Contrast Agent

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Classification 3 Indications 4 Contraindications 5 Adverse-effects 6 More General Terms 7 Additional Terms 8 References

More Specific Terms

• barium sulfate (BaSO4, Baricon, Barite)
• diatrizoate
• ethiodized oil (Ethiodol)
• ferumoxides (Feridex)
• ferumoxsil (Gastromark)
• gadobenate dimeglumine (Multihance)
• gadofosveset (Vasovist)
• gadolinium contrast (Omniscan)
• gadopentetate dimeglumine (Magnevist, Resovist)
• gadoteridol (Prohance)
• gadoxetate (Eovist, Primovist)
• indigotindisulfonate (Indigo Carmine)
• iodamide meglumine (Renovue-65, Renovue-DIP)
• iodixanol (Visipaque)
• iohexol (Omnipaque)
• iopamidol (Isovue)
• iopanoic acid (Telepaque)
• iothalamate (Conray, Conray-400)
• ioversol (Optiray)
• ioxaglate (Hexabrix)
• ioxilan (Oxilan)
• ipodate (Oragrafin)
• iso-sulfan blue (Lymphazurin)
• mangafodipir (Teslascan)
• micro-bubble contrast agent
• tyropanoate (Bilopaque)

Classification

• 1st generation agents:

• iodinated, ionic
• very hyperosmolar (1500-1800 mOsm/kg of water).

• 2nd generation agents: (i.e. iohexol)

• non- ionic
• lower osmolarity (780 mOsm/kg of water)

• 3rd generation agent: ( iodixanol)

• iso-osmolar to blood (290 mOsm/kg of water)
• least nephrotoxic agent

Indications

• for use in conjunction with diagnostic imaging

Contraindications

• (cautions)
• sensitivity to contrast
• allergies to shellfish [3]
• renal failure

Adverse-effects

• anaphylactoid

• occur with 2-6% of procedures
• may have the clinical appearance of anaphylaxis, but are more appropriately termed anaphylactoid, because they do not involve IgE
• complement activation
• low ionic strength contrast agents are less likely to result in an adverse reaction
• patients with a history of contrast reaction can be pretreated with the following protocol:

• 50 mg of prednisone every 6h for 3 doses, or 30 mg every 6 hours for 4 doses [3]
• last dose 1 hour before procedure
• 50 mg of diphenhydramine ( Benadryl) at time of last dose

• nephrotoxicity (see contrast nephropathy)

• selection of alternative diagnostic procedure

• radionuclide scintigraphy
• ultrasonography

• generally low morbidity & mortality

• iodinated contrast agents are associated with

• hypothyroidism (HR=1.6)
• hyperthyroidism (HR=3.0) [4]
  

• drug adverse effects of contrast agents

More General Terms

• pharmaceutical agent

Additional Terms

• contrast
• contrast nephropathy (contrast-induced nephropathy, CIN)

References

1. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 31, 598, 625
2. Medical Knowledge Self Assessment Program (MKSAP) 11, 15, American College of Physicians, Philadelphia 1998, 2009
3. Veterans Administration, Dept. of Radiology
4. Rhee CM et al. Association between iodinated contrast media exposure and incident hyperthyroidism and hypothyroidism. Arch Intern Med 2012 Jan 23; 172:153. PMID: [1]

contrast agent