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Related Concept Videos

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers01:12

Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers

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Class III antiarrhythmic drugs are a group of medications that can prolong action potentials in the heart. They achieve this by blocking potassium channels or enhancing inward currents from sodium channels. However, these drugs have a unique property of "reverse use-dependence," which is most pronounced at slower heart rates and can lead to torsades de pointes—a specific type of arrhythmia. However, it is essential to note that excessive QT interval prolongation—a measure of...
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Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
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The Thyroid Gland01:23

The Thyroid Gland

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
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Functions of Thyroid Hormones01:18

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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
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Heart Failure Drugs: Inotropic Agents01:26

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Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
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Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

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Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
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Total Thyroidectomy for Amiodarone-induced Thyrotoxicosis in the Hyperthyroid State.

R M Kaderli1, R Fahrner1, E R Christ2

  • 1Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.

Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [And] German Diabetes Association
|November 18, 2015
PubMed
Summary

Total thyroidectomy is a safe surgical option for patients with amiodarone-induced thyrotoxicosis (AIT), even if they are not euthyroid before surgery. Early surgical intervention is recommended to avoid prolonged medical treatment.

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Area of Science:

  • Endocrinology
  • Cardiology
  • Surgical Management

Background:

  • Amiodarone, an antiarrhythmic drug, can induce thyrotoxicosis.
  • Thyroidectomy is a treatment option for amiodarone-induced thyrotoxicosis (AIT).
  • Optimal preoperative antithyroid treatment and timing for thyroidectomy in AIT patients remain unclear.

Purpose of the Study:

  • To evaluate the safety and efficacy of total thyroidectomy under general anesthesia for AIT patients.
  • To determine if achieving a euthyroid state is necessary before surgery.

Main Methods:

  • Retrospective cohort study of 11 AIT patients undergoing total thyroidectomy.
  • Patients received preoperative treatment with carbimazole, steroids, and beta-blockers.
  • Some patients received potassium perchlorate, propylthiouracil, or plasmapheresis.

Main Results:

  • No significant intra- or postoperative complications, including thyroid storm.
  • Only one patient was euthyroid preoperatively.
  • One patient improved cardiac function, allowing removal from the cardiac transplant list.

Conclusions:

  • Total thyroidectomy under general anesthesia is safe for hyperthyroid AIT patients.
  • Early surgery is recommended, avoiding prolonged medical treatment and its side effects.
  • Interdisciplinary management is key to safe surgical outcomes in AIT.