All are given for control of thyrotoxicosis prior to surgery except
Carbimazole 30-40 mg per day is the drug of choice for preparation. When euthyroid (after 8-12 weeks), the dose may be reduced to 5 mg 8-hourly. The last dose of carbimazole may be given on the evening before surgery. An alternative method of preparation is to abolish the clinical manifestations of the toxic state, using b-adrenergic blocking drugs. These act on the target organs and not on the gland itself. Propranolol also inhibits the peripheral conversion of T4 to T3. The appropriate dosages are propranolol 40 mg t.d.s. or the longer acting nadolol 160 mg once daily. b-adrenergic blocking drugs do not interfere with the synthesis of thyroid hormones, and hormone levels remain high during treatment and for some days after thyroidectomy. It is, therefore, impoant to continue treatment for 7 days postoperatively.Iodine may be given with carbimazole or a b-adrenergic blocking drug for 10 days before operation. Iodide alone produces a transient remission and may reduce vascularity, thereby marginally improving safety.Ref: Bailey and love 27e, page no: 813
Carbimazole
Propranolol
Betamethasone
Lugol's iodine
Endocrinology and breast