醫療用碘

碘, 元素碘
臨床資料
商品名（英语：Drug nomenclature）	Iodoflex、Iodosorb及其他
AHFS/Drugs.com	Monograph
核准狀況	美 DailyMed: Iodine;
给药途径	局部外用藥物、口服給藥及肌肉注射
ATC碼	D08AG03 (WHO) ;
法律規範狀態
法律規範	加：处方药（℞-only）;
识别信息
CAS号	7553-56-2
UNII	9679TC07X4;
化学信息
化学式	I2

碘（英語：iodine）為一種化學元素，依其形態不同，於醫學上有諸多用途。^[3]元素碘與碘伏為局部外用抗菌劑。^[4]非元素形態之碘，於人體生物學中，扮演基本營養素之角色（參見生物學中之碘（英语：iodine in biology））。^[5]含有碘的有機化合物，亦為X光影像中常用之碘化顯影劑（英语：Iodinated contrast）。^[6]

給藥途徑有口服給藥、靜脈注射及皮下注射。^[7]

碘作為皮膚外用藥劑時，常見的副作用有不適及變色。^[3]建議居住於普遍缺乏碘地區的孕婦，要作碘補充，而在不缺乏碘的地區，則不建議額外攝入。^[1]碘為一種人體必需的稀有元素。^[1]

法國化學家貝爾納·庫爾圖瓦於1811年把碘自海藻中分離出，而瑞士醫生讓-弗朗索瓦·科因代特（英语：Jean-Francois Coindet）於1820年將碘的攝取量與甲狀腺腫大小程度間建立起關聯。^[8]碘最初被用作抗菌劑及治療甲狀腺腫之方式。^[9]^[10]

針對女性的研究顯示在母乳哺育期間使用碘化鈉對嬰兒的風險極低。^[7]

於世界衛生組織基本藥物標準清單中，包含以下型態之碘：^[11]

碘化鉀^[11]^:18,42,43
二胺碘顯影劑^[11]^:40
碘海醇^[11]^:40
碘托酸^[11]^:41
聚維酮碘^[11]^:41
"碘" – 較為明確的名稱則為碘化油（英语：Iodized oil）

而在超過110個國家中，可購得含有非元素碘之食鹽 - 即含碘食鹽。^[12]

形式與配方

元素碘

當元素碘用作抗菌劑，可為元素形態，或為水溶性三碘陰離子，係透過將碘化物添加至難溶於水之元素碘中，於原位生成（逆向化學反應，使部分游離元素碘供消毒用）。^[1]

另一替代方案，碘可由碘伏製得，碘伏包含與增溶劑錯合之碘（碘離子可粗略視為三碘陰離子水溶液中之碘伏）。此類製劑之範例有：^[13]

碘酊：碘溶於乙醇，或碘與碘化鈉溶於乙醇及水之混合液。
盧戈氏碘液：碘與碘化物僅溶於水中，主要形成三碘陰離子。盧戈氏碘液之游離碘 (I₂) 成分含量極微，與碘酊相異。
碘甘油：牙科用製備物。
聚維酮碘（一種碘伏）。
碘-V：碘 (I₂) 與腐植質形成籠形複合物（於此主客體化學籠形複合物中，碘分子被腐植質"包覆"）。是一種水溶性、固態、穩定之結晶籠形複合物。碘-V與其他碘伏不同，僅含有分子型態之碘 (I₂)。^[14]

碘抗菌作用迅速，於低濃度下即可發揮，因而會用於手術室中。^[15]其特定之運作機制仍未被充分了解。碘可滲透至微生物內部，並攻擊特定之胺基酸（如半胱氨酸及甲硫胺酸）、核苷酸及脂肪酸，最終導致細胞死亡。其亦具抗病毒作用，但對非脂質病毒及小病毒科的敏感度，低於對包膜病毒的。碘可能是攻擊包膜病毒之表面蛋白質，並可能透過與不飽和碳－碳鍵反應，而破壞膜脂肪酸之穩定性。^[16]

含碘鹽類

當碘作為營養素時，是以碘離子之型態進入細胞。^[17]海帶等食物中的碘元素，經常以碘化物形式存在。^[18]

碘化鉀是醫學上最常使用的碘鹽。低劑量的碘化鉀，以及更穩定的碘酸鉀，都是製造碘鹽的選擇。碘化鉀之飽和溶液用於治療急性甲狀腺功能亢進症。當碘-131這種同位素被用於非針對甲狀腺或甲狀腺類型組織的放射性藥品（例如碘苄胍（英语：iobenguane））時，碘化鉀也被用來阻斷甲狀腺對碘-131的吸收。^[19]^[20]

