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. Author manuscript; available in PMC: 2019 Sep 3.
Published in final edited form as: Pol Arch Intern Med. 2019 Jun 25;129(7-8):526–534. doi: 10.20452/pamw.14876

TABLE 5.

TREATMENT OF THYROTOXIC STORM

  1. Reduction of thyroid hormone production and secretion
    • Inhibition of T4 and T3 synthesis
      • Propylthiouracil, methimazole
    • Inhibition of T4 and T3 secretion
      • Inorganic iodide (potassium iodide, Lugol’s solution)
      • Radiographic contrast agents (sodium ipodate, iopanoic acid)
      • Lithium carbonate
      • Thyroidectomy
  2. Therapy directed against systemic disturbances
    • Treatment of fever
      • Acetaminophen
      • External cooling
    • Correction of volume depletion and poor nutrition
      • Intravenous fluid and electrolyes
      • Glucose (calories)
      • Vitamins
    • Supportive therapy
      • Oxygen
      • Vasopressor drugs
    • Treatment for congestive heart failure (diuretics, digoxin)
  3. Amelioration of the peripheral actions of thyroid hormone
    • Inhibition of extrathyroidal conversion of T4 to T3
      • Propylthiouracil
      • Radiographic contrast agents (sodium ipodate, iopanoic acid)
      • Glucocorticoids
      • Propranolol or other β-adrenergic antagonist drugs
    • Removal of T4 and T3 from serum
      • Cholestyramine, plasmapheresis, hemodialysis, hemoperfusion

  4. Treatment of any precipitating or underlying illness

Abbreviations: T3, triiodothyronine; T4, thyroxine.