Treatment of Thyroid Storm

Propylthiouracil: 600 mg orally given before iodine, then 200–400 mg every 6–8 hoursPropylthiouracil: 600 mg orally given before iodine, then 200–400 mg every 6–8 hours

Iodine: 5 drops (0.25 mL) saturated solution of potassium iodide orally every 6 hoursIodine: 5 drops (0.25 mL) saturated solution of potassium iodide orally every 6 hours

or

4–8 drops Lugol's solution 2% orally every 6–8 hours

or

1 g sodium iodide slowly by intravenous drip over 24 hours1 g sodium iodide slowly by intravenous drip over 24 hours

Propranolol: 60–80 mg orally every 4–6 hours with appropriate adjustment for heart rate and blood pressurePropranolol: 60–80 mg orally every 4–6 hours with appropriate adjustment for heart rate and blood pressure

or

Propranolol: 0.5–1 mg intravenously over 10–15 minutes every 4 hours (not to exceed 1 mg/minute) under close monitoringPropranolol: 0.5–1 mg intravenously over 10–15 minutes every 4 hours (not to exceed 1 mg/minute) under close monitoring

A repeat 1-mg propranolol dose given after 2 minutes, if needed, or esmololA repeat 1-mg propranolol dose given after 2 minutes, if needed, or esmolol

Intravenous dextrose solutionsIntravenous dextrose solutions

Correction of dehydration and electrolyte imbalance

Cooling blanket for hyperthermia

Antiarrhythmics (eg, calcium channel blockers, adenosine, beta-blockers) if necessary for atrial fibrillation

Treatment of underlying disorder, such as infection

Glucocorticoids: Hydrocortisone 100 mg intravenously every 8 hoursGlucocorticoids: Hydrocortisone 100 mg intravenously every 8 hours

or

Dexamethasone 2 mg intravenously every 6 hoursDexamethasone 2 mg intravenously every 6 hours

Definitive therapy after control of the crisis via ablation of the thyroid with iodine-131 or surgical treatment