Propylthiouracil (PTU): Mechanism of Action and Adverse Effects

Propylthiouracil for Grave's Hyperthyroidism
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Management of Grave's Hyperthyroidism
Mechanism of Action
One of the primary antithyroid drugs for short-term treatment that is used to treat the disease is propylthiouracil (PTU). This drug is one of the first-line management for hyperthyroidism. Generally, it blocks the action of thyroperoxidase to inhibit iodide oxidation and organification. Its dose may be increased to prevent the deiodination of tetraiodothyronine (T4) to triiodothyronine (T3) (Mooji et al., 2022).
Adverse Effects and Monitoring
The most evident minor adverse effects include urticaria, rash, and arthralgia, while the most evident significant adverse effects are lupus-like syndrome and agranulocytosis with a neutrophil count of <500milliliters (mL), and hepatitis. Thus, monitoring should be focused on these symptoms, mainly general or right upper quadrant abdominal pain, skin changes, and increased frequency of incurring diseases (T3). Complete blood count (CBC), prothrombin time (PT), partial thromboplastin (aPTT), and international normalized ratio (INR) should be done to monitor the adverse effects (Mooji et al., 2022; Amisha & Rehman, 2021).
Drug Interactions
It mainly interacts with Coumarins, preventing Vitamin K's action and resulting in excessive bleeding. It may also interact with antihypertensive drugs, causing an increase in the clearance and decreased effectivity of these, including beta-blockers and other drugs such as theophylline and digitalis (Amisha & Rehman, 2021). It may also interact with alternative medicine such as Spirulina, which increases thyroid activity (EL-Tantawi & Abozeid, 201...