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Antithyroid Drug

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121. Warfarin Therapy Management

• rosuvastatin Other • allopurinol • cimetidine • corticosteroids (oral) • proton pump inhibitors (PPI) – isolated case reports with all PPIs • thyroid supplements Antibiotics • rifampin Antidepressants • trazodone Antiepileptics • carbamazepine • phenobarbitone • primodone • phenytoin (later on) Other • antithyroid agents • cholestyramine Increased bleeding risk due to non-warfarin mechanisms Analgesics • aspirin • Cox II Inhibitors • Nonsteroidal anti-inflammatory drugs Anticoagulants/Antiplatelet agents (...) in these patients by about 66%. 3 Approximately a third of the patients who would benefit from warfarin never receive it, and over half of those who do receive warfarin are managed suboptimally 1,6 because of the complex pharmacology and numerous drug, disease, dietary and herbal interactions. Warfarin is given orally and is absorbed rapidly and completely. 6-8 Absorption is not impacted by food. It is almost fully bound to albumin in blood; thus hypoalbuminemic patients (e.g., malnourished, liver disorders

2015 Clinical Practice Guidelines and Protocols in British Columbia

122. A Somewhat Bizarre Case of Graves Disease Due to Vitamin Treatment (PubMed)

with X-linked adrenomyeloneuropathy recently diagnosed with Graves disease, was referred to our department to evaluate his response to antithyroid drugs. His thyroid function tests were still consistent with hyperthyroidism while he had been receiving carbimazole 40 mg/d for 6 weeks. We found no signs of thyrotoxicosis on physical examination despite the "frank and severe" biochemical hyperthyroidism. Noticing that all the patient's assays had been done at the same laboratory, we suspected assay

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2017 Journal of the Endocrine Society

123. Study of the Factors Leading to Fetal and Neonatal Dysthyroidism in Children of Patients With Graves Disease (PubMed)

of 100% and specificity of 64%. Using the newborn TRAb levels, the cutoff value of 6.8 IU/L best predicted for ND, with a sensitivity of 100% and a specificity of 94%. In our study, 65% of women with a history of Graves disease did not receive antithyroid drugs during pregnancy but still had infants at risk of ND.In pregnant women with TRAb levels ≥2.5 IU/L, fetal ultrasound monitoring is essential until delivery. All newborns with TRAb levels ≥6.8 IU/L should be examined by a pediatrician

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2017 Journal of the Endocrine Society

124. An association of myasthenia gravis with Hashimoto's thyroiditis in a patient with a multinodular goitre (PubMed)

hyperthyroidism secondary to Hashimoto's thyroiditis in multinodular goitre was diagnosed with generalised MG after 2 years. She presented with right eye ptosis (ocular) and difficulty in swallowing and chewing (bulbar). The diagnosis of MG was confirmed by fatigability testing, electromyography and the presence of AChR antibodies. Her symptoms showed improvement with pyridostigmine (Mestinon) 60 mg 6-hourly. Her antithyroid drug was tapered down according to her thyroid function test. Throughout a year

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2017 Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

125. Classification of Anemias

deficiency high RDW, low-normal reticulocyte , Hemolytic anemia Drug induced Aplastic anemia: allopurinol, antithyroid meds , chemo, chloramphenicol, chlorpromazine, clopidogrel, corticosteroids, furosemide, gold, indomethacin, interferon a2a&2b , isoniazid, methyldopa, NSAIDs, penicillamine, phenothiazines, procainamide, sulfonamides & ticlopidine. Drug induced Hemolysis in G6PD Deficiency: ascorbic acid, benzocaine, chloroquine, dapsone, hydroxychloroqine, nitrofurantoin, phenazopyridine, primaquine (...) , sulfacetamide, sulfamethoxazole, sulfanilamide & sulfapyridine. Drug induced Hemolytic anemia: ACEI, acetaminophen, ASA/NSAIDs, cephalosporins, chlorpromazine, chlorpropamide, diclofenac, hydrochlorothiazide, interferon a2a&2b , isoniazid, levodopa, levofloxacin, mefenamic acid, methadone, methyldopa, penicillins, probenecid, procainamide, quinine, quinidine, ribavirin, rifampin, sulfonamides, & tetracycline. (Direct antiglobulin test-DAT or Coomb’s test is used to detect cause of hemolytic anemia) Drug

