iodine that enters and is retained in the body become concentrated?
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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 recommended duration for taking antithyroid drugs to return thyroid function to normal?
What is the recommended duration for taking antithyroid drugs to return thyroid function to normal?
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Which solution is used in short-term treatment of hyperthyroidism?
Which solution is used in short-term treatment of hyperthyroidism?
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What should iodine preparations not be followed by?
What should iodine preparations not be followed by?
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In which condition is propranolol particularly useful?
In which condition is propranolol particularly useful?
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How does propranolol control symptoms of hyperthyroidism?
How does propranolol control symptoms of hyperthyroidism?
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What is sodium iodide 131I used to treat?
What is sodium iodide 131I used to treat?
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What is the primary test measured at specific intervals after radioactive iodine treatment?
What is the primary test measured at specific intervals after radioactive iodine treatment?
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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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Which medication is recommended during the first trimester of pregnancy due to teratogenic effects of the other?
Which medication is recommended during the first trimester of pregnancy due to teratogenic effects of the other?
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What is used to control symptoms of thyroid storm?
What is used to control symptoms of thyroid storm?
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What may be used to prepare patients with hyperthyroidism for surgery?
What may be used to prepare patients with hyperthyroidism for surgery?
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What happens if antithyroid medications are discontinued before therapy completion?
What happens if antithyroid medications are discontinued before therapy completion?
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What is the duration of action of propylthiouracil dependent on?
What is the duration of action of propylthiouracil dependent on?
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How is propylthiouracil metabolized?
How is propylthiouracil metabolized?
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What is the main action of propylthiouracil?
What is the main action of propylthiouracil?
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What is the only contraindication to propylthiouracil?
What is the only contraindication to propylthiouracil?
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What QSEN Alert is associated with the use of propylthiouracil?
What QSEN Alert is associated with the use of propylthiouracil?
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What should the nurse assess for as therapeutic effects of propylthiouracil?
What should the nurse assess for as therapeutic effects of propylthiouracil?
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What is the primary cause of Ms. Fields’ symptoms?
What is the primary cause of Ms. Fields’ symptoms?
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What is the primary function of propylthiouracil (PTU) in the treatment of Ms. Fields’ condition?
What is the primary function of propylthiouracil (PTU) in the treatment of Ms. Fields’ condition?
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Why is propranolol prescribed in addition to PTU for Ms. Fields?
Why is propranolol prescribed in addition to PTU for Ms. Fields?
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What is the role of the sympathetic nervous system in hyperthyroidism?
What is the role of the sympathetic nervous system in hyperthyroidism?
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When should propranolol be tapered and discontinued for Ms. Fields?
When should propranolol be tapered and discontinued for Ms. Fields?
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What is the expected timeline for therapeutic effects of PTU in Ms. Fields?
What is the expected timeline for therapeutic effects of PTU in Ms. Fields?
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What is the primary reason for routine liver function testing in patients using propylthiouracil?
What is the primary reason for routine liver function testing in patients using propylthiouracil?
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Which medication interaction should be of particular concern for patients taking propylthiouracil?
Which medication interaction should be of particular concern for patients taking propylthiouracil?
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What is the recommended frequency for administration of propylthiouracil due to its short plasma half-life?
What is the recommended frequency for administration of propylthiouracil due to its short plasma half-life?
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What are the therapeutic effects of propylthiouracil on patients with hyperthyroidism?
What are the therapeutic effects of propylthiouracil on patients with hyperthyroidism?
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What is the main reason for avoiding propylthiouracil in patients with known hypersensitivity to the medication?
What is the main reason for avoiding propylthiouracil in patients with known hypersensitivity to the medication?
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What is the main use of propylthiouracil in the treatment of hyperthyroidism?
What is the main use of propylthiouracil in the treatment of hyperthyroidism?
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What is the most likely cause of Ms. Fields' symptoms?
What is the most likely cause of Ms. Fields' symptoms?
