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755822 
Journal Article 
Review 
Amiodarone and thyroid dysfunction 
Padmanabhan, H 
2010 
1 
Southern Medical Journal
ISSN: 0038-4348
EISSN: 1541-8243 
103 
9 
922-930 
English 
20689491 
WOS:000281502000015 
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. 
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