A 29-year-old female patient presents to the nurse practitioner with complaints of an enlarged thyroid gland and protruding eyeballs. Upon assessment, the NP learns the patient has hypertension, nervousness, and fine tremors of the hands. Which of the following medications should be ordered for the patient?

Choice A reason: Levothyroxine is a synthetic form of thyroxine (T4) used to treat hypothyroidism. Administering this to a patient with signs of hyperthyroidism, such as exophthalmos, tremors, and hypertension, would worsen the condition. Choice B reason: Liotrix is a combination of synthetic T4 and T3 hormones, also used to treat hypothyroidism. Like levothyroxine, it is contraindicated in hyperthyroid states and would exacerbate the symptoms. Choice C reason: Liothyronine is synthetic T3 and is used in hypothyroidism or myxedema coma. It is not appropriate for treating hyperthyroidism and would intensify the patient’s symptoms. Choice D reason: Propylthiouracil (PTU) is an antithyroid medication that inhibits thyroid hormone synthesis and peripheral conversion of T4 to T3. It is indicated in hyperthyroidism and Graves’ disease, especially when symptoms include goiter and exophthalmos. PTU helps reduce hormone levels and alleviate symptoms.