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Half-life: Unknown.
IODINE, IODIDE
ROUTE
ONSET
PEAK
DURATION
potassium iodide†
PO
24 hr
10–15 days
variable†
Pima, SSKI, ThyroSafe, ThyroShield
†Radiation protection lasts 24 hr
strong iodine solution
Contraindications/Precautions
Contraindicated in: Hypersensitivity; Hyperkalemia; Pulmonary edema; Im-
TIME/ACTION PROFILE (effects on thyroid)
Lugol’s solution
Classification
Therapeutic: antithyroid agents
Pharmacologic: iodine containing agents
Pregnancy Category D
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paired renal function.
†For more information on potassium iodide as a radiation protectant see Potassium Iodide as a Thyroid Blocking Agent in Radiation Emergencies at www.fda.gov
Indications
Adjunct with other antithyroid drugs in preparation for thyroidectomy. Treatment of
thyrotoxic crisis. Radiation protectant following radiation emergencies or administration of radioactive iodine.
Action
Rapidly inhibits the release and synthesis of thyroid hormones. Decreases the vascularity of the thyroid gland. Decreases thyroidal uptake of radioactive iodine following
radiation emergencies or administration of radioactive isotopes of iodine. Iodine is a
necessary component of thyroid hormone. Therapeutic Effects: Control of hyperthyroidism. Decreased bleeding during thyroid surgery. Decreased incidence of
thyroid cancer following radiation emergencies.
Pharmacokinetics
Absorption: Converted in the GI tract and enters the circulation as iodine; also ab-
Use Cautiously in: Tuberculosis; Bronchitis; Cardiovascular disease; OB, Pedi:
Pregnancy or lactation (although iodine is required during pregnancy, excess
amounts may cause thyroid abnormalities/goiter in the newborn; excess use during
lactation may cause skin rash or thyroid suppression in the infant).
Adverse Reactions/Side Effects
CNS: confusion, weakness. GI: GI BLEEDING, diarrhea, nausea, vomiting. Derm: acneiform eruptions. Endo: hypothyroidism, goiter, hyperthyroidism. F and E: hyperkalemia. Neuro: tingling. MS: joint pain. Misc: hypersensitivity, iodism.
Interactions
Drug-Drug: Use with lithium may causeqhypothyroidism.qantithyroid effect of
methimazole and propylthiouracil.qhyperkalemia may result from combined
use with potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists or potassium supplements.
Route/Dosage
Preparation for Thyroidectomy
PO (Adults and Children): Strong iodine solution— 3– 5 drops (0.1– 0.3 mL) 3
times daily for 10 days prior to surgery. Potassium iodide saturated solution
(SSKI)— 1– 5 drops (50– 250 mg) 3 times daily for 10 days prior to surgery.
sorbed through skin and lungs; may also be obtained via recycling of iodothyronines.
Hyperthyroidism
Distribution: Concentrates in the thyroid gland and muscle; also found in skin,
PO (Adults and Children): Strong iodine solution— 1 mL in water 3 times daily.
Potassium iodide saturated solution (SSKI)— 6– 10 drops (300– 500 mg) 3
times daily.
PO (Infants ⬍1 yr): 3– 5 drops (150– 250 mg) 3 times daily.
skeleton, breasts, and hair. Readily crosses the placenta; enters breast milk.
Metabolism and Excretion: Taken up by the thyroid gland, then eliminated via
kidneys, liver, skin, lungs, and intestines.
⫽ Canadian drug name.
⫽ Genetic Implication.
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
Name /bks_53161_deglins_md_disk/iodineiodide
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Radiation Protectant to Radioactive Isotopes of Iodine
PO (Adults): Pima— 195 mg once daily for 10 days (start 24 hr prior to exposure
(continue until risk of exposure has passed or other measures have been implemented).
PO (Children ⬎1 yr): 130 mg once daily for 10 days (start 24 hr prior to exposure).
PO (Infants ⬍1 yr): 65 mg once daily for 10 days (start 24 hr prior to exposure).
Reduction of Thyroid Cancer after Nuclear Accident
PO (Adults and Children ⬎68 kg, including pregnant/lactating women): Iosat, ThyroSafe, ThyroShield— 130 mg once daily (continue until risk of exposure
has passed or other measures have been implemented).
PO (Children 3– 18 yr): 65 mg once daily.
PO (Children 1 mo– 3 yr): 32.5 mg once daily.
PO (Infants ⬍1 mo): 16.25 mg once daily.
NURSING IMPLICATIONS
Assessment
● Assess for signs and symptoms of iodism (metallic taste, stomatitis, skin lesions,
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Implementation
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cold symptoms, severe GI upset). Report these symptoms promptly.
Monitor response symptoms of hyperthyroidism (tachycardia, palpitations, nervousness, insomnia, diaphoresis, heat intolerance, tremors, weight loss).
Monitor for hypersensitivity reaction (rash, pruritus, laryngeal edema, wheezing).
Discontinue drug and notify physician immediately if these problems occur.
Lab Test Considerations: Monitor thyroid function before and periodically
during therapy. May alter results of radionuclide thyroid imaging and maypthyroidal uptake of 131I, 123I, and sodium pertechnetate 99mTc in thyroid uptake tests.
Monitor serum potassium levels periodically during therapy.
Lab Test Considerations: Monitor thyroid stimulating hormone (TSH) and
free T4 in neonates (within the first month of life) treated with potassium iodide for
development of hypothyroidism. Thyroid hormone therapy should be instituted if
hypothyroidism develops.
● Do not confuse iodine with Lodine (etodolac).
● For protection against inhaled radioiodines, administer potassium iodide prior to
or immediately coincident with passage of the radioactive cloud, though a substantial protective effect lasts 3– 4 hr after exposure.
● PO: Mix solutions in a full glass of fruit juice, water, broth, formula, or milk. Administer after meals to minimize GI irritation.
● Solution is normally clear and colorless. Darkening upon standing does not affect
potency of drug. Solutions that are brownish yellow should be discarded.
● Crystals may form, especially if refrigerated, but redissolve upon warming and
shaking.
Patient/Family Teaching
● Instruct patient to take medication as directed. Take missed doses as soon as pos-
sible but not just before next dose; do not double doses.
● Instruct patient to report suspected pregnancy to health care professional before
therapy is initiated.
● Advise patient to consult health care professional about avoiding foods high in io-
dine (seafood, iodized salt, cabbage, kale, turnips) or potassium.
● Advise patient to consult health care professional before using OTC or herbal cold
remedies. Some cold remedies use iodide as an expectorant.
● Hyperthyroidism: Instruct patient to take medication as ordered. Missing a dose
may precipitate hyperthyroidism.
Evaluation/Desired Outcomes
● Resolution of the symptoms of thyroid crisis.
● Decrease in size and vascularity of the gland before thyroid surgery. Use of iodides
in the treatment of hyperthyroidism is usually limited to 2 wk.
● Protection of the thyroid gland from the effects of radioactive iodine.
Why was this drug prescribed for your patient?
Potential Nursing Diagnoses
Deficient knowledge, related to medication regimen (Patient/Family Teaching)
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