which medication needs to be discontinued several days before i-131 treatment is started?

Abstract Background: It is a usual practice to discontinue thyroxine treatment for four weeks before (131)I ablation. Symptoms of hypothyroidism usually occur during this time.

Full Answer

How is I-131 removed from the body?

Radioactive I-131 is also volatile so it may be released as a gas during normal breathing. If the person's kidney function is normal (and they are not lactating), removal of most of the free radioactive I-131 occurs within the first few days through the production of urine. Contamination of the area the patient is in can happen in a number of ways.

How long before surgery can I Stop Taking my Medication?

If the medication needs to be stopped, it should be done one to two weeks (7-14 days) before surgery because it takes that long for the drug to be out of your system. You should discuss this with your surgeon and primary physician as early as possible. What medications may I take on the day of surgery?

When should a BZD be discontinued before ECT?

Many BZDs are long acting and may need to be discontinued some days before ECT • If the BZD cannot be discontinued, the use of higher stimulus or using flumazenil just before ECT to temporarily reverse effects of the BZD has been suggested

When to discontinue MAOI before ECT?

• If the MAOI has not been effective, a cautious approach when discontinuing the MAOI before ECT is recommended. There is no need for a washout period before starting ECT

What should I avoid before radioactive iodine treatment?

What Foods Should I Avoid Before Radioactive Iodine Treatment?Iodized salt.Dairy products like cheese, cream, yogurt, butter, and ice cream.Egg yolks, whole eggs, and foods containing whole eggs.Seafood like fish, shellfish, seaweed, and kelp.Foods that contain additives like carrageenan , agar-agar, and alginates.More items...•

When should I stop Carbimazole before radioactive iodine?

Conclusion: Patients under carbimazole treatment can be referred for radioiodine therapy after withdrawal of carbimazole for only 3 days. Three days of carbimazole withdrawal is long enough to restore the success of radioiodine therapy and short enough to avoid the risk of exacerbation of hyperthyroidism.

What must be completed prior to radioactive iodine therapy for Graves disease?

If you have been taking anti-thyroid medications, you must stop at least three days before the therapy is given. Frequently, your doctor will recommend stopping anti-thyroid medication for five to seven days before therapy. You will be able to return home following radioactive iodine treatment.

When is radioactive iodine contraindicated?

In toxic goitre, radioiodine is used mostly in recurrent nodules. Absolute contraindications for radioiodine treatment are pregnancy and lactation. Relative contraindications are thyroid nodules suspected of malignancy and age under 15 years.

Can you take carbimazole and propranolol at the same time?

Using propranolol together with methIMAzole may alter the effects of propranolol. Contact your doctor if you experience increase side effects such as uneven heartbeats, shortness of breath, dizziness, weakness, or fainting.

Can you take methimazole after radioactive iodine treatment?

We conclude that pretreating patients with methimazole before radioactive iodine therapy does not interfere with the final outcome. Similar cure rates and time required to achieve hypothyroidism after radioiodine were observed when patients were pretreated with methimazole compared to nonpretreated patients.

Which of the following is the most common complication of radioiodine treatment of Graves disease?

Background. Radioactive iodine (I131) is a common definitive treatment for Graves' Disease. Potential complications include worsening, or new development of Graves' eye disease and development of a radiation thyroiditis.

What are KI pills?

Potassium iodide (KI) can be used to protect the thyroid gland from radioactive iodine that may be released into the air in the unlikely event of a radiological emergency. In very small quantities, it is an essential nutrient for your thyroid gland to function properly.

What type of drug is Carbimazole?

Carbimazole is a drug used for the reduction of thyroid function. An imidazole antithyroid agent. Carbimazole is metabolized to methimazole, which is responsible for the antithyroid activity.

What are the contraindications of iodine?

Who should not take STRONG IODINE?active tuberculosis.a goiter.high levels of potassium in the blood.decreased kidney function.chronic inflammatory skin disease marked by blisters.pregnancy.Hashimoto thyroiditis, a disease of the thyroid.urticarial vasculitis.More items...

Why is iodine contraindicated in hyperthyroidism?