碘-131（通常以碘化物之型態存在）為放射性落塵之成分，因為甲狀腺會大量吸收並長時間儲存碘，而碘-131的放射性半衰期僅有8天，而使得它對人體構成極大的威脅。因此可能暴露於輻射塵中環境放射性碘（碘-131）的民眾，會被指示服用非放射性碘化鉀錠。典型成人劑量為每24小時攝入130毫克錠劑，提供100毫克（10萬微克）的離子碘（正常健康之每日碘攝取量約為100微克）。攝取此大劑量非放射性碘，可最大程度減少甲狀腺對放射性碘的吸收。^[21]

碘化物鹽類於有機螯合物問世之前，曾用於口服方式，用於治療鉛中毒或汞中毒，例如由比利時醫生路易·梅爾森斯（英语：Louis Melsens）及眾多19世紀與20世紀初期醫師所大力推廣的療法。^[22]^[23]

有機碘化合物

碘為一種具有高電子密度（英语：electron density）及高原子序數之元素，其透過最內層電子之光電效應，吸收低於33.3千電子伏特（keV）之X射線。^[6]有機碘化合物經靜脈注射後可用作X射線顯影劑。此應用常與先進之X射線技術（如血管攝影及電腦斷層掃描）結合使用。目前，所有水溶性放射性顯影劑皆使用含碘化合物。

碘海醇（顯影劑）
二胺碘顯影劑（顯影劑）
碘托酸（顯影劑）
碘番酸（英语：Iopanoic acid）（顯影劑）

碘化油，係由植物油之脂肪酸醚酯與氫碘酸反應製成，為另一重要的有機碘製備物，是一種碘補充劑，偏遠社區的民眾經由每年口服一次，以預防地域性甲狀腺腫。^[1]^[24]碘化油亦用作非水溶性放射性顯影劑。^[25]

其他有機碘藥物包含：

胺碘酮，一種抗心律不整藥物。
碘化甘油，史上曾被用作黏液活性藥（祛痰劑）。^[26]

