Blog | Saturday, April 12, 2014

Internal Medicine 2014: The "5 Bs" for acute hyperthyroidism


When treating acute hyperthyroidism, remember the “5 Bs,” said Hossein Gharib, MD, MACP, at a Friday session titled "Clinical Triad: Endocrinology for the Hospitalist." They are: 1. Block hormone synthesis with antithyroid drugs; 2. Block hormone release by administering iodine; 3. Block T4 to T3 conversion with PTU; 4. Beta-blockade using propranolol or metoprolol; and 5. Block enterohepatic circulation with cholestyramine. The second option is to be used in "probably a patient with hyperthyroidism and Graves disease," Dr. Gharib said. He also noted that the fifth option "is seldom used nowadays."