Q: 22 years old female is admitted to ICU with thyroid storm. Iodine solution is planned to be administered. Patient is having severe nausea and may not tolerate oral intake. Can it be given intravenously?
A) Yes
B) No
Answer: A
In a thyroid storm, iodine should be planned to be administered an hour after the first dose of thionamide. Iodine is mostly available as a potassium iodide-iodine solution, popularly known as Lugol's solution. The standard dose is 10 drops. If a patient cannot tolerate oral intake it can be added to intravenous fluid (IVF). Moreover, iodine may cause esophageal or duodenal mucosal damage leading to bleeding and should be diluted in a beverage or given with food.
The iodine solution can also be administrated rectally.
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References:
1. Benua RS, Becker DV, Hurley JR. Thyroid storm. In: Current Therapy in Endocrinology and Metabolism, Bardin CW (Ed), Mosby, St. Louis 1994. p.75.
2. Yeung SC, Go R, Balasubramanyam A. Rectal administration of iodide and propylthiouracil in the treatment of thyroid storm. Thyroid 1995; 5:403.
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