參見

碘的同位素，具有醫療用途同位素列表

參考文獻

^ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 World Health Organization. Stuart MC, Kouimtzi M, Hill SR , 编. WHO Model Formulary 2008. World Health Organization. 2009: 499. ISBN 9789241547659. hdl:10665/44053 .
^ Diagnostic agents. Health Canada. 2018-05-08 [2024-04-13].
^ ^3.0 ^3.1 Iodine. The American Society of Health-System Pharmacists. [2017-01-08]. （原始内容存档于2017-01-13）. – This article deals with iodine for topical use. The listed brand names (Iodoflex, Iodosorb) are more appropriately attributed to cadexomer iodine, ATC code D03AX01.
^ Iodine Deficiency. American Thyroid Association. [2022-11-18]. （原始内容存档于2022-11-18）（美国英语）.
^ Iodine Deficiency. American Thyroid Association. [2022-11-18]. （原始内容存档于2022-11-18）（美国英语）.
^ ^6.0 ^6.1 Lancaster JL. Chapter 4: Physical Determinants of Contrast (PDF). Physics of Medical X-Ray Imaging. The University of Texas Health Science Center. （原始内容 (PDF)存档于2015-10-10）.
^ ^7.0 ^7.1 Sodium iodide (oral route, injection route, intravenous route). Mayo Clinic. [2025-03-23].
^ Leung AM, Braverman LE, Pearce EN. History of U.S. iodine fortification and supplementation. Nutrients. November 2012, 4 (11): 1740–1746. PMC 3509517 . PMID 23201844. doi:10.3390/nu4111740 .
^ Starke JA. 14. Application of Iodine Water Purification Tablets: Iodine’s Efficacy against Cryptosporidium parvum.. Preedy VR, Burrow GN, Watson RR (编). Comprehensive Handbook of Iodine: Nutritional, Biochemical, Pathological and Therapeutic Aspects. Academic Press. 2009: 135. ISBN 9780080920863. （原始内容存档于2017-08-12）（英语）.
^ Sneader W. Legacy of the Past. Drug Discovery: A History. John Wiley & Sons. 2005. ISBN 9780471899792. （原始内容存档于2017-01-13）（英语）.
^ ^11.0 ^11.1 ^11.2 ^11.3 ^11.4 ^11.5 World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. hdl:10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
^ Wesley AS, Horton S. Economics of Food Fortification. Watson RR, Gerald JK, Preedy VR (编). Nutrients, Dietary Supplements, and Nutriceuticals: Cost Analysis Versus Clinical Benefits. Springer Science & Business Media. 2010: 37. ISBN 9781607613084. （原始内容存档于2017-01-13）.
^ Block SS. Disinfection, sterilization, and preservation. Hagerstwon, MD: Lippincott Williams & Wilkins. 2001: 159. ISBN 978-0-683-30740-5.
^ Köntös Z. Efficacy of "Essential Iodine Drops" against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). PLOS ONE. 2021-07-09, 16 (7): e0254341. Bibcode:2021PLoSO..1654341K. PMC 8270147 . PMID 34242340. doi:10.1371/journal.pone.0254341 .
^ Patwardhan N, Kelkar U. Disinfection, sterilization and operation theater guidelines for dermatosurgical practitioners in India. Indian Journal of Dermatology, Venereology and Leprology. 2011, 77 (1): 83–93. PMID 21220895. doi:10.4103/0378-6323.74965 .
^ McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clinical Microbiology Reviews. January 1999, 12 (1): 147–179. PMC 88911 . PMID 9880479. doi:10.1128/CMR.12.1.147.
^ Eskin BA, Grotkowski CE, Connolly CP, Ghent WR. Different tissue responses for iodine and iodide in rat thyroid and mammary glands. Biological Trace Element Research. July 1995, 49 (1): 9–19. PMID 7577324. S2CID 24230708. doi:10.1007/BF02788999.
^ Nagataki S, Shizume K, Nakao K. Thyroid function in chronic excess iodide ingestion: comparison of thyroidal absolute iodine uptake and degradation of thyroxine in euthyroid Japanese subjects. The Journal of Clinical Endocrinology and Metabolism. May 1967, 27 (5): 638–647. PMID 4164900. doi:10.1210/jcem-27-5-638.
^ Solubility of KI in water. Hazard.com. 1998-04-21 [2013-01-21].
^ EANM procedure guidelines for 131I-meta-iodobenzylguanidine (131I-mIBG) therapy (PDF). 2009-06-17. （原始内容 (PDF)存档于2009-06-17）.
^ "Potassium Iodide (KI) | Radiation Emergencies | CDC", U.S. Centers for Disease Control, 2006-10-11, accessed 2010-11-14.
^ "Sur l'emploi de l'iodure de potassium pour combattre les affections saturnines et mercurielles", in Annales de chimie et de physique, t. 26, 3^e série, 1849.
^ "On the Employment of Iodide of Potassium as a Remedy for the Affections Caused by Lead and Mercury", in Br Foreign Med Chir Rev. 1853 Jan; 11(21): 201–224.
^ Ingenbleek Y, Jung L, Férard G, Bordet F, Goncalves AM, Dechoux L. Iodised rapeseed oil for eradication of severe endemic goitre. Lancet. November 1997, 350 (9090): 1542–1545. PMID 9388412. doi:10.1016/s0140-6736(97)02427-6.
^ Olliff J, Riley P. Radiological contrast agents and radiopharmaceuticals. Side Effects of Drugs Annual. 2012, 34: 749–760. ISBN 978-0-444-59499-0. doi:10.1016/b978-0-444-59499-0.00046-5.
^ Petty TL. The National Mucolytic Study. Results of a randomized, double-blind, placebo-controlled study of iodinated glycerol in chronic obstructive bronchitis. Chest. January 1990, 97 (1): 75–83. PMID 2403903. doi:10.1378/chest.97.1.75.

[WHO2008-1] 1.0 ^1.1 ^1.2 ^1.3 ^1.4 World Health Organization. Stuart MC, Kouimtzi M, Hill SR , 编. WHO Model Formulary 2008. World Health Organization. 2009: 499. ISBN 9789241547659. hdl:10665/44053 .

[2] Diagnostic agents. Health Canada. 2018-05-08 [2024-04-13].

[AHFS2017-3] 3.0 ^3.1 Iodine. The American Society of Health-System Pharmacists. [2017-01-08]. （原始内容存档于2017-01-13）. – This article deals with iodine for topical use. The listed brand names (Iodoflex, Iodosorb) are more appropriately attributed to cadexomer iodine, ATC code D03AX01.

[4] Iodine Deficiency. American Thyroid Association. [2022-11-18]. （原始内容存档于2022-11-18）（美国英语）.

[5] Iodine Deficiency. American Thyroid Association. [2022-11-18]. （原始内容存档于2022-11-18）（美国英语）.

[CONTRAST-6] 6.0 ^6.1 Lancaster JL. Chapter 4: Physical Determinants of Contrast (PDF). Physics of Medical X-Ray Imaging. The University of Texas Health Science Center. （原始内容 (PDF)存档于2015-10-10）.

[Mayo_Clinic-7] 7.0 ^7.1 Sodium iodide (oral route, injection route, intravenous route). Mayo Clinic. [2025-03-23].

[Leung-8] Leung AM, Braverman LE, Pearce EN. History of U.S. iodine fortification and supplementation. Nutrients. November 2012, 4 (11): 1740–1746. PMC 3509517 . PMID 23201844. doi:10.3390/nu4111740 .

