What is the recommended oral drug therapy for treating thyrotoxicosis in a patient presenting with severe symptoms?

In cases of thyrotoxicosis presenting with severe symptoms, the recommended oral drug therapy is propylthiouracil (PTU). Propylthiouracil is an antithyroid medication that works by inhibiting the synthesis of thyroid hormones and decreasing the conversion of thyroxine (T4) to triiodothyronine (T3) in peripheral tissues. This dual-action makes it particularly effective in managing hyperthyroid crises, such as those seen in thyrotoxicosis, where rapid control of thyroid hormone levels is necessary.

PTU is often favored in acute situations, especially in patients who may also be experiencing significant cardiovascular symptoms, as it can help stabilize their condition more swiftly compared to other treatments. Although beta-blockers can provide symptomatic relief from tachycardia and anxiety, they do not address the underlying cause of thyrotoxicosis, which is the excessive hormone production. Levothyroxine and radioactive iodine are not appropriate in this acute presentation; levothyroxine is used to treat hypothyroidism, and radioactive iodine is typically indicated for longer-term management of hyperthyroidism rather than immediate treatment in severe cases.

Using propylthiouracil allows for a more comprehensive approach to managing