Neurological Manifestations of Thyroid Disease Medication
- Author: Gabriel Bucurescu, MD, MS; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE more...
The goal is to establish a euthyroid state. In hypothyroidism, this involves thyroid replacement, which is attained readily. In hyperthyroidism, elevated thyroid hormone is treated with surgery, which causes hypothyroidism and requires thyroid replacement, or with drugs and radioactive iodine.
Symptoms that are associated with abnormal thyroid states are treatable.
These medications are preferred for suppressing thyroid function.
Propylthiouracil is a derivative of thiourea that inhibits organification of iodine by the thyroid gland. It also inhibits the conversion of T4 to T3, which is advantage over other agents.
Methimazole suppresses thyroid function and has a mechanism similar to that of PTU; it does not inhibit peripheral conversion of T4 to T3. Methimazole is fifteen times as potent as PTU. PTU-equivalent dosing can be used, divided thrice daily.
Beta-adrenergic blocking agents
These agents are used to treat symptomatic hyperthyroidism.
This nonselective, beta-adrenergic blocking agent treats symptomatic tachycardia. Propranolol has membrane-stabilizing activity and decreases the automaticity of contractions.
These agents are used in thyroid hormone replacement.
Levothyroxine is synthetic, but it is identical to natural T4; in its active form, levothyroxine influences the growth and maturation of tissues; it is involved in normal growth, metabolism, and development.
These agents replace depleted electrolytes.
Potassium chloride is essential for the transmission of nerve impulses, maintenance of intracellular tonicity, and maintenance of normal renal function. It is also vital for skeletal and smooth muscles. Potassium chloride replaces potassium lost in thyrotoxic periodic paralysis.
These agents provide immunosuppressive therapy for Graves ophthalmopathy, especially in cases of severe exophthalmos.
Prednisone is a widely used glucocorticoid that suppresses inflammatory processes by reversing increased capillary permeability and suppressing PMN activity; it is used to treat allergic, inflammatory, and autoimmune disorders.
These agents may help relieve painful polyneuropathy.
By inhibiting the reuptake of serotonin and/or norepinephrine by presynaptic neuronal membrane, amitriptyline may increase the synaptic concentration of these neurotransmitters in the CNS; it is useful as an analgesic for certain chronic and neuropathic pain.
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