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Methimazole

Methimazole

Mechanism of Action: 

  • Similar to PTU, Methimazole inhibits thyroid peroxidase, thereby preventing the synthesis of thyroid hormones.

  • However, unlike PTU, Methimazole does not inhibit the peripheral conversion of T4 to T3.

Uses: 

  • Methimazole is commonly used in the treatment of hyperthyroidism, particularly in Graves' disease.

  • It's preferred over PTU in most cases due to a lower incidence of severe side effects.

Considerations: 

  • While Methimazole is generally safer than PTU, it can still cause side effects like skin rash, joint pain, and in rare cases, agranulocytosis.

  • It's typically avoided in the first trimester of pregnancy due to a slightly higher risk of congenital abnormalities.

  • Both medications require careful dosing and regular monitoring, including thyroid function tests and blood cell counts.

  • The choice between Propylthiouracil and Methimazole depends on the patient’s specific circumstances, including pregnancy status, severity of hyperthyroidism, and potential side effects.

  • The goal of therapy is to achieve a euthyroid state, where thyroid hormone levels are normal.


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