The doctor on call agrees that Sam will need an anti-thyroid drug. He agrees that methimazole may be used but he would prefer to use propylthiouracil as it may exert more rapid effects due to inhibition of de-iodination of T4 and it may be safer during the first trimester of pregnancy. 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. Finally, he also agrees that iodine solution should be administered as it may temporarily inhibit release of thyroid hormones. 

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.