The Common Vein

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Contrast Agents FAQ
Ashley Davidoff MD
UNDER CONSTRUCTION
Allergic Reactions
What factors contrribute to a adverse effects of contrast agents?
The characteristics of contrast agents that relate to adverse reactions include, ionicity, osmolality, and agent-specific chemotoxicity
How have the low osmolality non ionic agents affected adverse reactions?
Low osmolality, nonionic contrast agents cause fewer moderate and moderately severe reactions when compared to conventional ionic agents; by about 5 to 1 adverse reactions.  They have not affected the mortality rate.
Premedication includes the use of Benadryl and Corticosteroids.  Which of these two is more essential?
The corticosteroids are the essential component of the premedication.
What is the minimal period prior to administration of contrast does one have to administer the cortisone?
At least 6 hours.
Diabetes

Choice of contrast

What contrast agennts should be used in diabetic who are not in renal failure?
There is no advantage of using non ionic agents in this set of patients.
What contrast agents should be used in diabetics who are in renal failure?
Low osmolality, nonionic contrast media  should be used in patients with diabetics in renal failure
 

Metformin

Myeloma and contrast
 Dehydration is the major risk factor in patients with myeloma, and therefore as long as a patient is well hydrated prior to and following the procedure, there is no contraindication to using i/v contrast in patients with myeloma
 
 
7) Most anaphylactoid contrast reactions are caused by classic direct antigen-antibody reactions? True or false?
False, the exact mechanism(s) of contrast reactions is not fully clarified; a classic Ag-Ab interaction has not been consistently demonstrated.
Pregnancy and Lactation
Should a  lactating mother discard her breast milk for 24 hours after receiving intravenous iodinated contrast.
Only about 1% of the contrast administered to a lactating mother is excreted in her milk, and only about 2% of that is absorbed by the feeding infant.  It is therefore not necessary to withhold breast milk after administration of i/v contrast.  The knowledge base of the amount and effect of gadolinium in breast milk after gadolinium administration is insufficient to make any recommendations and it is suggested that maternal milk directly from the breast shoulds be held for 24 hours.
 
9
Web references
Radiology Life Support Arnold Publishers




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Contrast Agents FAQ
Ashley Davidoff MD
UNDER CONSTRUCTION
Allergic Reactions
What factors contrribute to a adverse effects of contrast agents?
The characteristics of contrast agents that relate to adverse reactions include, ionicity, osmolality, and agent-specific chemotoxicity
How have the low osmolality non ionic agents affected adverse reactions?
Low osmolality, nonionic contrast agents cause fewer moderate and moderately severe reactions when compared to conventional ionic agents; by about 5 to 1 adverse reactions.  They have not affected the mortality rate.
Premedication includes the use of Benadryl and Corticosteroids.  Which of these two is more essential?
The corticosteroids are the essential component of the premedication.
What is the minimal period prior to administration of contrast does one have to administer the cortisone?
At least 6 hours.
Diabetes

Choice of contrast

What contrast agennts should be used in diabetic who are not in renal failure?
There is no advantage of using non ionic agents in this set of patients.
What contrast agents should be used in diabetics who are in renal failure?
Low osmolality, nonionic contrast media  should be used in patients with diabetics in renal failure
 

Metformin

Myeloma and contrast
 Dehydration is the major risk factor in patients with myeloma, and therefore as long as a patient is well hydrated prior to and following the procedure, there is no contraindication to using i/v contrast in patients with myeloma
 
 
7) Most anaphylactoid contrast reactions are caused by classic direct antigen-antibody reactions? True or false?
False, the exact mechanism(s) of contrast reactions is not fully clarified; a classic Ag-Ab interaction has not been consistently demonstrated.
Pregnancy and Lactation
Should a  lactating mother discard her breast milk for 24 hours after receiving intravenous iodinated contrast.
Only about 1% of the contrast administered to a lactating mother is excreted in her milk, and only about 2% of that is absorbed by the feeding infant.  It is therefore not necessary to withhold breast milk after administration of i/v contrast.  The knowledge base of the amount and effect of gadolinium in breast milk after gadolinium administration is insufficient to make any recommendations and it is suggested that maternal milk directly from the breast shoulds be held for 24 hours.
 
