Rectal Administration of Propylthiouracil in Suppository Form in Patients With Thyrotoxicosis and Critical Illness: Case Report and Review of Literature

Zweig, Susan B.; Schlosser, Jonathan R.; Thomas, Sylvia A.; Levy, Carol J.; Fleckman, Adrienne M.

doi:10.4158/ep.12.1.43

Cited by 20 publications

(10 citation statements)

References 7 publications

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“…Rectal administration of ATDs in thyroid storm has also been previously reported, given either as enemas or as suppositories [29,30]. Detailed methods for preparation of ATD enemas or suppositories are described elsewhere [29,30].…”

Section: • Commentsmentioning

confidence: 99%

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

et al. 2016

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Section: • Commentsmentioning

confidence: 99%

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

et al. 2016

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“…Vomiting and acute abdomen, especially when compounded by diarrhea, make the treatment of thyrotoxicosis extremely difficult (1)(2)(3)(4)(5). Thyrotoxic patients have been reported to present with acute abdomen (6), including gastroduodenal perforation (1)(2)(3) or bowel ileus/obstruction (4)(5).…”

Section: The Clinical Problemmentioning

confidence: 98%

“…Rectal administration of thionamides has been demonstrated to represent an effective treatment option for patients who cannot take oral therapy (1)(2)(3)(4)(5)18). Rectal formulations of antithyroid drugs include enemas or suppositories (1-5, Surgery 216 ALFADHLI AND GIANOUKAKIS 17-20).…”

Section: Medical Therapy Via a Nonoral Routementioning

confidence: 99%

“…M anagement of patients with severe thyrotoxicosis in the absence of a functional gastrointestinal tract represents a rare but significant clinical challenge associated with high morbidity and mortality (1)(2)(3)(4)(5). Vomiting and acute abdomen, especially when compounded by diarrhea, make the treatment of thyrotoxicosis extremely difficult (1)(2)(3)(4)(5).…”

Section: The Clinical Problemmentioning

confidence: 99%

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Management of Severe Thyrotoxicosis When the Gastrointestinal Tract Is Compromised

Alfadhli

Gianoukakis²

2011

Thyroid

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“…A new device, the catheter, offers an alternative route via rectal mucosal absorption, which is a route long-known to be effective and easy to access [1][2][3][4][5][6][7][8][9][10][11] . Absorption through the rectal mucosa is generally rapid, with blood levels of many drugs attaining therapeutic levels rapidly, in part as a result of avoiding the first-pass effect.…”

Section: Introductionmentioning

confidence: 99%

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Honasoge

Lyons

Hesse

et al. 2016

JoVE

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The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption). Although originally intended for the palliative care market, the utility of this device in the emergency setting has recently been described. Specifically, reports of patients being treated for dehydration, alcohol withdrawal, vomiting, fever, myocardial infarction, hyperthyroidism, and cardiac arrest have shown success with administration of a wide variety of medications or fluids (including water, aspirin, lorazepam, ondansetron, acetaminophen, methimazole, and buspirone). Device placement is straightforward, and based on the observation of expected effects from the medication administrations, absorption is rapid. The rapidity of absorption kinetics are further demonstrated in a recent report of the measurement of phenobarbital pharmacokinetics. We describe here the placement and use of this device, and demonstrate methods of pharmacokinetic measurements of medications administered by this method.

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Rectal Administration of Propylthiouracil in Suppository Form in Patients With Thyrotoxicosis and Critical Illness: Case Report and Review of Literature

Cited by 20 publications

References 7 publications

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition)

Management of Severe Thyrotoxicosis When the Gastrointestinal Tract Is Compromised

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

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