ropy|th|ourac|| (1U)

Administration/Storage
O Give with meals to minimize GI irritation.
O /minister q 8 hr to maintain serum /rug levels.
O ncourage Ilui/ intake oI 3 to 4 L//ay, unless contrain/icate/.
O $tore in tight, light-resistant container at room temperature.
Assessment/Interventions
O -tain patient history, inclu/ing /rug history an/ any known allergies.
O -tain -aseline weight, BP, -o/y temperature an/ pulse rate an/ monitor perio/ically
/uring therapy.
O nsure that -aseline thyroi/ Iunction has -een evaluate/ prior to therapy an/ reassess
q 2 to 3 mo /uring therapy.
O etermine -aseline WBC count an/ /iIIerential -eIore a/ministration an/ monitor Ior
agranulocytosis /uring Iirst 3 mo oI therapy.
O onitor I& an/ check Ior e/ema.
O BeIore /ischarge, o-tain /ietary consult Ior patient regar/ing io/ine intake; shellIish
an/ io/ine-containing Ioo/s may -e restricte/.
O ssess Ior signs oI hypoprothrom-inemia; monitor prothrom-in time /uring therapy,
especially /uring surgical proce/ures.
O ssess patient Ior /evelopment an/ tolerance oI symptoms oI hyperthyroi/ism or
hypothyroi/ism.
O II symptoms oI hypersensitivity occur (eg, swollen lymph no/es, skin eruption or
itching), notiIy physician. rug may -e /iscontinue/.
'#SAGSIGNSSYMPTMS

Nausea, vomiting, epigastric /istress, hea/ache,
Iever, arthralgia, pruritis, e/ema, pancytopenia;
most serious eIIect: agranulocytosis

Patient/Familyducation
O Instruct patient to take resting pulse /aily an/ encourage patient to keep recor/e/
chart.
O /vise patient to monitor weight at least 2 to 3 times/wk or per physician instruction,
o-taining weight at same time, using same scale. ncourage patient to keep recor/e/
chart.
O mphasize importance oI Iollowing /ietary restrictions regar/ing shellIish, io/ize/
salt an/ other Ioo/s high in io/ine.
O plain that /esire/ response may take several months iI the thyroi/ is greatly
enlarge/.
O /vise patient to carry Medi-Alert i/entiIication at all times /escri-ing me/ications.
O Instruct patient to notiIy /entist or physician oI /rug regimen -eIore surgical or /ental
proce/ures.
O mphasize importance oI Iollow-up visits to monitor eIIectiveness oI /rug therapy.
O Caution patient not to stop taking me/ication a-ruptly to avoi/ thyroi/ crisis.
O Instruct patient to report the Iollowing symptoms to physician: $ore throat, Iever,
rash, mouth sores; col/ intolerance, mental /epression; tachycar/ia, irrita-ility;
persistent nausea, steatorrhea or vomiting, /rowsiness, yellowing oI skin or whites oI
eyes; unusual -lee/ing or -ruising.
O /vise patient that /rug may cause /rowsiness an/ to use caution while /riving or
perIorming other activities requiring mental alertness.
O Instruct patient not to take otc me/ications without consulting physician.


Methimazole
Administration/Storage
O /minister aroun/ clock in 3 equal /oses (ie, q 8 hr).
O /minister each /ose with same amount oI Ioo/ to Iacilitate uniIorm a-sorption.
O $tore in light-resistant container at room temperature.
Assessment/Interventions
O -tain patient history, inclu/ing /rug history an/ any known allergies.
O ssess Ior history oI liver /isease.
O ssess symptoms oI hyperthyroi/ism that patient is eperiencing.
O -tain -aseline vital signs an/ monitor /uring treatment.
O -tain -aseline hepatic -loo/ work inclu/ing -iliru-in an/ liver enzymes.
O -tain -aseline CBC an/ monitor careIully /uring Iirst 2 months oI treatment.
O -tain -aseline thyroi/ levels an/ monitor monthly initially an/ q 23 mo Ior long-
term therapy.
O onitor /rug's eIIects on hyperthyroi/ symptoms.
O onitor PT, especially -eIore surgery, to assess increase/ risk oI -lee/ing.
O -serve Ior potential a/verse reactions inclu/ing rash or Iever, an/ notiIy physician iI
any occur.
'#SAGSIGNSSYMPTMS

Nausea, vomiting, epigastric /istress, hea/ache,
Iever, arthralgia, pruritus, e/ema, pancytopenia,
agranulocytosis, eIoliative /ermatitis, hepatitis,
neuropathies, CN$ stimulation or /epression.