2014 RxFiles

126. Urticaria

classified as: Chronic spontaneous urticaria (previously called chronic idiopathic urticaria) — this has no identifiable external cause but may be aggravated by heat, stress, certain drugs, and infections. Autoimmune urticaria — characterized by the presence of immunoglobulin G (IgG) autoantibodies to the high-affinity receptor for IgE (Fc epsilon R1). Chronic inducible urticaria (CINDU, previously called physical urticaria) — occurs in response to a physical stimulus and can be further classified (...) causing significant social or psychological problems. Have I got the right topic? Have I got the right topic? From birth onwards. This CKS topic covers the diagnosis, assessment, and management of urticaria in primary care. This CKS topic does not cover in detail the specialist or secondary care management of urticaria. It also does not cover the management of angio-oedema, anaphylaxis, or acute drug reactions. There are separate CKS topics on , , , , , and . The target audience for this CKS topic

2018 NICE Clinical Knowledge Summaries

127. Alopecia, androgenetic - male

topic on for more information. Iron deficiency and poor nutritional status. Drugs, including those: Implicated in . With an androgenic effect (such as anabolic steroids). With an antithyroid action (such as carbimazole). Other systemic disease , such as a recent severe infection, systemic lupus erythematosus, or cancer. Basis for recommendation Basis for recommendation The information on differential diagnoses is based on expert opinion in a European consensus guideline on the diagnostic evaluation (...) drugs, such as antidepressants, anabolic steroids, carbimazole, or chemotherapy. Excessive dietary habits or rapid weight loss. Inflammation, papules or pustules, scaling, or scarring of the scalp. Laboratory testing for the diagnosis of androgenetic alopecia is generally unnecessary. Tests for thyroid function, full blood count, and a ferritin level should be considered, particularly if telogen effluvium is suspected, the presentation is atypical, or there are features that suggest hypothyroidism

2018 NICE Clinical Knowledge Summaries

128. THE PRIMARY CILIUM IN THE HUMAN THYROCYTE: CHANGES IN FREQUENCY AND LENGTH IN RELATION TO THE FUNCTIONAL PATHOLOGY OF THE THYROID GLAND. (PubMed)

biosynthetic hyperactivity after long-term antithyroid drug treatment.Our results suggest a direct relationship between ciliogenesis and both follicle activity and tissue heterogeneity in the functional pathology of the thyroid gland.

2019 Thyroid

129. Trimester-specific reference ranges for thyroid hormones in pregnant women. (PubMed)

history of thyroid disease, and consumption of estrogen or antithyroid drugs. Thyroid palpation was performed to exclude the thyroid goiter. Thyroid function and urine iodine were measured by chemiluminescence and arsenic cerium analysis.The trimester-specific reference ranges in Nanjing were as follows: thyroid-stimulating hormone (TSH) 0.02 to 3.78 mIU/L, free thyroxine (FT4) 13.93 to 26.49 pmol/L, total thyroxine (TT4) 103.39 to 319.43 nmol/L in the 1st trimester. TSH 0.47 to 3.89 mIU/L, FT4 12.33

