Potassium perchlorate 200mg capsules

IntroductionPerchlorates are ionic inhibitors antagonizing iodine transport into thyrocytes, hampering thyroid hormone synthesis. Nevertheless, perchlorates are not considered as first-line treatment in hyperthyroidism and thyrotoxicosis as compared to other pharmacological and non-pharmacological interventions.AimReassessing the therapeutic role of perchlorates in hyperthyroidism and thyrotoxicosis throughout a systematic review of the Literature.MethodsGuidelines were searched and examined to summarize current recommendations on the use of perchlorates in the management of hyperthyroidism. Randomized and non-randomized clinical trials were also searched and reviewed to summarize the efficacy/effectiveness and safety of perchlorates in hyperthyroidisms and thyrotoxicosis.ResultsThe management of specific forms of hyperthyroidism was considered, including Graves' disease (GD) in non-pregnant adults, hyperthyroidisms in pregnancy, iodine media contrast-induced hyperthyroidism, amiodarone-induced hyperthyroidisms, and thyroid storm. Most of the reported studies had remarkable limitations in terms of study design (non-controlled trials, lack of blinding), low number of participants, and the lack of clinically relevant endpoints, such as cardiovascular events, cardiovascular mortality, and teratogenicity. Overall, perchlorates could be considered a second-line treatment after thionamides, radioiodine, and total thyroidectomy in both GD and hyperthyroidisms in pregnancy. The therapeutic potential of perchlorates alone or in combination with other agents could be considered a second-line treatment of iodine-related hyperthyroidisms and thyroid storm.ConclusionDespite the low level of evidence, perchlorates could be considered in such specific forms of thyroid disorders, including iodine-induced hyperthyroidism and thyroid storm.

Abstract licence: CC BY

BACKGROUND: While rare, radiological and nuclear (RN) emergencies pose complex challenges that require tailored preparedness strategies. A key aspect is the strategic stockpiling of medical countermeasures (MCMs), yet existing literature offers limited and fragmented recommendations regarding their appropriate composition. METHODS: This systematic review, conducted following PRISMA guidelines, aims to consolidate and critically appraise available evidence on stockpiling for RN emergencies. Seven databases and selected grey literature sources were screened from 2011 onward. Studies were included if they provided direct or indirect recommendations on stockpiling items. Data extraction was conducted in two steps by independent pairs of reviewers, and identified items were categorized as therapeutics, medical devices, personal protective equipment (PPE), or RN-specific equipment. Items were further analyzed for regulatory status, administration route, shelf-life, and storage requirements. RESULTS: Thirty-two articles met the inclusion criteria. Therapeutics dominated the findings, with 50 distinct agents identified, most frequently potassium iodide, Prussian Blue, Ca-/Zn-DTPA, and hematopoietic growth factors such as filgrastim. In contrast, medical devices were not supported by a sufficient level of stockpiling recommendation, while PPE (6 of 32 articles) and RN equipment (14 of 32 articles) were cited less often. Pediatric considerations were rarely addressed, with 2 studies explicitly focused on this population. Gaps in operational guidance, regulatory harmonization, and standardized planning emerged across the literature. CONCLUSIONS: This review highlights that stockpiling recommendations for RN emergencies remain limited, with greater guidance concentrated on a few therapeutics and little direction for other items. The findings provide an informative evidence base to support more consistent policy and preparedness planning.

Abstract licence: CC BY-NC-ND