β-blockers (Propranolol, Esmolol)
- Standard of acute care - most of the immediately life-threatening consequences of thyroid storm are cardiovascular
- Effective in controlling heart rate; with a slower rate the cardiac failure may actually improve and the blood pressure may paradoxically increase
Diltiazem
- Effective at controlling heart rate in patients in which β-blockade is contraindicated such as asthma
Corticosteroids
- Thyroid disease (particularly long-standing hyperthyroidism) is associated with a diminished adrenal reserve
- Routinely used in thyroid storm to address the coexisting hypoadrenal state