Choice of Antithyroid Medications in Hyperthyroidism

Hyperthyroidism is a condition where production of thyroid hormone is higher than normal, causing several symptoms and signs. This condition is usually due to autoimmune problem. Hyperthyroidism can be treated with medicines or with surgical procedures, depends on structural abnormality found in each case. Medicines can control the symptoms and signs of hypethyroidism, but cannot cure the basic problem causing this condition (i.e. autoimmune process).

Several medications which are used in pharmacological therapy against hyperthyroidism: radioiodine, thioureylenes (consists of carbimazole, propylthiouracil, and methimazole), and iodine.

PDE5 inhibitors: From Pulmonary Hypertension to Male ED

Erectile dysfunction is an abnormal condition that happens as an interaction between psychological factors and physiological factors. Erection occurs as the resultant of some physiological factors: increased penile blood flow, increased sinusoidal filling, increased venous outflow.

One of the medicines that used to treat this condition is from PDE5 inhibitors class. Besides apomorphine, alprostadil, papaverine, phentolamine, and phenylephrine; this is the mostly used medicines to treat erectile dysfunction. PDE-5 inhibitors have some advantages rather than other medicines: it can be taken orally, and it only enhance erectile dysfunction as the response against sexual stimulation. But it also has a warning: it cannot be used altogether with nitrates, due to resultant vasodilatation effect that is potentially fatal when these medicines are taken simultaneously.

Medicines Group based on Availability on Market

Based on its availability in market, medicines are classified into four groups. Each group has its own logo on the package, to make it easier for patients to identify.

What are the groups?

Controversies about Cardiotoxicity Effect of Second-Generation Antihistamines

What medicines are they?
Five examples of famous second-generation antihistamines are cetirizine, terfenadine, astemizole, ebastine, and loratadine.

What are their advantages compared to first-generation antihistamines?
First-generation antihistamines have several weaknesses; namely their tendency to cross blood-brain barrier and consequent sedative-anticholinergic side effects. Their half-life is also shorter, thus limiting their efficacy against allergic symptoms. These weaknesses have been "covered" by the second-generation antihistamines.
Overall, antihistamines are rapidly and completely absorbed after oral administration with peak plasma concentration reached within 1-4 hours. Most of second-generation antihistamines undergo an extensive first-pass metabolism via cytochrome P450 (Cyp3A4). But several of them (e.g. mizolastine) is not metabolized by this pathway, but by glucuronidation enzyme.