Which treatment option is the best first-line management for thyroid storm?

In the management of thyroid storm, beta-blockers play a crucial role as the initial treatment option primarily for heart rate control. Thyroid storm leads to a hypermetabolic state characterized by elevated thyroid hormone levels, which causes symptoms such as tachycardia, hypertension, and hyperthermia. By administering beta-blockers, the excessive sympathetic stimulation is counteracted, resulting in a reduction of heart rate and alleviation of symptoms related to increased adrenergic activity. This action helps stabilize the patient while other therapeutic measures can be implemented.

While other treatments, such as antipyretics, glucocorticoids, and IV fluids, are also important in the overall management of thyroid storm, they do not directly address the immediate concerns of tachycardia and hypertension as effectively as beta-blockers. Antipyretics can help reduce fever, glucocorticoids can assist in decreasing inflammation and managing adrenal insufficiency, and IV fluids are vital for hydration and general supportive care. However, controlling the heart rate with beta-blockers is paramount in the acute setting, making it the most appropriate first-line management.