THYROID STORM NEW ,THYROTOXICOSIS, pptx.

In this ppt we get idea about thyroid storm, its causes and treatment for thyroid storm

1. DR.D.Y.PATIL COLLEGE OF PHARMACY AKURDI SUBJECT NAME: SEMINAR AND ASSIGNMENT PRESENTED BY: ANKITA SANDESH HALDANKAR GUIDED BY: DR. ASHISH V. KULKARNI ROLL NO. 02

2. THYROID STORM

3. CONTENT Definition Introduction Thyroid storm trigerring stresses Causes of thyroid storm Sign and Symptoms of thyroid storm Diagnosis Treatment of thyroid storm Management Prognosis Conclusion Reference

4. DEFINITION When thyroid gland generate too much thyroid hormones, which result in high situations of circulating hormones in the rotation, a situation known as ‘thyroid storm’ emerges. Exacerbation of pre being hyperthyroidism due to any of the following: 1.Graves’ complaint 2.Poisonous multinodular goiter 3.Poisonous adenomas 4.Hypersecretory thyroid melanoma Severe, acute complication of hyperthyroidism

5. INTRODUCTION Thyroid storm: A Critical Complication of Hyperthyroidism. Thyroid storm, alternatively referred to as thyrotoxic crises , represents a severe and life -threatening complication of hyperthyroid. This condition manifests as an intensified form of thyrotoxicosis and entails a sudden, widespread impact on multiple body system. Despite significant advancement in treatment and supportive care, the mortality rate associated with thyroid storm ranges from 8% to 25%. Therefore, early recognition and prompt initiation of aggressive interventions are paramount in mitigating mortality risks. The clinical diagnosis of thyroid storm remains pivotal in its management.

6. PATHOPHYSIOLOGY

7. THYROID STORM TRIGERRING SRESSES

8. What Causes Thyroid Storm? Thyroid Storm is when hyperthyroidism (excess T3/T4 hormone) reaches life-threatening levels in the body. Factors that can cause a Thyroid Storm: Improper Thyroid Medication / Dosage Diabetic Ketoacidosis: blood becomes dangerously acidic. Intense Exercise & Low Blood Sugar Severe emotional distress. Severe Injury, Childbirth, Broken Bones Goiters on glands or reproductive organs Heart Attack, Heart Failure, Stroke Drug Side-Effects: Sudafed, Aspirin, Imaging Contrast & Heart Meds

9. Symptoms of a Thyroid Storm Mostly exaggerated version of symptoms of hyperthyroidism Weight loss because of BMR Heat intolerance because of body producing more heat Rapid HR ,Sweating , Hyperactivity because effect of thyroid hormone on Sympathetic NS Thyroid Storm Heat intolerance turns to fever Hyperactivity &anxiety turns to agitation, confusion Thyroid storm is extremely severe & can cause death if it is not quickly recognized & managed.

10. DIAGNOSIS Definite Thyroid Storm (TS1 ): Thyrotoxicosis (elevated FT3 and/or FT4) along with at least one CNS manifestation and one or more other symptoms (fever, tachycardia, CHF, GI/Hepatic), OR a combination of at least three features among fever, GI/Hepatic, CHF, or tachycardia. Suspected Thyroid Storm (TS2 ): Thyrotoxicosis (elevated FT3 and/or FT4) with a combination of at least two features among tachycardia, CHF, GI/Hepatic, and fever, OR a patient with a history of thyroid disease, presence of goiter and exophthalmos, who meets the criteria for TS1 but TFTs are not available.

11. LABORATORY STUDIES Laboratory test results are not used in the diagnosis of thyroid storm; instead, clinical symptoms are used. Do not wait for laboratory confirmation of thyrotoxicosis before starting treatment if the patient's clinical picture is compatible with thyroid storm. Thyroid studies: These tests are only helpful if the patient has not received a previous diagnosis because the results are typically consistent with hyperthyroidism. CBC count: A minor case of leukocytosis is revealed. Tests for liver function (LFTs): LFTs frequently show nonspecific abnormalities like increased urine, aspartate aminotransferase (AST), alanine aminotransferase (ALT) ABG levels: Urinalysis testing and measurements of blood gas and electrolyte levels can be used to evaluate and track short-term treatment

12. IMAGING STUDIES The following imaging studies may be indicated: Chest radiography: Congestive heart failure-related cardiac enlargement may be seen on chest radiography. Additionally, radiography may show signs of a lung infection or pulmonary edema brought on by heart failure. CT scanning: If a patient's diagnosis remains unclear following early stabilization and they have changed mental status, a head CT scan may be required to rule out other neurologic diseases. When keeping an eye out for cardiac arrhythmias, ECG is helpful. The most frequent cardiac arrhythmia linked to thyroid storm is atrial fibrillation. There is also a chance of other arrhythmias such atrial flutter and, less frequently, ventricular tachycardia.

13. TREATMENT PRINCIPLES Correct hyperthyroidism Block synthesis of additional hormones Block release of preformed hormones Inhibit peripheral conversion to T4 to T3 Measures to decrease circulating hormone levels Definitive treatment Normal homeostatic decompensation Treat precipitating events

14. TREATMENT OF THYROID STORM High Inflow O2 Rapid cooling if markedly hyperthermic Ice packs, cooling mask, mist/ suckers, nasogastric tube lavage, acetaminophen( Salicylates contraindicated because cause supplemental deiodination to T3) IV fluid gelcap if dehydrated May need inotropes rather if in CHF IV boluses of labetolol ( 10 – 20 mg) or propranolol mg, with reprise boluses as necessary

15. MANAGEMENT OF THYROID STORM

16. PROGNOSIS This depends on early opinion and prompt aggressive treatment. Mortality of treated cases is at10.7. The major causes of mortality are multiple organ failure and congestive cardiac failure. Significant morbidity may develop from brain injury, desuetude atrophy of the muscles, cerebrovascular complaint, renal function impairment, and indeed psychosis.

17. CONCLUSION Thyroid storm is an endocrine exigency that requires multidisciplinary treatment aimed at addressing all way of thyroid hormone function while furnishing probative care and resolving all possible pouring factors. Thyroid storm is a severe form of hyperthyroidism with high mortality. This condition is characterized by multiple organ failure, decompensation and death thus, opinion and multidisciplinary medical care is needed. Its treatment include beta adrenergic blocker and corticosteroids.

18. REFERENCE https://www.slideshare.net/drterd/thyroid-storm https://www.slideshare.net/slideshow/thyroid-storm-45724171/45724171 .De Groot LJ, Bartalena L, Feingold KR. Endotext [Internet]. Rockville Pike, Maryland: National Center for Biotechnology Information; 2018 [cited 2020Feb4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278927/ Kopp P. Thyrotoxicosis of other etiologies [Internet]. Endotext [Internet]. U.S. National Library of Medicine; 2010 [cited 2022Jan28]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285562/ Akamizu T, Satoh T, Isozaki O, et al. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. Thyroid. 2012 [cited 2020Feb5];22(7):661-679. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22690898