The disease is caused by excessive release of thyroid hormone by the thyroid gland. This disproportionate discharge of thyroid hormone from the thyroid gland is accountable for numerous signs and symptoms such as tachycardia,…
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esis of thyroid hormone, using antithyroid drugs (propylthiouracil, methimazole, and iodide) or reducing the amount of thyroid tissue with radio iodine (131I) or by thyroidectomy.
The main antithyroid drugs are thiomides such as propylthiouracil and methimazole. These drugs inhibit the function of thyroid peroxidase enzyme (TPO), diminishing organification as well as oxidation of iodide. Antithyroid drugs also decrease thyroid antibody levels by an unknown mechanism (Davidson, 2002; Rang, Dale, Ritter, & Flower, 2009).
These drugs are grouped as thioureylenes. They decrease the output of thyroid hormone from the gland and cause gradual reduction in signs and symptoms of thyrotoxicosis, where the Basal metabolic rate and pulse rate return to normal over a period of three to four weeks. Their exact mechanism is not clear, but there is evidence that they inhibit the iodination of tyrosyl residues in thyroglobulin (TG). The drugs are also capable of impeding thyroperoxidase-catalyzed oxidation reactions by acting as a substrate for the hypothesized peroxidase-iodinium complex, thus competitively inhibiting the interaction with tyrosine. Additionally, PTU displays reducing action of de-iodination of T4 to T3 in peripheral tissues (Brunton, Chabner, & Knollman, 2011; DiPiro et al., 2014; Rang et al., 2009; Haslett, Chilvers, Boon, Colledge, & Hunter, 2014).
It is highly plasma protein bound. The plasma half life is 1–2 hours, so multiple doses are required. A single dose acts for 4–8 hours. No active metabolite is formed during drug metabolism (Brunton et al., 2011; DiPiro et al., 2014; Rang et al., 2009)
A feeble amount of the drug passes through the placenta and milk. Therefore, it is suitable to treat hyperthyroidism in pregnancy. It can also be used in thyroid storm and in patients developing adverse effects with carbimazole. These drugs are used pre-operatively to make the patient euthyroid before performing thyroidectomy along with 131I (Brunton et al.,
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