Chronic excessive iodine supply can also lead to goiter [11] and may accelerate the development of subclinical thyroid disorders to overt hypothyroidism or hyperthyroidism, increase the incidence of autoimmune thyroiditis, and increase the risk of thyroid cancer [10, 12, 13].

Why is adrenaline contraindicated in hyperthyroidism?

Epinephrine and other vasoconstrictors in local anesthetic drugs cause cardiovascular stimulation, and hyperthyroid patients can develop dysrhythmias, tachycardia, and thyrotoxic crisis when administered these drugs.

When should I stop taking metformin before surgery?

Action: Patients with type II diabetes mellitus should stop oral hypoglycemics several days prior to surgery (especially metformin which is known to contribute to postoperative lactic acidosis). Patients on Insulin (SC or IV) should omit their morning dose.

How long before surgery to stop platelets?

Use may be associated with increased bleeding due to platelet dysfunction.#N#Action: To be stopped 5-7 days before surgery if possible. Transfusion of fresh platelets if bleeding is an issue postoperatively (6).#N#Restart in ward at discretion of treating physician.

What happens if you stop taking beta blockers?

1. Beta blockers. A sudden stop can result in rebound hypertension, tachycardia and recurrent myocardial ischemia. Action: To be continued up to and including morning of surgery and restarted immediately afterwards or eventually substituted with short acting beta blockers (eg. propranolol, metoprolol, esmolol).

What is perioperative use?

Perioperative use can prevent postoperative myocardial ischemic events (1). 2. ACE inhibitors and angiotensin receptor blockers. Continued use can result in peroperative hemodynamic instability (2). • for hypertension : continue up to the day of surgery.

Is permanent discontinuation preventable?

Permanent discontinuation will need to be very carefully assessed beforehand as this can severely raise risk for a patient, making an individual highly vulnerable to complications which are preventable.

Is alternate day a secondary option?

Alternate day dosing will be carefully considered by a treating doctor as the lipid lowering capability is limited – meaning that lipid lowering percentages will be less than that of a daily dose. Alternate days may not be an option for very high-risk patients but can be considered as a secondary option should intolerance of the medication persist.

Can you stop atorvastatin?

Discontinuation of Atorvastatin / Lipitor should only take place with the guidance of a treating medical practitioner. A doctor will normally take a very conservative approach when it comes to potentially withdrawing a patient from Atorvastatin therapy. Discontinuation is likely to only happen as and when absolutely necessary.

Can you tolerate atorvastatin for long term?

Patients who are particularly high risk for cardiovascular complications will likely require long-term therapy in order to avoid severe adverse reactions, or mortality.

Does atorvastatin have a longer half life?

Atorvastatin / Lipitor does have a longer half-life, meaning that lipid reduction is effective over an extended period of time. Should tolerance of the medication be something of an issue for a patient, an alternate day dosage strategy can be considered.

What is required prior to stopping a medication?

A comprehensive assessment is required prior to stopping medicine. Among other indicators, your doctor needs to consider “your current clinical condition and life circumstances, your past clinical history, reasons to consider stopping versus continuing treatment, side effects and the presence of stressors and supports, as well as the dose and the length of time you’ve been taking a medicine,” Baldessarini said. You and your doctor should talk about these indicators along with how he or she plans to discontinue the drug.

How to ask a doctor about discontinuing a medication?

First, make sure that your doctor has experience or specialty training and certification to treat your illness. It’s reasonable to ask the following questions, according to Banov: “Are you familiar with various options for treating me and for discontinuing treatment? Do you feel comfortable treating me during discontinuation? About how often have you treated this disorder and discontinued the medicines I am taking?”

How long can you take a psychotropic drug?

Also, some mental health conditions require taking medicine indefinitely. Ultimately, how long a person takes a psychotropic drug depends on his or her individual illness, its responses to treatment and their personal situation, according to Dr. Ross J. Baldessarini, professor of psychiatry and neuroscience at Harvard Medical School and director of the psychopharmacology program at the McLean Division of Massachusetts General Hospital. For instance, some individuals struggling with depression may take an antidepressant for nine months to a year and get better; others may need two to five years; and still others, may be “so genetically loaded for depression, that they may need to stay on them indefinitely,” Dr. Banov said.

