Main symptoms
Heat intolerance
Weight loss
Diarrhoea
Tachycardia
Other symptoms
Excitability
Tremors
Angina pain
Sweating
Arrhythmias
Tests
Low TSH
High T4 (thyroxine)
High T3 (Triiodothyronine)
Treatment
Carbimazole
Propylthiouracil
MoA
Anti-thyroid drugs interfere with synthesis of thyroid hormones
Carbimazole
Drug of choice
SE:
Bone marrow suppression
Rashes/itching
Bone marrow suppression
Agranulocytosis + Neutropenia
Pt counselling = report signs of infection e.g. fever, malaise, mouth ulcers, sore throat
Propylthiouracil
Alternative
SE = hepatotoxicity
Hyperthyroidism - pregnancy
Blocking replacement regimen and radioactive iodine is C/I
1st trimester
Propylthiouracil
2nd trimester
Carbimazole