Which drug is effective in the treatment of Thyrotoxicosis?

Appeared in: UPPSC 2023

Explanation

Carbimazole is a thioamide antithyroid drug used to control thyrotoxicosis.
It functions as a prodrug, converting to the active metabolite methimazole.
Its primary mechanism is inhibiting the thyroid peroxidase enzyme, which blocks the synthesis of new thyroid hormones (T3 and T4).
This leads to a gradual reduction in circulating thyroid hormone levels, alleviating the symptoms of hyperthyroidism.

Option A: Omeprazole is a proton pump inhibitor (PPI) that reduces stomach acid production.
Option C: Fluconazole is an antifungal medication.
Option D: Tinidazole is an antiprotozoal and antibacterial agent.

Clinical Relevance

Nursing practice connection: Knowing Pharmacological management of thyrotoxicosis helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A critical nursing responsibility is to educate patients on Carbimazole about the signs of agranulocytosis, a rare but life-threatening side effect. Instructing the patient to immediately report any instance of fever, sore throat, or mouth ulcers is a key safety measure.
Nurses must monitor thyroid function tests (TSH, T3, T4) regularly to assess the drug's efficacy and titrate the dose, preventing both undertreatment (persistent thyrotoxicosis) and overtreatment (drug-induced hypothyroidism).
What if the patient was in their first trimester of pregnancy? Propylthiouracil (PTU) would be the preferred antithyroid drug. Carbimazole is associated with a higher risk of congenital malformations (embryopathy) during the first trimester.

How to Approach the Question

First, identify the key term in the question: 'Thyrotoxicosis'. Understand that this is a condition of excess thyroid hormone.
The question asks for a drug to 'treat' this condition. This requires a medication that will lower thyroid hormone levels, known as an antithyroid drug.
Next, analyze the four options provided by classifying each drug based on its primary pharmacological action.
Omeprazole is a proton pump inhibitor for stomach acid.
Carbimazole is an antithyroid drug.
Fluconazole is an antifungal.

Concept Tested & Keywords

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E6 Medicine Davidson Principles Practice 24e p. 664-666

E6 Pharmacology KD Tripathi Essentials 9e Part 1 p. 304-306

E6 Pharmacology Nurses Shanbhag 3e p. 247-249

Practise the full UPPSC 2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.