Document Detail

Toxicological considerations for antithyroid drugs in children.
MedLine Citation:
PMID:  21323607     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Propylthiouracil (PTU), methimazole (MMI) and carbimazole are indicated for the treatment of hyperthyroidism in adult and pediatric patients. The aim of this review is to present all the relevant information regarding the use of antithyroid drugs (ATD) in pediatric thyrotoxic cases, the pediatric toxicology of ATD and the warning which has recently been issued for PTU by the FDA.
AREAS COVERED: Epidemiology, diagnosis and treatment of pediatric thyrotoxicosis are all presented in this article. The authors also extensively discuss the details regarding the pharmacology, bioactivation, biodisposition, bioavailability and pharmacokinetic properties of the two main ATD (MMI and PTU).
EXPERT OPINION: The FDA recently reported that use of PTU is associated with a higher risk for clinically serious or fatal liver injury compared to MMI in both adult and pediatric patients. They also found that congenital malformations were reported approximately three times more often with prenatal exposure to MMI compared with PTU and especially with the use of MMI during the first trimester of pregnancy. The authors believe that PTU should not be used in pediatric patients unless the patient is allergic to or intolerant of MMI, and there are no other treatment options available. That being said, PTU may be the treatment of choice during, and just before, the first trimester of pregnancy.
Spiros Karras; Themistoklis Tzotzas; Gerasimos E Krassas
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Publication Detail:
Type:  Journal Article; Review     Date:  2011-02-17
Journal Detail:
Title:  Expert opinion on drug metabolism & toxicology     Volume:  7     ISSN:  1744-7607     ISO Abbreviation:  Expert Opin Drug Metab Toxicol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-22     Completed Date:  2011-07-07     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  101228422     Medline TA:  Expert Opin Drug Metab Toxicol     Country:  England    
Other Details:
Languages:  eng     Pagination:  399-410     Citation Subset:  IM    
Panagia General Hospital, Department of Endocrinology, Diabetes and Metabolism, N. Plastira, 22, N. Krini 55132, Thessaloniki, Greece.
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MeSH Terms
Agranulocytosis / complications
Antithyroid Agents / therapeutic use,  toxicity*
Carbimazole / therapeutic use,  toxicity*
Child, Preschool
Evidence-Based Medicine
Graves Disease / drug therapy
Hyperthyroidism / drug therapy
Liver Failure / complications
Methimazole / therapeutic use,  toxicity*
Propylthiouracil / therapeutic use,  toxicity*
Randomized Controlled Trials as Topic
Thyrotoxicosis / drug therapy
Vasculitis / complications
Reg. No./Substance:
0/Antithyroid Agents; 22232-54-8/Carbimazole; 51-52-5/Propylthiouracil; 60-56-0/Methimazole

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