How long should you be monitored after stopping a drug?

Because people may not experience symptoms for weeks or even months after stopping a medicine, Baldessarini noted that patients should be “especially closely monitored clinically during and following drug discontinuation for several months.”

How long does it take to stop taking antidepressants?

Gradually and safely discontinuing a drug doesn’t happen in a few days. Some drugs, including antidepressants, don’t show benefits for several weeks when they’re started; it seems best to avoid discontinuing faster than over several weeks, Banov said.

What to ask a doctor if you haven't started a medicine yet?

If you haven’t started a medicine yet, Baldessarini encourages people to ask their doctors the following: “Can you give me an idea of how long I’ll be taking the medicine? What are the common side effects? What is the cost? When and how do I come off the medicine?”

How long do you have to take antidepressants for depression?

For instance, some individuals struggling with depression may take an antidepressant for nine months to a year and get better; others may need two to five years; and still others, may be “so genetically loaded for depression, that they may need to stay on them indefinitely,” Dr. Banov said.

How often should a nurse use an incentive spirometer?

The nurse encourages a patient who has undergone total joint arthroplasty to use the incentive spirometer every 2 hours. The nurse also encourages the patient to breathe deeply and cought frequently. Which complication is the nurse seeking to prevent by using this intervention?

When to avoid resistive exercises?

Avoid resistive exercises when the joints are inflammed.

What is hydroxychloroquine prescribed for?

A patient with RA is prescribed hydroxychloroquine for joint and muscle pain. Which statements should the nurse include in the teaching?

What is leflunomide used for?

The drug leflunomide is often used for pain management in patients with RA/ What is the drug's initial loading dose?

Can an older adult with OA of the left hip perform ADLs?

Assessment findings reveal that an older adult with severe OA of the left hip can no longer perform ADLs and has had several falls in the home over the past month. To which community resource does the nurse refer the patient?

What is the radiation from I-131?

Radioactive I-131 emits both gamma and beta radiation. The gamma radiation allows it to be easily detected and located with radiation survey meters and imaged by nuclear medicine imaging techniques. The gamma radiation from I-131 in the patients is the major source of external radiation to others after an I-131 procedure.

What is the basic radiation safety associated with radioactive I-131?

Basic radiation safety associated with radioactive I-131 involves using the principles of time and distance to reduce exposure to others as the basis for precautions to take after treatment.

What is the NRC radiation safety brochure?

The NRC staff developed a printable brochure to inform patients about radiation safety precautions that they need to follow before, during, and after treatment with radioactive drugs. The brochure is intended to foster a radiation-safety oriented dialogue between patients and their health care team. [NOTE: This tri-fold brochure is formatted to print double-sided].

What is the acronym for the American Thyroid Association?

The ATA: American Thyroid Association provides a brochure on frequently asked questions with radioactive iodine treatments.

What is the purpose of iodine?

Stable Iodine, an essential trace element, is used by the thyroid gland to produce two thyroid hormones (T3 and T4) . In papillary and follicular thyroid cancers (differentiated thyroid cancer) and hyperthyroidism, the thyroid and cancer cells produce too much thyroid hormones. In these cases, radioactive I-131 can be used to replace stable iodine and kill both the normal and abnormal thyroid cells regardless of where they are located.

Does thyroid carcinoma have radioactive 131?

Thyroid carcinoma patients, receiving radioactive I-131, have already had surgery to remove their thyroid gland but some "thyroid tissue" may remain. Therefore, they have less thyroid tissue to use the radioactive 1-131 and most of the radioactive I-131 remains in circulation as the body processes it and gets rid of it. It is processed by the parts of the body that produce fluids, such as the kidneys that produce urine, the sweat glands that produce sweat, and the salivary glands that produce saliva, and the mammary glands that produce milk if the person is lactating. Radioactive I-131 is also volatile so it may be released as a gas during normal breathing. If the person's kidney function is normal (and they are not lactating), removal of most of the free radioactive I-131 occurs within the first few days through the production of urine.