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2019 Medicine

130. Richard Lehman’s journal review—5 February 2018

. Antithyroid drugs in pregnancy Between 2008 and 2014, nearly 13,000 South Korean women took antithyroid drugs during the first trimester of pregnancy. Theoretically, the figure should have been zero, because the risk of congenital malformations from these drugs has long been known, so women likely to conceive should strenuously avoid them. But , perhaps this figure is as good as real life can get. Data from the national database allow us to quantify the risks associated with methimazole (...) , they were nearly all men in their early-mid 60s with mildly symptomatic heart failure with a reduced ejection fraction, and half of it was non-ischaemic. They were all people with AF “ who did not have a response to antiarrhythmic drugs, had unacceptable side effects, or were unwilling to take these drugs.” The 369 recruited patients were then randomized to receive more of the medical therapy that wasn’t working or that they weren’t likely to take, or catheter ablation treatment. As a condition

2018 The BMJ Blog

131. MANAGEMENT OF ENDOCRINE DISEASE: Predictive scores in Autoimmune Thyroid Disease. Are they useful? (PubMed)

of the development of overt AITD, the Graves' Events After Therapy-GREAT score: a prediction score for the risk of recurrence after antithyroid drugs withdrawal and the Prediction Graves' Orbitopathy-PREDIGO score: a prediction score for the development of Graves' Orbitopathy in newly diagnosed patients with Graves' hyperthyroidism. Their construction, clinical applicability, the possible preventative measurements which can be taken to diminish the risks and the potential future developments which can improve

2019 European Journal of Endocrinology

132. Preoperative Thyroid Autoimmune Status and Changes in Thyroid Function and Body Weight After Bariatric Surgery. (PubMed)

recruited 101 patients with morbid obesity (44 men and 57 women) who received bariatric surgery at Zhongshan Hospital, Fudan University. Those who had used thyroid hormone replacement or antithyroid drugs were excluded. General linear models were used to compare the changes in body weight and thyroid function in participants with different thyroid autoimmune statuses.After bariatric surgery, serum-free triiodothyronine (FT3) (4.94 ± 0.73 vs 4.33 ± 0.59 pmol/L, P < 0.001) and thyroid-stimulating hormone

2019 Obesity Surgery

133. Increased Remission Rates After Long-Term Methimazole Therapy in Patients with Graves' Disease: Results of a Randomized Clinical Trial. (PubMed)

Increased Remission Rates After Long-Term Methimazole Therapy in Patients with Graves' Disease: Results of a Randomized Clinical Trial. Background: Studies differ regarding whether, compared with courses of conventional duration, longer-term antithyroid drug treatment increases frequency of remission in patients with Graves' hyperthyroidism. We prospectively conducted a randomized, parallel-group study comparing relapse rates in patients receiving longer-term versus conventional-length

2019 Thyroid Controlled trial quality: uncertain

134. Long-term Methimazole Therapy in Juvenile Graves' Disease: A Randomized Trial. (PubMed)

Long-term Methimazole Therapy in Juvenile Graves' Disease: A Randomized Trial. Recent studies show that long-term (LT) antithyroid drugs reduce relapse of hyperthyroidism in patients with Graves' disease. Our objective was to evaluate the effectiveness and safety of LT methimazole treatment and to compare remission rates in Graves' disease patients after LT and short-term (ST) therapy.In this randomized, parallel group trial, 66 consecutive patients with untreated juvenile Graves

2019 Pediatrics Controlled trial quality: uncertain

135. Adjuvant rituximab, a potential treatment for the young patient with Graves' hyperthyroidism (RiGD): study protocol for a single-arm, single-stage, phase II trial. (PubMed)

of rituximab (500 mg) and a 12-month course of antithyroid drug (usually carbimazole) can result in a meaningful increase in the proportion of patients in remission at 2 years, the primary endpoint. A single-stage, phase II A'Hern design is used. 27 patients aged 12-20 years with newly presenting Graves' hyperthyroidism will be recruited. Markers of immune function, including lymphocyte numbers and antibody levels (total and specific), will be collected regularly throughout the trial.The trial (...) will determine whether the immunomodulatory medication, rituximab, will facilitate remission above and beyond that observed with antithyroid drug alone. A meaningful increase in the expected proportion of young patients entering remission when managed according to the trial protocol will justify consideration of a phase III trial.Ethics and dissemination The trial has received a favourable ethical opinion (North East - Tyne and Wear South Research Ethics Committee, reference 16/NE/0253, EudraCT number 2016

