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Hi,
Why I could not reply to this question and I have to post a a new message ? What's going on here ?
Yes, Danille, methimazole and proylthiouracil have both a common mechanism of action: inhibit the thyroidal peroxidase activity : inhibit organification and coupling of thyroid hormone synthesis.
Propylthiouracil, in addition to Methimazole, reduces peripheral conversion of T4 to T3. It is the only one that can be used in pregnancy as well.
matoka
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Thank you Matoka.
Yes PTU can be used in pregnancy. But the reason is not it can't cross the placenta, it can. But it is heavily protein bound so it is safe to be used in pregnancy. I saw in a question that it can cause hypothyroidism in fetus. Because any unbound PTU will cross the placenta.
Matoka, thank you so much for hanging around here. I know you already took your step 1. I wish I were you. Less than 3 weeks to go and I still have a lot to work on. This is a nightmare.
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Danille,
I wish I had had more time for my step 1 exam, to be better prepared, to feel more confident, to review and consolidate much more learned material. Unfortunately, it did not happen and I have to deal with the current situation.I'm still hanging around this step 1 forum, because I like it, I'm trying to conquer my anxiety, impacience , tension, stress, given by this criminal step 1 exam.I'm still ambiguous, cloudy regarding my step 1 result.
Step 1 is not an impossible exam, on the contrary, it's a doable exam by definition.
Yes, PTU is safed to be used in pregnancy as you mentioned but still can cross the placenta and gives hypothiroidism in fetus. There is such a question in the first form of NBME self assessment tests where hapilly,I gave the right answer by guessing and intuition. After that I found the explanation in Goljan's 100 pages high yield facts:pharmacology !
Danille, I'm perfectly sure that you are well prepared by now and will pass your exam successfully, will obtain over a median score, even a high score. I don't know why but I have this intuition. Good luck on your exam.
matoka
