Conventional preparation of thyrotoxic patients for surgery using thiouracils and iodides may not be possible because of either, inability to obtain satisfactory therapeutic levels of the drugs or idiosyncratic reactions to the drugs. An alternative regime using potassium iodide and propranolol in combination has previously been shown to be both safe and effective in the pre-operative control of mild to moderate thyrotoxicosis. The use of this combination in a patient with severe thyrotoxicosis is described. Potassium iodide and propranolol can be used successfully to prepare patients with all degrees of thyrotoxicosis for surgery.
HeymaPLarkinsRGHigginbothamLNgK Wah. D-propranolol and DL-propranolol both decrease conversion of L-thyroxine to L-triiodothyronine. Br Med J1980; 2:24–25.
2.
ShanksRGHaddenDRLoweDCMcDevittDGMontgomeryDAD. Controlled trial of propranolol in thyrotoxicosis. Lancet1969; 1:993–994.
3.
ToftADIrvineWJMcIntoshS. Propranolol in the treatment of thyrotoxicosis by subtotal thyroidectomy. J Clin Endrocrinol Metab;1976; 43:1312–1316.
4.
FeekCMSawersJSAIrvineWJBeckettGJRatcliffeWAToftAD. Combination of potassium iodide and propranolol in preparation of patients with Graves’ disease for thyroid surgery. N Engl J Med1980; 302:883–885.
5.
EmersonCHEl ZaheriMMS. Potassium iodide and propranolol in Graves’ disease (letter). N Engl. J Med1980; 303:527.
6.
FeelyJ. Potassium iodide and propranolol in Graves’ disease (letter). N Engl J Med1980; 303:528.
7.
FeelyJForrestAGunnAHamiltonWStevensonICrooksJ. Propranolol dosage in thyrotoxicosis. J Clin Endocrinol Metab1980; 51:658–661.
8.
FeelyJCrooksJ. Pharmacodynamics of propranolol in thyrotoxicosis. Clin Res1979; 27: 775a.
9.
CarruthersSGGhosalAMcDevittDGNelsonJKShanksRG. The assessment of ß-adrenoreceptor blocking drugs in hyperthyroidism. Br J Clin Pharmacol 0000; 1: 93.
