Iodine

A to Z Drug Facts

Iodine

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(EYE-uh-dine)

Iodine Tincture, Iodopen, Strong Iodine (Lugol's Solution), Strong Iodine Tincture

Class: Thyroid; trace metal; Antiseptic; expectorant

Action Antiseptic: Topical iodine possesses microbicidal properties. Thyroid drug: Large doses of iodides inhibit thyroid hormone production and release into bloodstream. Enhances secretion of respiratory fluids, thus decreasing mucus viscosity.

Indications

Antiseptic: Externally, to achieve broad microbicidal benefits. Thyroid agent: As adjunct to antithyroid drug in hyperthyroid patients to prepare for thyroidectomy and to treat thyrotoxic crisis or neonatal thyrotoxicosis; thyroid blocking in radiation emergency. Trace metal: Supplement to IV solutions given for TPN. Expectorant: Treatment of chronic pulmonary diseases complicated by tenacious mucus, including bronchial asthma, chronic bronchitis, bronchiectasis, and pulmonary emphysema; adjunctive treatment in respiratory conditions such as cystic fibrosis and chronic sinusitis and to prevent atelectasis after surgery.

Contraindications Hypersensitivity to iodides; impaired renal function; acute bronchitis; hyperthyroidism; Addison's disease; acute dehydration; heat cramps; hyperkalemia; iodism; tuberculosis.

Route/Dosage

Topical Antiseptic

Apply prn to intact skin.

Thyroid Agent Prior to Thyroidectomy

PO 2 to 6 drops of strong iodine solution (Lugol's Solution) tid for 10 days prior to surgery.

For Thyroid Blocking in Radiation Emergency

Use at direction of state or local public health authorities.

Trace Metal for TPN (Supplied as Sodium Iodide)

FOR METABOLICALLY STABLE ADULTS: 1 to 2 mcg/kg/day (normal adults, 75 to 150 mcg/day). PREGNANT AND LACTATING WOMEN, GROWING CHILDREN: 2 to 3 mcg/kg/day.

Expectorant

ADULTS: PO 300 to 1000 mg initially after meals. If tolerated, 1 to 1.5 g tid. Children: PO Half adult dose.

Interactions

Lithium: May have synergistic hypothyroid activity; may result in hypothyroidism. Potassium-sparing diuretics: Increase risk of hyperkalemia, cardiac arrhythmias, and cardiac arrest.

Lab Test Interferences Potassium iodide may alter thyroid function test results.

Adverse Reactions

CV: Irregular heartbeat. CNS: Confusion; unusual tiredness. DERM: Rash; acne. EENT: Swelling of neck, throat, or salivary glands. GI: Bleeding. META: Thyroid adenoma; goiter; myxedema; thyroid gland enlargement; acute parotitis. OTHER: Hypersensitivity manifested by angioneurotic edema, cutaneous and mucosal hemorrhages, and symptoms resembling serum sickness (eg, fever, arthralgia, lymph node enlargement and eosinophilia); numbness; tingling; pain or weakness in hands or feet; unusual tiredness; weakness or heaviness of legs; fever; “iodism” (eg, metallic taste, burning mouth and throat, sore teeth and gums, symptoms of head cold, and, sometimes, stomach upset and diarrhea).

Precautions

Pregnancy: Category C (trace metal); Category D (potassium iodide). Lactation: Excreted in breast milk. Children: Safety and efficacy not established. Topical: For external use only; highly toxic if ingested. Avoid contact with eyes and mucous membranes. Iodine preparations stain skin and clothing. Oral: Hypothyroidism: Prolonged use can lead to hypothyroidism. Special risk patients: Pulmonary tuberculosis is considered a contraindication to use of iodides by some authorities; use with caution in such cases and in patients with cardiac disease, myotonia congenita, or renal impairment. Cystic fibrosis patients may have increased susceptibility to adverse effects. GI effects: Nonspecific small bowel lesions have occurred with enteric-coated potassium salts.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Do not give trace metal undiluted by direct injection into peripheral vein.
Measure solutions carefully with calibrated dropper.
Dilute expectorant in 60 ml of flavored beverages (eg, chocolate or plain milk, orange juice) to minimize bitter taste.
Mix solutions in full glass of fruit juice, water, or milk.
Administer after meals to minimize irritation.
Have patient sip expectorant through straw to decrease burning sensation in mouth and to prevent discoloration of teeth.
Store in airtight, light-resistant container at room temperature.

Assessment/Interventions

Obtain patient history, including drug history and any known allergies.
Assess for signs and symptoms of iodism (eg, metallic taste, stomatitis, skin lesions, cold symptoms).
Monitor thyroid function before and periodically during course of therapy.
Notify physician of any signs of hyperthyroidism (eg, tachycardia, palpitations, nervousness, insomnia, tremors, weight loss, diaphoresis).
Report to physician any signs of iodism or sensitivity to drug.

OVERDOSAGE: SIGNS & SYMPTOMS
	Iodine is corrosive; toxic symptoms are related primarily to local GI tract irritation. Gastroenteritis, abdominal pain, and diarrhea (sometimes bloody) may be seen. Fatalities may occur from circulatory collapse, because of shock, corrosive gastritis, or asphyxiation from swelling of glottis or larynx

Patient/Family Education

Explain name, dose, action, and side effects of iodine product.
Tell patient to discontinue use and notify physician if fever, skin rash, metallic taste, swelling of throat, burning of mouth and throat, sore gums and teeth, head cold symptoms, severe GI distress, or enlargement of thyroid gland (goiter) occur.
Inform patient if replacement therapy is to be taken for life.
Explain that sudden discontinuation of drug should not be done without physician's guidance.
Teach patient which foods are high in iodine (eg, seafood, kale, turnips, and iodized salt).
Explain that darkening of solution does not affect potency.