지메스컨설팅

자료실(수강자료)

(step2CK)hyperthyroidism 치료
운영자 / 2005-09-16 11:46:44

(임신,청소년,중년 등의 나이에 따른 치료법의 차이가 매우 중요)

A.Medications: Antithyroid Medications
Methimazole 15-30 mg per day
Propylthiouracil (PTU) 100-200 mg PO tid (Indicated in pregnancy)
Indications
Hyperthyroidism in children and adolescents
Pregnancy (PTU)

B.Medications: Antiadrenergic Medications
Beta Blockers (non-selective preferred)
Diltiazem (Cardizem)
Indications
Thyroiditis
Concurrent initially with ablation, PTU/MTZ, surgery
Controls Tremor, Palpitations, nervousness

C.Management: Ablation

1.Radioactive Iodine
Recurrent Hyperthyroidism after Antithyroid Drugs
Toxic Nodule in patient over age 40 years

2.Subtotal thyroidectomy
Pregnancy intollerant to antithyroid medications
Children intollerant to antithyroid medications
Toxic Nodule under age 40 years
Large thyroid Goiter causing local compression

D.Monitoring after ablation
Thyroid Stimulating Hormone may not be accurate
Follow Free T4, Free T3 to base Thyroid Replacement