[9] Starke JA. 14. Application of Iodine Water Purification Tablets: Iodine’s Efficacy against Cryptosporidium parvum.. Preedy VR, Burrow GN, Watson RR (编). Comprehensive Handbook of Iodine: Nutritional, Biochemical, Pathological and Therapeutic Aspects. Academic Press. 2009: 135. ISBN 9780080920863. （原始内容存档于2017-08-12）（英语）.

[10] Sneader W. Legacy of the Past. Drug Discovery: A History. John Wiley & Sons. 2005. ISBN 9780471899792. （原始内容存档于2017-01-13）（英语）.

[WHO21st-11] 11.0 ^11.1 ^11.2 ^11.3 ^11.4 ^11.5 World Health Organization. World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. hdl:10665/325771 . WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.

[12] Wesley AS, Horton S. Economics of Food Fortification. Watson RR, Gerald JK, Preedy VR (编). Nutrients, Dietary Supplements, and Nutriceuticals: Cost Analysis Versus Clinical Benefits. Springer Science & Business Media. 2010: 37. ISBN 9781607613084. （原始内容存档于2017-01-13）.

[13] Block SS. Disinfection, sterilization, and preservation. Hagerstwon, MD: Lippincott Williams & Wilkins. 2001: 159. ISBN 978-0-683-30740-5.

[14] Köntös Z. Efficacy of "Essential Iodine Drops" against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2). PLOS ONE. 2021-07-09, 16 (7): e0254341. Bibcode:2021PLoSO..1654341K. PMC 8270147 . PMID 34242340. doi:10.1371/journal.pone.0254341 .

[15] Patwardhan N, Kelkar U. Disinfection, sterilization and operation theater guidelines for dermatosurgical practitioners in India. Indian Journal of Dermatology, Venereology and Leprology. 2011, 77 (1): 83–93. PMID 21220895. doi:10.4103/0378-6323.74965 .

[pmid9880479-16] McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clinical Microbiology Reviews. January 1999, 12 (1): 147–179. PMC 88911 . PMID 9880479. doi:10.1128/CMR.12.1.147.

[EskinGrotkowski1995-17] Eskin BA, Grotkowski CE, Connolly CP, Ghent WR. Different tissue responses for iodine and iodide in rat thyroid and mammary glands. Biological Trace Element Research. July 1995, 49 (1): 9–19. PMID 7577324. S2CID 24230708. doi:10.1007/BF02788999.

[18] Nagataki S, Shizume K, Nakao K. Thyroid function in chronic excess iodide ingestion: comparison of thyroidal absolute iodine uptake and degradation of thyroxine in euthyroid Japanese subjects. The Journal of Clinical Endocrinology and Metabolism. May 1967, 27 (5): 638–647. PMID 4164900. doi:10.1210/jcem-27-5-638.

[19] Solubility of KI in water. Hazard.com. 1998-04-21 [2013-01-21].

[20] EANM procedure guidelines for 131I-meta-iodobenzylguanidine (131I-mIBG) therapy (PDF). 2009-06-17. （原始内容 (PDF)存档于2009-06-17）.

[21] "Potassium Iodide (KI) | Radiation Emergencies | CDC", U.S. Centers for Disease Control, 2006-10-11, accessed 2010-11-14.

[22] "Sur l'emploi de l'iodure de potassium pour combattre les affections saturnines et mercurielles", in Annales de chimie et de physique, t. 26, 3^e série, 1849.

[KI_en-23] "On the Employment of Iodide of Potassium as a Remedy for the Affections Caused by Lead and Mercury", in Br Foreign Med Chir Rev. 1853 Jan; 11(21): 201–224.

[Ingenbleek-24] Ingenbleek Y, Jung L, Férard G, Bordet F, Goncalves AM, Dechoux L. Iodised rapeseed oil for eradication of severe endemic goitre. Lancet. November 1997, 350 (9090): 1542–1545. PMID 9388412. doi:10.1016/s0140-6736(97)02427-6.

[25] Olliff J, Riley P. Radiological contrast agents and radiopharmaceuticals. Side Effects of Drugs Annual. 2012, 34: 749–760. ISBN 978-0-444-59499-0. doi:10.1016/b978-0-444-59499-0.00046-5.

[26] Petty TL. The National Mucolytic Study. Results of a randomized, double-blind, placebo-controlled study of iodinated glycerol in chronic obstructive bronchitis. Chest. January 1990, 97 (1): 75–83. PMID 2403903. doi:10.1378/chest.97.1.75.

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醫療用碘

形式與配方

元素碘

含碘鹽類

有機碘化合物

參見

參考文獻

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