The doctor on call agrees that Sam will need an anti-thyroid drug. He agrees that propylthiouracil is a good choice as it may exert rapid effects due to inhibition of de-iodination of T4. He also agrees that propranolol should be administered to counteract sympathetic overactivity. Hydrocortisone is also useful to suppress the immune-mediated responses in Grave's disease. 

The doctor also recommends that iodine solution is administered as it may temporarily inhibit release of thyroid hormones, with beneficial effects in this acute emergency. 

Further development 

Sam is stabilized and discharged. She is very disturbed by the outcome of her non-compliance with her medication and decides to set a daily alarm on her phone to remind her to take her medication, which is now switched to methimazole as she is well into her second trimester.