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drug adverse effects of contrast agents

Adverse effects: 1) anaphylactoid a) occur with 2-6% of procedures b) may have the clinical appearance of anaphylaxis, but are more appropriately termed anaphylactoid, because they do not involve IgE c) low ionic strength contrast agents are less likely to result in an adverse reaction d) previously, patients with a history of contrast reaction coud be pretreated with the following protocol: 1] 50 mg of prednisone every 6h for 3 doses 2] last dose 1 hour before procedure 3] 50 mg of diphenhydramine (Benadryl) at time of last dose e) current guidelines (2023) recommend proceeding with non-ionic, low ionic or iso-osmolar contrast with consideration of premedication with glucocorticoid & antihistamine [3] 2) nephrotoxicity (see contrast nephropathy) a) selection of alternative diagnostic procedure 1] radionuclide scintigraphy 2] ultrasonography b) generally low morbidity & mortality

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DRUGS: contrast agent FORM: drug adverse effects contrast agent

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, American College of Physicians, Philadelphia 1998
  3. NEJM Knowledge+