Graves' Disease: Treatment – Hyperthyroidism (Thyrotoxicosis)

by Carlo Raj, MD

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    Let’s talk about management. Let’s try to control the symptoms first. So, before you do anything, you want to make sure that you’re able to properly regulate the blood pressure and the heart rate in a patient with Graves’ disease. With all that T3, T4, you cause increased sensitisation of your catecholamines upon the beta-1 receptor, so it would only make sense that you try to control heart rate and control or manage your palpitations. So, you’re looking for drugs that are then going to slow down or block your beta receptors. Atenolol or, if it’s non-selective, propranolol. Used to control the palpitations. “Hey, doc, I feel like my heart is going to jump out of my chest.” Tremors, nervousness, tachy-, anxiety, heat intolerance. The ophthalmopathy, local symptoms, how do you control this? Lubricants in the eye drops because it’s like you have all that orbit that’s protruding forward. My goodness, it is now exposed to the elements, right? So, therefore, at this point, the lacrimal gland can only take care of what’s normally, you know, controlled by the eyelids, but if it’s exophthalmos symptomatic, be smart about how you manage your patient. Take your time. Understand what the patient is complaining of and then manage your patient accordingly. May require oral steroids, if at all responsive to anti-inflammatory, radiotherapy or perhaps even surgical decompression because you are looking at increased intraocular pressure, aren’t you? So, therefore, it might necessitate some of that decompression that you want to make sure that you address in Graves’ ophthalmopathy. Targeting the disease itself. So, now, we’ll talk about, apart from symptomatic treatment or management that we discussed earlier, let’s go and start taking care of the thyroid gland. Thionamides, inhibits thyroid peroxidase. It does not inhibit the release of pre-formed thyroid hormones. So,...

    About the Lecture

    The lecture Graves' Disease: Treatment – Hyperthyroidism (Thyrotoxicosis) by Carlo Raj, MD is from the course Thyroid Gland Disorders.

    Included Quiz Questions

    1. Exophthalmos
    2. Palpitations
    3. Heat intolerance
    4. Anxiety
    5. Tachycardia
    1. Inhibiting thyroid peroxidase
    2. Inhibit the release of preformed thyroid hormone
    3. Inhibit TBG synthesis
    4. Inhibit release of TRH
    5. Inhibit production of TSI
    1. Aplasia cutis
    2. Hepatotoxicity
    3. Teratogenicity
    4. Agranulocytosis
    5. Gynecomastia
    1. Radioactive Iodine
    2. PTU
    3. Methimazole
    4. Steroids
    5. Atenolol

    Author of lecture Graves' Disease: Treatment – Hyperthyroidism (Thyrotoxicosis)

     Carlo Raj, MD

    Carlo Raj, MD

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