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2019 BMJ open Controlled trial quality: uncertain

136. Propylthiouracil-induced organizing pneumonia: A case report. (PubMed)

Propylthiouracil-induced organizing pneumonia: A case report. Propylthiouracil (PTU) is a common antithyroid drug which can treat hyperthyroidism effectively. PTU is, however, associated to multiple adverse effects. In rare case, PTU can cause interstitial pneumonia.A 40-year-old woman presented with dyspnea and was diagnosed with pulmonary infection at the first time. After the treatment with moxifloxacin, her symptoms still got worse.The lung tissues biopsy confirmed the diagnosis

2019 Medicine

137. Patients Treated for Hyperthyroidism Are at Increased Risk of Becoming Obese: Findings from a Large Prospective Secondary Care Cohort. (PubMed)

population (Health Survey for England, 2007-2009). Next, we investigated the effect of treatment with an antithyroid drug (ATD) alone in regard to ATD with radioactive iodine (131I) therapy. We modeled the longitudinal weight data in relation to the treatment pathway to thyroid function and the need for long-term thyroxine replacement. Results: During treatment of hyperthyroidism, men gained 8.0 kg (standard deviation ±7.5) and women 5.5 kg (±6.8). At discharge, there was a significantly increased risk

2019 Thyroid

138. The long-term outcome of treatment for Graves' hyperthyroidism. (PubMed)

The long-term outcome of treatment for Graves' hyperthyroidism. The treatment efficacy of antithyroid drug therapy(ATD), radioactive iodine(I131) or surgery for Graves' hyperthyroidism is well described. However, there are few reports on the long-term total outcome of each treatment modality as how many require levothyroxine supplementation, the need of thyroid ablation or the individual patient's estimation of their recovery.We conducted a pragmatic trial to determine the effectiveness

2019 Thyroid

139. Interventions for hyperthyroidism pre-pregnancy and during pregnancy. (PubMed)

included in the review.As we did not identify any eligible trials, we are unable to comment on implications for practice, although early identification of hyperthyroidism before pregnancy may allow a woman to choose radioactive iodine therapy or surgery before planning to have a child. Designing and conducting a trial of antithyroid interventions for pregnant women with hyperthyroidism presents formidable challenges. Not only is hyperthyroidism a relatively rare condition, both of the two main drugs (...) searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2013).We planned to include randomised controlled trials, quasi-randomised controlled trials, and cluster-randomised trials comparing antithyroid interventions for hyperthyroidism pre-pregnancy or during pregnancy with another intervention or no intervention (placebo or no treatment).Two review authors assessed trial eligibility and planned to assess trial quality and extract the data independently.No trials were

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2013 Cochrane

140. Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee

- dine or surgery which may account for up to one-third of cases of hypothyroidism in the community. 6 Less frequent causes include surgery and radioiodine ablation for benign nodular thy- roid disease and thyroid cancer, external beam irradiation of malignant tumours of the head and neck and drugs including lithium, amiodarone and interferon. 1 Congenital hypothyroidism affects about one newborn in 3500–4000 births. 7 The term subclinical hypothyroidism describes the ?nding of a raised serum TSH (...) Endocrinology (2015) doi:10.1111/cen.12824in 5–10% of the population, being more common in women and increasing with age. 9 It can progress to overt hypothyroidism, par- ticularly if antithyroid antibody positive. 10 In the community, the mostcommon aetiology ischronic autoimmune thyroiditis. 6 There has been a growing controversy about the upper limit of the reference range for serum TSH. 11,12 Reference ranges are derived from a reference population that comprises a large group of subjects who do not have

2015 British Thyroid Association

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