The medical management of Graves' disease.
There are many different approaches to treat Graves' hyperthyroidism. Medical therapy is used short-term to prepare patients for radioiodine or surgery, or it is used long term with the hope of achieving a remission. b-adrenergic blocking agents are useful in all patients without a contraindication, especially selective long-acting agents such as atenalol. Thionamides are the mainstay of medical treatment. Methimazole is more potent, may be used as a single daily dose, and may have less toxicity than PTU. Severe hyperthyroidism or thyroid storm may be treated with methimazole and ipodate. Patients are prepared for surgery with methimazole and SSKI, or b-adrenergic blocking agents and ipodate.
Ross
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Thyroid Unit, Mass. General Hospital, Boston, MA 02114, USA.