Patient/Familyducation
O Instruct patient in importance oI taking proper /ose eactly as sche/ule/.
O /vise patient not to stop, start or a/ust /ose oI any me/ications, inclu/ing otc,
without /iscussing with physician.
O plain to patient the importance oI complying with Iollow-up appointments an/ la-
work.
O Instruct patient to check pulse /aily.
O /vise patient that io/ine-restrictive /iet may -e necessary.
O InIorm patient that response to therapy may take months.
O Instruct patient to report these symptoms to physician: rash, Iever, sore throat,
-ruising or signs oI inIection or aun/ice.
O /vise patient that /rug may cause /rowsiness an/ to use caution while /riving or
perIorming other tasks requiring mental alertness.
















ropy|th|ourac|| (1U)
AdmlnlsLrasl / enylmpanan
- 8erlkan dengan makanan unLuk memlnlmalkan lrlLasl Cl
- AdmlnlsLrasl q 8 [am unLuk memperLahankan kadar obaL dalam serum
- Mendorong asupan calran darl 3 sampal 4 L / harl kecuall konLralndlkasl
- Slmpan dalam wadah yang keLaL cahayaLahan pada suhu kamar
enllalan / lnLervensl
- MendapaLkan rlwayaL paslen Lermasuk se[arah obaL dan alergl dlkeLahul
- MendapaLkan beraL awal 8 suhu Lubuh dan denyuL nadl dan memanLau secara perlodlk selama
Lerapl
- asLlkan bahwa fungsl Llrold awal Lelah dlevaluasl sebelum Lerapl dan menllal kemball q 2 sampal 3
bulan selama Lerapl
- 1enLukan dasar hlLung W8C dan dlferenslal sebelum pemberlan dan monlLor unLuk agranuloslLosls
selama 3 bulan perLama Lerapl
- MemanLau l C dan memerlksa unLuk edema
- Sebelum deblL memperoleh makanan berkonsulLasl unLuk paslen mengenal asupan yodlum
kerang dan makanan yang mengandung lodlne dapaL dlbaLasl
- Menllal LandaLanda hypoproLhromblnemla memanLau proLhrombln Llme selama Lerapl LeruLama
selama prosedur pembedahan
- ka[l paslen unLuk pengembangan dan Loleransl ge[ala hlperLlroldlsme aLau hlpoLlroldlsme
- !lka ge[ala hlpersenslLlvlLas Ler[adl (mlsalnya pembengkakan kelen[ar geLah benlng erupsl kullL
aLau gaLal) memberlLahu dokLer CbaL dapaL dlhenLlkan
Cverdosls 1AnuA CL!ALA
Mual munLah gangguan eplgasLrlum saklL kepala demam arLralgla prurlLus edema
panslLopenla efek pallng serlus agranuloslLosls

