Radio-iodine Measurements of Thyroid Function During and After P.A.S. Treatment of Tuberculosis

Balint, John A.; Fraser, Russell; Hanno, M. G. W.

doi:10.1136/bmj.1.4873.1234

Cited by 11 publications

(3 citation statements)

References 6 publications

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“…Of the two patients who completed their MDR‐TB therapy and had documentation of thyroxine management, both individuals were able to cease thyroxine therapy and had normalisation of their thyroid function. This suggests that PAS and prothionamide withdrawal may potentially result in the normalisation of thyroid function, which is consistent with previous mechanistic studies where withdrawal resulted in normalisation of radio‐iodine uptake and goitre resolution …”

Section: Discussionsupporting

confidence: 91%

“…Although the evidence for PAS‐induced hypothyroidism and potential underlying mechanisms are less clear than for thionamides, several studies have demonstrated that co‐administration of PAS and a thionamide significantly increases the risk of hypothyroidism, suggesting that PAS may impact thyroid function independent of, or at least additional to thionamide‐like anti TB drugs . In vitro , PAS has been reported to interfere with the normal iodination of thyroid hormone, but at less than one‐tenth the potency of anti‐thyroid drugs . Some, but not all, experimental studies in humans have reported that PAS reduces thyroidal iodine uptake.…”

Section: Discussionmentioning

confidence: 99%

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Hypothyroidism associated with therapy for multi‐drug‐resistant tuberculosis in Australia

Cheung

Van

Lan

et al. 2019

Internal Medicine Journal

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Hypothyroidism associated with therapy for multi‐drug‐resistant tuberculosis in Australia

Cheung

Van

Lan

et al. 2019

Internal Medicine Journal

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“…Indeed, goiters and hypothyroidism are not uncommon in tubercular patients who receive large amounts of paraminosalicylic acid. 20 Moreover, paraminobenzoic acid has been used clinically in the treatment of thyrotoxicosis. 80 Although these compounds are not sufficiently effective to be useful in current therapy, the goitrogenic side effects should be carefully observed.…”

Section: Organic Antithyroid Compoundsmentioning

confidence: 99%

Clinical pharmacology of antithyroid compounds

Selenkow

Collaço

1961

Clin Pharma and Therapeutics

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Successful treatment of hyperthyroidism is predicated upon an understanding of the pharmacology of antithyroid drugs as well as upon a knowledge of their effects on pathways of thyroidal iodide metabolism. Research into the relationship between chemical structure and biologic action of numerous antithyroid compounds has served as a basis for their classification and for selection of those of greatest potency for clinical trial. Biochemical determination of the site and mode of action of compounds affecting thyroid hormonogenesis, although incomplete, allows a tentative working hypothesis which must be periodically revised as further evidence is accumulated. During the 17 years since the introduction of thiouracil, clinical pharmacologic investigations have established optimal dosage schedules, the incidence of toxic reactions, and the indications for the effective use of these drugs. Such studies have further served to develop programs for the management of patients with hyperthyroidism with special emphasis on the use of antithyroid compounds in long‐term therapy, preoperative preparation, and use during childhood or pregnancy. Although refinements in surgical approach and the general availability of radioactive iodine have necessitated modifications in the indications for their use, antithyroid drugs still maintain a secure position as therapeutic agents in the treatment of hyperthyroidism.

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Safety and Tolerability Profile of Second-Line Anti-Tuberculosis Medications

Ramachandran

Swaminathan

2015

Drug Saf

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Tuberculosis (TB) remains a major public health problem, representing the second leading cause of death from infectious diseases globally, despite being nearly 100 % curable. Multidrug-resistant (MDR)-TB, a form of TB resistant to isoniazid and rifampicin (rifampin), two of the key first-line TB drugs, is becoming increasingly common. MDR-TB is treated with a combination of drugs that are less effective but more toxic than isoniazid and rifampicin. These drugs include fluoroquinolones, aminoglycosides, ethionamide, cycloserine, aminosalicyclic acid, linezolid and clofazimine among others. Minor adverse effects are quite common and they can be easily managed with symptomatic treatment. However, some adverse effects can be life-threatening, e.g. nephrotoxicity due to aminoglycosides, cardiotoxicity due to fluoroquinolones, gastrointestinal toxicity due to ethionamide or para-aminosalicylic acid, central nervous system toxicity due to cycloserine, etc. Baseline evaluation may help to identify patients who are at increased risk for adverse effects. Regular clinical and laboratory evaluation during treatment is very important to prevent adverse effects from becoming serious. Timely and intensive monitoring for, and management of adverse effects caused by, second-line drugs are essential components of drug-resistant TB control programmes; poor management of adverse effects increases the risk of non-adherence or irregular adherence to treatment, and may result in death or permanent morbidity. Treating physicians should have a thorough knowledge of the adverse effects associated with the use of second-line anti-TB drugs, and routinely monitor the occurrence of adverse drug reactions. In this review, we have compiled safety and tolerability information regarding second-line anti-TB drugs in both adults and children.

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Radio-iodine Measurements of Thyroid Function During and After P.A.S. Treatment of Tuberculosis

Cited by 11 publications

References 6 publications

Hypothyroidism associated with therapy for multi‐drug‐resistant tuberculosis in Australia

Hypothyroidism associated with therapy for multi‐drug‐resistant tuberculosis in Australia

Clinical pharmacology of antithyroid compounds

Safety and Tolerability Profile of Second-Line Anti-Tuberculosis Medications

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