Does I-131 emit beta radiation?

Radioactive I-131 emits both gamma and beta radiation and a person receiving an I-131 procedure will continue to emit both gamma and beta radiation until the I-131 is gone. The amount of I-131 will decrease over time as the unstable I-131 decays or as the body processes the iodine and eliminates the I-131 from the body.

How long does an ECT last?

The goal of ECT is to produce a controlled and monitored seizure lasting from 30 to 90 seconds in duration to be considered therapeutic.1,4–6Although the exact mechanism of ECT is unknown, the induced seizure affects nearly every neurotransmitter system, including β-adrenergic, serotonin, muscarinic, cholinergic, and dopaminergic systems.6,7Brain-derived neurotrophic factor may also play a role in the efficacy of ECT.8There are no absolute contraindications to ECT; nevertheless, ECT can induce side effects and may be physically risky for certain individuals. As such, all patients must be assessed prior to ECT for the presence of conditions such as cardiovascular disease, space-occupying intracranial lesion with the evidence of elevated intracranial pressure, recent cerebral hemorrhage or stroke, bleeding or otherwise unstable vascular aneurysm, and severe pulmonary disease, as all of these can be associated with increased risk of complications from the general anesthesia and induction of seizure activity.1ECT is considered safe with a mortality of ~1/10,000 patients or 1/80,000 treatments.6Most patients report some adverse cognitive effects during and after a course of ECT, such as postictal confusion state (the result of both anesthesia and the seizure), anterograde amnesia (decreased ability to retain newly acquired information), and retrograde amnesia (forgetting recent memories).9However, objective tests indicate that cognitive abnormalities caused by ECT are generally short lived. Acute confusional states typically resolve 10 to 30 minutes after the procedure, whereas anterograde amnesia resolves within 2 weeks after completing the course. Retrograde amnesia recovers more slowly than anterograde amnesia.10Permanent memory loss is rare but can occur.9,11Other adverse effects include myalgias, headache, nausea, drowsiness, and musculoskeletal weakness.1,4–7

Is there evidence for drug interactions in ECT?

Despite the vast potential for drug interactions in patients receiving ECT, available evidence on those interactions that are clinically significant is scarce, and it is almost exclusively retrospective in nature, or derived from case reports or case series. A summary of the existing evidence as presented in this article can inform clinicians on the potential and documented consequences of these interactions, and assist them weighing the risks and benefits before making decisions on the concurrent use of medications in patients receiving ECT.

Is electroconvulsive therapy safe?

Electroconvulsive therapy (ECT) has demonstrated to be highly effective and safe, even life saving for many psychiatric disorders such as major depression, bipolar disorder and schizophrenia. Most patients who require ECT are also on concurrent pharmacotherapy. As such, the objective of this article is to provide a review of the most recent literature focusing on the medications used during an ECT procedure and on the effects of concurrent psychiatric and non-psychiatric medications on the effectiveness and safety of ECT. The review also attempts to summarize the recommendations derived from existing documents to guide pharmacotherapy decisions for patients undergoing ECT. For this purpose, using electronic databases, an extensive search of the current literature was made using ECT and medications or drug classes as keywords.

How long before surgery can you eat?

Do not eat or drink anything for at least eight hours before your scheduled surgery. Do not chew gum or use any tobacco products.

What tests do I need before surgery?

Required tests may include blood work, heart testing (EKG) or x-rays. Your primary care physician should have these ordered during your pre-op visit. All tests need to be done within 30 days of your procedure.

Can you bring a CPAP machine with you to sleep apnea surgery?

If you are currently using a CPAP machine for sleep apnea, please bring the machine with you the day of surgery.

Risks

Quotes

Causes

Treatment

Diagnosis

Prevention

Research

• In bipolar disorder, Baldessarini and his research team found years ago that the rate of discontinuing ongoing treatment determines the risk and timing of relapse, he said. Initially, their research found that risk for relapse after discontinuing lithium was reduced by one half or more when slow dose-reduction over several weeks was compared to abr...

See more on psychcentral.com

Effects