aslen / keluarga endldlkan
- An[urkan paslen unLuk mengambll pulsa lsLlrahaL harlan dan mendorong paslen unLuk LeLap
dlrekam bagan
- An[urkan paslen unLuk memanLau beraL badan pallng Lldak 2 sampal 3 kall / mlnggu aLau lnsLruksl
dokLer per mendapaLkan beraL badan pada saaL yang sama dengan menggunakan skala yang sama
uorong paslen unLuk LeLap dlrekam bagan
- 1ekankan penLlngnya menglkuLl pembaLasan makanan LenLang kerang garam beryodlum dan
makanan lalnnya yang Llnggl yodlum
- !elaskan bahwa respon yang dllnglnkan mungkln memakan wakLu beberapa bulan [lka Llrold sangaL
dlperbesar
- An[urkan paslen unLuk melakukan ldenLlflkasl MedlemberlLahuan seLlap saaL menggambarkan
obaL
- An[urkan paslen unLuk memberlLahu dokLer glgl aLau dokLer darl re[lmen obaL sebelum prosedur
bedah aLau glgl
- Menekankan penLlngnya kun[ungan Llndak lan[uL unLuk memanLau efekLlvlLas Lerapl obaL
- aslen erhaLlan unLuk Lldak berhenLl mlnum obaL LlbaLlba unLuk menghlndarl krlsls Llrold
- An[urkan paslen unLuk melaporkan ge[alage[ala berlkuL unLuk dokLer SaklL Lenggorokan demam
ruam luka muluL lnLoleransl dlngln depresl menLal Laklkardl lrlLablllLas mual perslsLen
sLeaLorrhea aLau munLah menganLuk mengunlng kullL aLau puLlh maLa perdarahan yang Lldak
blasa aLau memar
- Menyarankan paslen bahwa obaL dapaL menyebabkan kanLuk dan menggunakan haLlhaLl saaL
mengemudl aLau melakukan keglaLan laln yang memerlukan kewaspadaan menLal
- An[urkan paslen unLuk Lldak mengambll obaL oLc Lanpa konsulLasl dokLer


,th|mazo|
AdmlnlsLrasl / enylmpanan
- AdmlnlsLrasl seklLar [am dalam 3 dosls sama (yalLu q 8 [am)
- AdmlnlsLrasl dosls maslngmaslng dengan [umlah makanan yang sama unLuk memfaslllLasl
penyerapan seragam
- Slmpan dalam wadah Lahan cahaya pada suhu kamar
enllalan / lnLervensl
- MendapaLkan rlwayaL paslen Lermasuk se[arah obaL dan alergl dlkeLahul
- Menllal unLuk rlwayaL penyaklL haLl
- Menllal ge[ala hlperLlrold bahwa paslen mengalaml
- MendapaLkan LandaLanda vlLal dan dasar memanLau selama pengobaLan
- MendapaLkan dasar haLl ker[a darah Lermasuk blllrubln dan enzlm haLl
- MendapaLkan C8C basellne dan memonlLor dengan cermaL selama 2 bulan perLama pengobaLan
- MendapaLkan LlngkaL dasar Llrold dan memanLau bulanan awalnya dan q mo 23 unLuk Lerapl
[angka pan[ang
- MemanLau efek obaL pada ge[ala hlperLlrold
- MemanLau 1 LeruLama sebelum operasl unLuk menllal penlngkaLan rlslko pendarahan
- AmaLl reaksl meruglkan yang poLenslal Lermasuk ruam aLau demam dan memberlLahu dokLer [lka
ada Ler[adl
Cverdosls 1AnuA CL!ALA
Mual munLah gangguan eplgasLrlum saklL kepala demam arLralgla prurlLus edema
panslLopenla agranuloslLosls dermaLlLls eksfollaLlf hepaLlLls neuropaLl sLlmulasl aLau depresl SS

aslen / keluarga endldlkan
- An[urkan paslen penLlngnya mengambll dosls yang LepaL persls seperLl yang dl[adwalkan
- An[urkan paslen unLuk Lldak berhenLl memulal aLau menyesualkan dosls obaLobaLan Lermasuk
oLc Lanpa berdlskusl dengan dokLer
- !elaskan pada paslen penLlngnya memaLuhl Llndak lan[uL [an[l dan prakLlkum
- An[urkan paslen unLuk memerlksa denyuL nadl seLlap harl
- An[urkan paslen yang yodlumresLrlkLlf dleL mungkln dlperlukan
- MemberlLahukan paslen bahwa respon Lerhadap Lerapl dapaL mengambll bulan
- An[urkan paslen unLuk melaporkan ge[alage[ala ke dokLer ruam demam saklL Lenggorokan
memar aLau LandaLanda lnfeksl aLau penyaklL kunlng
- Menyarankan paslen bahwa obaL dapaL menyebabkan kanLuk dan menggunakan haLlhaLl saaL
mengemudl aLau melakukan LugasLugas laln yang memerlukan kewaspadaan menLal