Endocrinology Metabolism

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By Woodruff T.K.

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131I should be considered after thyroid storm. The patient may well require thyroid hormone replacement afterwards but is not in any major danger in the short or medium term if compliance is less than ideal. Further Reading 1 Sarlis NJ, Gourgiotis L. Thyroid emergencies. Rev Endocr Metab Disord 2003; 4: 129–36. 2 Vannucchi G, Chiti A, Mannavola D, et al. Radioiodine treatment of non-toxic multinodular goitre: effects of combination with lithium. Eur J Nucl Med Mol Imaging 2005; 32: 1081–8. 3 Kokuho T, Kuji T,Yasuda G, Umemura S.

The drug sensitizes users to ultraviolet-A light and use of a high sun protection factor (SPF) barrier is recommended. It may also cause a blue-grey discoloration of the skin. Amiodarone may cause sleep disturbances and nightmares. 1. 1 Surveillance of patients taking amiodarone Time period Recommendation Before starting Clinical examination Electrolytes Liver tests Thyroid tests and antibodies* ECG and chest X-ray Every 6 months Electrolytes Liver tests Thyroid tests Annually Slit lamp examination† *Patients with thyroid antibodies should have thyroid tests every 3 months.

Alternatively, potassium iodide 100–130 mg every 6 hours can be used. In emergency 500–1000 mg sodium iodide can be given every 8 hours. b ␤-blockers. Propranolol is the preferred agent as it has an addition action decreasing deiodination of T4 to T3. They will help control tachycardia, tremor, sweating and agitation. Propranolol can be given at an initial dose of 40–120 mg, repeated at 6-hourly intervals. In an emergency, 1–3 mg can be given intravenously. b Dexamethasone. Corticosteroids inhibit release of thyroid hormone and also inhibit peripheral conversion to triiodothyronine.

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