Case 9: Double Trouble

Name of preceptor: Dra. Bagain

Precept section and group no.: A8

Name of student: Eviza,Kimberly F.

Reflection: Write briefly your reflection regarding what you learned in this case.
In this case, it was reiterated multiple times that we must pay attention to pregnancy cases,
since our case was dealing with hyperthyroidism, and the drugs indicated for it has the capacity
to cross the placenta. In our discussion, we chose the drug group of Thioamides, and the P-drug
choices were Methimazole and Propylthiouracil.

Leaning towards Propylthiouracil, we were able to vote for this drug, as it is indicated in
special cases like the first trimester of pregnancy which is applicable to the case. But we also
noted that methimazole is the drug of choice for hypothyroidism as it is more potent than
Propylthiouracil, but it was not chosen because the transfer across placenta in high .

Drug Formulary: Please fill in the spaces below the information of the p-drug for this case.
Generic Name
Therapeutic Classification
Pharmacologic Classification
Mechanism of Action
Side Effects
Contraindications
Drug Interactions
Prophylthiouracil
Antithyroid
Thioamides
• Interferes with thyroid peroxidase, preventing iodine
from being oxidized in the thyroid gland which
results in diminished thyroid hormone synthesis.
• Also inhibits formation of thyroglobulin by
interfering with the coupling reaction of iodotyrosyl
residues.
• Blocks the peripheral deiodination of thyroxine to
tri-iodothyronine.
• Bleeding
• Hypoprothrombinemia
• Bone marrow suppression
• Exfoliative dermatitis
• Fever
• Hypothyroidism
• Pregnancy Category D
• Previous history of hypersensitivity to PTU or any of
its drug components
• Hepatic impairment or myelosuppression and
pediatric patients
• Pregnancy and lactation
• May potentiate the effect of oral anticoagulants.

1

Dose/Conc. per Dosage Form
Dosage (adult &/or pediatric)
Specific Instructions
Brand Name
• Concomitant β-blockers, digoxin and theophylline
may require dosage adjustments according to
changes in patient’s thyroid status
Oral Tablets
• 50 mg/tablet
• Pregnant Adult: Initially 100-200mg daily
1 tablet every 8 hours
• Adult: Initially, 400 mg daily; Maintenance (once
euthyroid): 50-150 mg daily usually continued for
1-2 years. Adjust dose based on patient’s
tolerability, clinical response and thyroid status.
• Should be taken with food
Halycil
Prophylthiouracil DHA