8/6/2019 Drugs Thyroid Diseases

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8/6/2019 Drugs Thyroid Diseases

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8/6/2019 Drugs Thyroid Diseases

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Thyroid Storm

Sudden, Acute Exacerbation ofThyrotoxicosis

Requires vigorous management

Drugs

Cardiac Symptoms

y Propranolol (Slow IV) Except in presence of Severe Heart Failurey Diltiazem (if Propranolol is contraindicated) Release of Thyroid Hormones

y Saturated solution ofPotassium Iodide solution(10 drops, Orally, Daily)

Synthesis of Thyroid Hormones (Orally, Rectally)

y Propylthiouracily MethimazoleHydrocortisone (50mg IV 6 hourly)y Prevents Shocky Blocks T4 T3 conversionGeneral supportive measures

Drug Interactions

Thyroid Hormone Production Thyroid Hormone Absorption Metabolism of ThyroxineDisplace Thyroid Hormone

from Protein Binding

Lithium Sucralfate (Carafate) Rifampicin (Rifadin) Furosemide (Lasix)

Iodine-containing medications Ferrous Sulfate (Slow Fe) Phenobarbital Mefenamic Acid (Ponstan)

Amiodarone (Cordarone) Cholestyramine (Questran) Carbamazepine (Tegretol) Salicylates

Colestipol (Colestid) Warfarin (Coumadin)

Aluminium-contai ning Antacids Oral Hypoglycaemic Agents

Calcium products