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23024583
Tirotoxicosis
Description
tratamiento URG tirotoxicosis
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Mind Map by
Elena Cr
, updated more than 1 year ago
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Created by
Elena Cr
about 4 years ago
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Resource summary
Tirotoxicosis
TRIADA: Hipertermia + Taquicardia + Agitación
Tratamiento
O2: ventimask 30%
Vía periférica + monitorización hemoD
FluidoT con corrección hidroelectrolítica
Hipertermia
1. Paracetamol c/6h + medidas físicas
2. Clorpromacina 25 mg/6h
HBPM
Corticoides iv
Dexametasona 2mg/6h iv
Hidrocortisona: bolo 100mg iv + post 100mg/8h iv
Investigar causas y desencadenantes
Hipertiroidismo
Bloqueo síntesis hormonas
1. Propiltiouracilo (PTU): carga 600-1000 mg vo/SNG --> 200mg/4h --> 100mg/8h
2. Tiamizol (Tirodril): carga 60-100 mg vo/SNG --> 20-40 mg/6h --> mantenimiento 5-20 mg/8h
Bloqueo liberación
Yodo inorgánico
Yoduro potásico 5 gotas/6h vo/SNG
Solución yodoyodurada: 10 gotas/8h vo/SNG
Ipodato sódico 1-2g/día vo/SNG
Si intolerancia: carbonato de litio (Plenur) 400mg/8h --> manteniendo litemia <1,5-1 mEq/L
Efectos adrenérgicos
Betabloqueantes
1. Propanolol 0,5-1 mg/5min iv hasta control FC (máx 7mg) ó 40-80mg/4-6h vo
2. Cardioselectivos: atenolol o metoprolol 1mg/5min iv hasta control (máx 10mg)
Ante sospecha => TTO
Todos ingreso hospitalario (preferente UCI)
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