Thyroid

Question 1

Carbimazole and pancreatitis

Answer 1

Carbimazole can cause neutropenia. It should not be used in patients with a history of acute pancreatitis
associated with previous treatment. Re-exposure may result in life threatening acute pancreatitis with a
decreased time to onset. The other drugs listed, do not cause neutropenia and/or pancreatitis.

Question 2

Carbimazole and contraception

Answer 2

MHRA advises all females of child bearing age should use effective contraception during treatment

Question 3

Carbimazole interaction

Answer 3

Increased risk with other drugs that also cause myelosuppresion like bleomycin, mTX, Mercaptopurine, Trimethoprim, sulfasalazine

Question 4

Propylthiouracil CI

Answer 4

Severe hepatic impairment

Question 5

Propylthiouracil cautions

Answer 5

use half dose if renal function is below 10 and 75% if between 10-50

Question 6

Propylthiouracil in pregnancy

Answer 6

Can be given in pregnancy but the blocking replacement regimen is not suitable. Can cross the placenta and in high doses can cause fetal goitre and hypothyroidism

Question 7

Propylthiouracil counselling

Answer 7

Bone marrow suppression
Liver disorders