PHAR 451 Lecture Notes - Lecture 7: Hypoparathyroidism, Palpitations, Euthyroid
6 Oct 2016
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Document Summary
Hyperthyroidism: rationalize a diagnosis of hyperthyroidism on the basis of signs and symptoms combined with lab tests, design, implement and monitor (efficacy/toxicity) an effective pharmacotherapeutic plan for managing graves". Effective for symptoms, regardless of cause of hyperthyroidism. Helps with palpitations, tachycardia, tremulousness, anxiety, heat intolerance. Similar 6-week biochemical outcomes, similar patient satisfaction and sick leave at 2 years. % at 1-2 years, 50% relapse) may allow patient to be euthyroid without drugs. Don"t want to loose parathyroid at the same time. Achieve clinical and biochemical euthyroidism in 3-8 weeks. Use for 12-24 months, then taper to assess for remission. If relapse after remission, consider i131 or surgery. More rapid onset 80% euthyroid at 10 weeks. Anca positivity 0% anca positivity reports of cholestasis, but very few reports of serious liver failurer. 20-30 mg/day in large goiter has similar efficacy to 30 or 40 mg/day. Reports of fatal hepatic necrosis, death boxed warning for liver injury.
