Hypothyroid

Preferred b/c predictable no s/e like t3

takes >2 weeks for clinical improvment

Adverse Rxn-transient hyperthyroidism, regularly check tsh and t4 

reduce dose in elderly and cardiac pts

Hypothyroid

problem- T₃ not needed and causes typical hyperthyroid effects(tremor, palpitations, diarrhea)

Anti thyroid

Class- Thioamides

inhibit oxidation and coupling steps of thyroid hormone synthesis

slow onset

excreted slower than PTU therefore is more potent

Adverse Rxn: agranulocytosis

Antithyroid

Class: Thioamides

inhibit oxidation and coupling steps of thyroid hormone synthesis

slow onset

Preferred in pregnancy

antithyroid

gets taken up by thyroid and destroys T₄ producing cells

(+) 100% cure rate

(-) multiple doses may be needed, chance of delayed hypothryoidism

cannot give if preggers or nursing

Β-adrenergic Blockers 

propanolol

reduces tachycardia, sweating, tremor, nervousness

decreases conversion of T₄ to T₃ by inhibiting 5' deiodinase

inhibit hormone release

atrophy the gland(reduces vascular supply)

rapid onset 2-7 days

used in thyroid storm