Exam 1 - Treatment of Thyroid Storm

Question 1

What are the characteristics of Thyroid Storm?

Answer 1

● Sudden exacerbation of hyperthyroidism cause by rapid release (leakage) of thyroid hormone
● Treatment: PTU (but not methimazole)
● Propranolol to treat sympathetic effects and also slightly inhibits conversion of T4 to T3
● Potassium iodide (given 4 hours after PTU) is given because it works relatively rapidly to decrease any further release of T3 and T4 from thyroglobulin.
● Iodinated contrast media can be used instead of iodides and will decrease conversion of T4 to T3
● Hydrocortisone or dexamethasone inhibit the conversion of T4 to T3 ( similar to PTU) and can protect against shock
● Regimen of above drugs reduces serum T3 levels to about normal within 24­-48 hours
● Cooling blankets