Hyperfunction of the thyroid gland: monitoring the prescription of drugs

Pathology of the thyroid gland – quite common.

Thyroid hormones have a multidirectional effect, so the hyperfunction of this gland can manifest itself as a whole symptom complex.

In this publication on estet-portal.com we bring to your attention a guide to laboratory control and clinical observation of patients with hyperthyroidism, in particular with hyperthyroidism and thyrotoxicosis.

• Hyperthyroidism in adults
• Peculiarities of treatment of hyperthyroidism in children
• Monitoring of prescription of drugs for hyperthyroidism Hyperthyroidism in adults Radioactive iodine isotope therapyas the first line of choice for adults with secondary hyperthyroidism is recommended against the background of multiple nodular changes in the thyroid gland, except in clinical situations where this tactic is unacceptable, for example, there is a risk of compression, malignancy ; during pregnancy, or if the birth of a child is expected within the next 4-6 months. Follow us on 
Instagram

!

To suggest  

total thyroidectomy

 or lifelong antithyroid drugs as the first line of choice in adults with secondary hyperthyroidism associated with multiple nodular changes is possible only if treatment with radioactive iodine isotopes is unacceptable. Therapy with radioactive iodine isotopes or 

surgery (hemithyroidectomy)

as the first line of choice for treatment of hyperthyroidism in adults is indicated in the presence of a single nodule or lifelong prescription of antithyroid drugs are contraindicated, as well as in case of resistant hyperthyroidismfor.

Causes of pain in the thyroid gland Peculiarities of treatment of hyperthyroidism in children Children and adolescents with 

Graves' disease

 or toxic nodular goiter are recommended antithyroid drugs for at least 2 years and possibly  long-term use as the first line of choice in children and adolescents with Graves' disease.

What is the danger of subacute thyroiditis Consider continuing or resuming antithyroid drugs, and considering radioiodine isotope therapy or surgery (total thyroidectomy) for children and adolescents with Graves' disease who are on antithyroid drugs only in case of  

relapse of hyperthyroidism

.

Children and adolescents with secondary hyperthyroidism against the background of single or multiple nodular changes are shown to prescribe antithyroid drugs in the  carbimazole titration mode, as well as the possibility of using radioactive iodine isotopes

 and 

Cancel and do not prescribe in the future thyrostatic drugs possible if patients developta agranulocytosis.

Monitoring the prescription of drugs for hyperthyroidism

For adults, children and adolescents who receive thyrostatic drugs, TSH, T4 and T3 levels should be evaluated every 6 weeks until TSH reaches the control range, and then   assessment of TSH levels every 3 months until the withdrawal of antithyroid drugs. Monitoring of general clinical blood counts and liver enzyme activity is not recommended in adults, children and adolescents who receive thyrostatic drugs to correct hyperthyroidism, if there is no evidence of the possible development of agranulocytosis or liver dysfunction.

For adults who have discontinued thyrostatic drugs, TSH levels should be assessed within 8 weeks of stopping the drug, then − TSH every 3 months for 1 year and then TSH once a year.

Monitoring of the condition of patients after surgical treatment includes prescribing hormone replacement therapy

 − 

levothyroxine

, taking into account recommendations for dosage and monitoring of hypothyroidism.

It is also important to assess the level of TSH and T4 2 and 6 months after surgery, and then − Once a year for adults, children and adolescents who have had a hemithyroidectomy.

Share: