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Citation
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HERO ID
755822
Reference Type
Journal Article
Subtype
Review
Title
Amiodarone and thyroid dysfunction
Author(s)
Padmanabhan, H
Year
2010
Is Peer Reviewed?
1
Journal
Southern Medical Journal
ISSN:
0038-4348
EISSN:
1541-8243
Volume
103
Issue
9
Page Numbers
922-930
Language
English
PMID
20689491
DOI
10.1097/SMJ.0b013e3181e90500
Web of Science Id
WOS:000281502000015
Abstract
Amiodarone is a potent antiarrhythmic drug associated with thyroid dysfunction. Its high iodine content causes inhibition of 5'-deiodinase activity. Most patients remain euthyroid. Amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH) may occur depending on the iodine status of individuals and prior thyroid disease. AIT is caused by excess iodine-induced thyroid hormone synthesis (type I AIT) or by destructive thyroiditis (type II AIT). If the medical condition allows it, discontinuation of the drug is recommended in type I AIT. Otherwise, large doses of thioamides are required. Type II AIT is treated with corticosteroids. Mixed cases require a combination of both drugs. Potassium perchlorate has been used to treat resistant cases of type I AIT but use is limited by toxicity. Thyroidectomy, plasmapheresis, lithium, and radioiodine are used in select cases of AIT. AIH is successfully treated with levothyroxine. Screening for thyroid disease before starting amiodarone and periodic monitoring of thyroid function tests are advocated.
Keywords
Anti-Arrhythmia Agents; Antithyroid Agents; Glucocorticoids; Iodine Radioisotopes; Perchlorates; Thyroid Hormones; Methimazole; 554Z48XN5E; Amiodarone; N3RQ532IUT; Thyroxine; Q51BO43MG4; perchlorate; VLA4NZX2P4; Index Medicus; Glucocorticoids -- therapeutic use; Methimazole -- therapeutic use; Thyroxine -- therapeutic use; Antithyroid Agents -- therapeutic use; Thyroid Hormones -- blood; Risk Factors; Continuity of Patient Care; Thyroidectomy; Hormone Replacement Therapy; Thyroid Gland -- diagnostic imaging; Plasmapheresis; Ultrasonography; Iodine Radioisotopes -- therapeutic use; Perchlorates -- administration & dosage; Amiodarone -- adverse effects; Hypothyroidism -- therapy; Thyrotoxicosis -- therapy; Thyrotoxicosis -- chemically induced; Hypothyroidism -- diagnosis; Thyrotoxicosis -- diagnosis; Amiodarone -- administration & dosage; Hypothyroidism -- chemically induced; Anti-Arrhythmia Agents -- administration & dosage; Anti-Arrhythmia Agents -- adverse effects; Amiodarone -- pharmacokinetics; Anti-Arrhythmia Agents -- pharmacokinetics; Thyrotoxicosis -- classification
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