It should be remembered that the objective of treatment with radioactive iodine and the antithyroid drugs is reduction of thyroid activity to normal levels. This is not easily accomplished, and so the patient must be evaluated frequently for signs of ineffective treatment with persistence of symptoms, and for overeffective treatment which can bring about symptoms of hypothyroidism. The antithyroid drugs, especially propylthiouracil, are prescribed as initial treatment for children, young adults, and pregnant women. The prime candidates for this therapy are patients with small goiters, recent onset of the disease, and mild symptoms. They require that the patient take the medication at the prescribed time and strictly according to schedule.
Propylthiouracil produces agranulocytosis, which can develop rather quickly.
For this reason patients receiving this drug must be instructed to report to the physician any sore throat, fever, or rash, so that WBC tests can be done and the patient's condition evaluated. The iodine preparations often are given routinely for a period of 10 to 14 days prior to surgery to reduce the vascularity of the thyroid. Patients with hyperthyroidism are subject to a variety of complex and long-term problems of physical and mental health. Because of the increased irritability, it is helpful to keep environmental stimuli at a minimum. Patients should be approached in a calm and unhurried manner and their wishes regarding visitors during hospitalization respected.