Which sequence of drugs represents the correct order of administration when managing thyroid storm?
- A Iodide first, followed by antithyroid drug, followed by beta blocker
- B Beta blocker first, antithyroid drug next, and iodide given at least one hour after the antithyroid drug ✓
- C Antithyroid drug and iodide simultaneously, beta blocker only if arrhythmia develops
- D Radioactive iodine first, followed by beta blocker and corticosteroid
Correct answer: B. Beta blocker first, antithyroid drug next, and iodide given at least one hour after the antithyroid drug
Explanation
Standard management is propranolol for adrenergic control, then propylthiouracil or carbimazole to block new hormone synthesis, and only afterwards Lugol iodine or sodium iodide to inhibit hormone release. Giving iodine before the synthesis block provides substrate and can worsen the storm, so it must follow the antithyroid drug by about an hour. Radioactive iodine has no role in storm and glucocorticoids are added as adjuncts.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.