|
Endocrine Disease:Hyperthyroid |
|
Hyperthyroidism The increase in metabolic rate causes a combination of weight loss and increased intake of food. The increased heat generated causes discomfort in warm environments, excessive sweating, a greater intake in water and increase ventilation. The increase in Beta-adrenergic responsiveness is manifest by a rapid heart rate, tremor, nervousness and an anxious state. Weakness is caused by loss of muscle mass. The thyroid gland is usually enlarged.
Risks of General Anaesthesia Risk of precipitating dangerous dysrhythmias. Patients may also have heightened anxiety and irritability. The sympathetic overactivity may lead to fainting, but the risks of giving local anaesthesia and adrenaline in moderate amounts are more theoretical.
Benzodiazepines may potentiate antithyroid drugs and Nitrous Oxide— rapidly controllable. Sedation is desirable since anxiety may precipitate a thyroid crisis.
Thyroid crisis— a life threatening condition in which there is a rapid deterioration of thyrotoxicosis with hyperpyrexia, tachycardia, extreme restlessness. It may be precipitated by infection or surgery. Treatment requires potassium iodide and propylthiouracil and propanol or chlorpromazine.
Agranulocytosis—treatment with carbimazole occasionally may lead to agranulocytosis, which may cause oral or oropharyngeal ulceration.
|
