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Thyroid Drugs (Carbimazole Propythiouracil (MOA (Thionamides …
Thyroid Drugs
Carbimazole
Propythiouracil
MOA
Thionamides
thyroperoxidase inhibitors
prevent iodination of tyrosine
→ ↓ T4/T3 synthesis
Carbimazole is a pro-drug
converted to methimazole
SE
Agranulocytosis often transient and benign
Hypersensitvity rash, pruritis
Hepatitis
CI
Pregnancy
Children
Tracheal compression
do surgery
Propythiouracil is reserved for those
intoleant of carbimazole due to risk of
hepatitis
Titrate to normal TSH or block and
replace.
Thyroxine
SE
Precipitation of heart failure
Osteopaenia
AF
Over-Rx → hyperthyroidism
Interacts increases warfarin
Introduce T4 slowly in the elderly
Radioiodine: I 131
MOA
Radioiodine is localised to thyroid
→ destruction of gland
SE
→ hypothyroidism
Can precipitate thyroid storm
Stop thionamide before use