PHRM 211 Lecture Notes - Lecture 2: Thioamide, Thyroidectomy, Goitre
Document Summary
Recommended for all people with symptoms of hyperthyroidism (especially elderly with hr > 90 bpm or coexistent cvd) Chronic thionamides (atds) preferred in canada, europe, japan. Thyroidectomy last resort for drug failure, massive goitre, coexisting malignancy. Similar 6-week biochemical outcomes, similar patient satisfaction and sick leave at 2 years. Goal : achieve clinical and biochemical euthyroidism in 3-8 weeks. Once daily dosing (vs tid with ptu) Pregnancy (just before and during 1st trimester only) less placental transfer, no aplasia cutis. Acute thyrotoxicosis? (thyroid storm) inhibits t4 t3 conversion, unlike mmi. Dosing : 100 mg po tid (150 mg in large goitre) in 1st trimester of pregnancy. Ptu also causes birth defects , though less serious ones than mmi (e. g. sinus/cyst in the face and neck region and malformations of the urinary system). Both mmi & ptu are considered safe for nursing mothers (lactation).
