A 35-year-old unresponsive man is brought to the emergency room after an episode of agitation and confusion. He has a history of inadequately treated Graves’ disease. Physical examination reveals temperature of 102.5F. Blood pressure of 100/70 mm Hg, and pulse of 165 per minute.
After stabilizing this patient, which of the following would be the best pharmacotherapy for treating his underlying condition?
A- Dobutamine
B- Iodine
C- Levothyroxine
D- Propylthiouracil
E- Warfarin
Answer
The patient is brought unconscious due to a medical emergency commonly known as a ‘thyroid storm’. It is a rare condition occurs due to inadequate treatment of Grave’s disease and thyrotoxicosis. Once primary stabilization has been carried out, propylthiouracil or methimazole will be the best pharmacologic treatment as it will prevent the endogenous synthesis of thyroxine from taking place in the body, thus preventing worsening of the patient’s condition and hopefully preventing future episodes.
The correct answer is D