GRAVES DISEASE-MEDICAL MGM

SUMMARY

1. Methimazole(MMI)/propylthiouracil(PTU) +/- thyroid ablation (¹³¹I). PTU carries increased risk of death from acute liver failure so is no longer first line therapy.

2. Beta blockers for adrenergic symptoms.

3. MMI is used in non-pregnant patients. PTU is the only drug approved for first trimester.

4. Side effects of both MMI & PTU: hepatoxicity & agranulocytosis.

5. Pre-treat with MMI/PTU & beta-blockers prior to ablation.

6. Almost all patients become hypothyroid after ablation.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].