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What is the function of propylthiouracil (PTU) in the treatment of hyperthyroidism?
What is the function of propylthiouracil (PTU) in the treatment of hyperthyroidism?
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Why is propranolol prescribed in addition to PTU for Ms. Fields?
Why is propranolol prescribed in addition to PTU for Ms. Fields?
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What is the primary effect of propranolol in the treatment of hyperthyroidism?
What is the primary effect of propranolol in the treatment of hyperthyroidism?
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What is the role of the nurse in Ms. Fields' treatment?
What is the role of the nurse in Ms. Fields' treatment?
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What is the expected time frame for therapeutic effects of propylthiouracil (PTU)?
What is the expected time frame for therapeutic effects of propylthiouracil (PTU)?
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Study Notes
Thyroid Treatment Options and Considerations
- Radioactive iodine is concentrated in the thyroid gland, destroying thyroid cells without harming other tissues, ultimately leading to hypothyroidism.
- Ablative dose of radioactive iodine initially causes a release of thyroid hormone, which may increase symptoms and require monitoring for thyroid storm.
- Beta-blockers are used to control symptoms of thyroid storm, while thyroid hormone replacement is initiated 4 to 18 weeks after stopping antithyroid medications.
- TSH measurements can be misleading after radioactive iodine treatment; serum free T4 is the principal test measured at specific intervals until normal thyroid function is established.
- Radioactive iodine treatment avoids many side effects of antithyroid medications, but patients can contaminate their environment and must follow precautions.
- Antithyroid medications, such as methimazole or propylthiouracil, inhibit stages of thyroid hormone synthesis and are used until the patient is euthyroid.
- Baseline blood tests are performed before initiating antithyroid medications, and the therapeutic dose is determined based on clinical criteria.
- Antithyroid medications should be taken on an empty stomach, and their gradual tapering occurs over several months once symptom relief is achieved.
- Toxic complications of antithyroid medications are relatively uncommon, but periodic follow-up is essential to monitor for potential adverse effects.
- Propylthiouracil is recommended during the first trimester of pregnancy due to the teratogenic effects of methimazole, which should be used during the remainder of the pregnancy and when breastfeeding.
- Discontinuation of antithyroid medications before therapy completion often leads to relapse within 6 months, necessitating discussion of potential relapse and treatment strategies.
- Potassium iodide, in combination with antithyroid agents or beta-adrenergic blockers, may be used to prepare patients with hyperthyroidism for surgery, reducing the effects of hyperthyroidism and preventing thyroid storm.
Propylthiouracil: Uses, Effects, and Nursing Implications
- Propylthiouracil is an antithyroid drug approved by the FDA for treating hyperthyroidism
- It inhibits thyroid hormone production and peripheral conversion of T4 to T3
- It is used in preoperative preparation for thyroidectomy, before/after radioactive iodine therapy, and in the treatment of thyroid storm
- Propylthiouracil has a short plasma half-life and must be given every 8 hours
- Adverse effects include signs of hypothyroidism, hematologic effects, dermatologic effects, CNS effects, GI effects, and other reported effects
- It is contraindicated in patients with known hypersensitivity to the medication
- Evidence suggests a link between propylthiouracil and vasculitis, requiring close monitoring and aggressive wound care
- It may interact with anticoagulants, amiodarone, potassium iodide, sodium iodide, and lithium
- Patients should take propylthiouracil around the clock in evenly divided doses
- Therapeutic effects include slower pulse rate, normal activity level, decreased nervousness, and weight gain
- Adverse effects should be monitored, including heart rate, lung and heart sounds, speech, emotional status, weight, and bowel movements
- Routine liver function testing is essential due to the risk of liver injury with propylthiouracil use, as indicated by a BLACK BOX WARNING from the FDA
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Description
Test your knowledge of thyroid treatment options and considerations with this quiz. Explore topics such as radioactive iodine treatment, antithyroid medications, monitoring protocols, and medication considerations during pregnancy.
