A useful drug in hyperthyroidism! - USMLE Forums
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  #1  
Old 07-24-2011
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Drug A useful drug in hyperthyroidism!

A 27-year-old woman has suffered from intermittent heat intolerance, sweating, tremors, tachycardia, and muscle weakness for 3 months. Despite an increased appetite, she has experienced weight loss. Blood studies show a thyroid-stimulating hormone value of less than 0.05 μU/mL and a total thyroxine (T4) value of 18 μg/dL. A drug that could be beneficial to this patient and acts to inhibit the synthesis of thyroid hormones and prevent the conversion

A. methimazole
B. propranolol
C. propylthiouracil
D. radioactive iodine (131I)
E. sodium iodide
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  #2  
Old 07-24-2011
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C - PTU, because it prevents peripheral converstion as well
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Old 07-24-2011
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Methimazole & Propylthiouracil - they both inhibit the organification & coupling of thyroid hormones by inactivating enzymes MIT & DIT. However, in this pt the peripheral T4 levels are high and Propylthiouracil acts peripherally to inhibit conversion of T4 to T3.

Propylthiouracil would be the best drug in this patient.
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Old 07-24-2011
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I'll Go with Answer C, since it who blocks peripheral conversion T4 to T3.

The other one who addresses the same Block (peripheral conversion), is B-Blocker medication, but that would recommend to be given in a Thyroid-toxicosis storm.
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Old 07-24-2011
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Yeah, uncless theres a curve ball I'm missing, its c propylthiouracil.
I also remember reading in Uworld that beta blockers are used to prevent the acute symptoms coz they prevent peripheral conversion and sympathetic outflow. Triangle of treatment - objective is to decrease the following - synthesis, peripheral conversion and sympathetic outflow.
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Old 07-24-2011
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Default Ans.

C.Propylthiouracil
Inhibits synthesis by inhibiting peroxidase enzyme, and also decreases peripheral conversion of T4 to T3.
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Old 07-24-2011
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B proplanolol
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Old 07-24-2011
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Star C

C. propylthiouracil
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Old 07-24-2011
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C. propylthiouracil
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Old 07-24-2011
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Search Correct answer

Correct answer is C)

The patient’s clinical and laboratory findings suggest the diagnosis of Graves disease, a form of hyperthyroidism frequently treated with propylthiouracil (PTU). PTU is a thioamide compound that inhibits peroxidase and thereby prevents the oxidation of iodide. This in turn blocks the organification of iodine and inhibits the synthesis of thyroid hormones. In addition, PTU inhibits the deiodination and conversion of T4 to T3 in peripheral tissues. Because PTU is highly protein-bound, it is the preferred thioamide for use in pregnant women with hyperthyroidism.
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Old 11-27-2012
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go with c
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