Wednesday September 06, 2006
Where is my thyroxine doc ?


Q; What is the PO to IV conversion of thyroxine ?


A; 50% of patient's previous PO dose.

It may help to continue patient's baseline thyroxine replacement in ICU and if needed in IV form with 50% of PO dose 1. It gets more important if patient stay in ICU gets longer. Many times, it is the absence of baseline thyroxine replacement which prevents recovery of hemodynamics. Cases have been reported in literature with serious consequences that can potentially result from failure to provide adequate thyroid hormone therapy 2, 3.


Previous related pearls:

7 Pearls re. Myxedema Coma

Iodide in Thyroid Storm



Reference:

1. LEVOTHYROXINE SODIUM FOR INJECTION - bedfordlabs.com
2. Severe Myxedema After Cardiopulmonary Bypass - Anesth Analg 2003;96:62-64
3. Severe Hypothyroidism After Coronary Artery Bypass Grafting - Ann Thorac Surg 2005;80:714-716