9
Web references
Radiology Life Support Arnold Publishers




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Contrast Agents FAQ
Ashley Davidoff MD
UNDER CONSTRUCTION
Allergic Reactions
What factors contrribute to a adverse effects of contrast agents?
The characteristics of contrast agents that relate to adverse reactions include, ionicity, osmolality, and agent-specific chemotoxicity
How have the low osmolality non ionic agents affected adverse reactions?
Low osmolality, nonionic contrast agents cause fewer moderate and moderately severe reactions when compared to conventional ionic agents; by about 5 to 1 adverse reactions.  They have not affected the mortality rate.
Premedication includes the use of Benadryl and Corticosteroids.  Which of these two is more essential?
The corticosteroids are the essential component of the premedication.
What is the minimal period prior to administration of contrast does one have to administer the cortisone?
At least 6 hours.
Diabetes

Choice of contrast

What contrast agennts should be used in diabetic who are not in renal failure?
There is no advantage of using non ionic agents in this set of patients.
What contrast agents should be used in diabetics who are in renal failure?
Low osmolality, nonionic contrast media  should be used in patients with diabetics in renal failure
 

Metformin

Myeloma and contrast
 Dehydration is the major risk factor in patients with myeloma, and therefore as long as a patient is well hydrated prior to and following the procedure, there is no contraindication to using i/v contrast in patients with myeloma
 
 
7) Most anaphylactoid contrast reactions are caused by classic direct antigen-antibody reactions? True or false?
False, the exact mechanism(s) of contrast reactions is not fully clarified; a classic Ag-Ab interaction has not been consistently demonstrated.
Pregnancy and Lactation
Should a  lactating mother discard her breast milk for 24 hours after receiving intravenous iodinated contrast.
Only about 1% of the contrast administered to a lactating mother is excreted in her milk, and only about 2% of that is absorbed by the feeding infant.  It is therefore not necessary to withhold breast milk after administration of i/v contrast.  The knowledge base of the amount and effect of gadolinium in breast milk after gadolinium administration is insufficient to make any recommendations and it is suggested that maternal milk directly from the breast shoulds be held for 24 hours.
 
9
Web references
Radiology Life Support Arnold Publishers

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Contrast Agents FAQ
Ashley Davidoff MD
UNDER CONSTRUCTION
Allergic Reactions
What factors contrribute to a adverse effects of contrast agents?
The characteristics of contrast agents that relate to adverse reactions include, ionicity, osmolality, and agent-specific chemotoxicity
How have the low osmolality non ionic agents affected adverse reactions?
Low osmolality, nonionic contrast agents cause fewer moderate and moderately severe reactions when compared to conventional ionic agents; by about 5 to 1 adverse reactions.  They have not affected the mortality rate.
Premedication includes the use of Benadryl and Corticosteroids.  Which of these two is more essential?
The corticosteroids are the essential component of the premedication.
What is the minimal period prior to administration of contrast does one have to administer the cortisone?
At least 6 hours.
Diabetes

Choice of contrast

What contrast agennts should be used in diabetic who are not in renal failure?
There is no advantage of using non ionic agents in this set of patients.
What contrast agents should be used in diabetics who are in renal failure?
Low osmolality, nonionic contrast media  should be used in patients with diabetics in renal failure
 

Metformin

Myeloma and contrast
 Dehydration is the major risk factor in patients with myeloma, and therefore as long as a patient is well hydrated prior to and following the procedure, there is no contraindication to using i/v contrast in patients with myeloma
 
 
7) Most anaphylactoid contrast reactions are caused by classic direct antigen-antibody reactions? True or false?
False, the exact mechanism(s) of contrast reactions is not fully clarified; a classic Ag-Ab interaction has not been consistently demonstrated.
Pregnancy and Lactation
Should a  lactating mother discard her breast milk for 24 hours after receiving intravenous iodinated contrast.
Only about 1% of the contrast administered to a lactating mother is excreted in her milk, and only about 2% of that is absorbed by the feeding infant.  It is therefore not necessary to withhold breast milk after administration of i/v contrast.  The knowledge base of the amount and effect of gadolinium in breast milk after gadolinium administration is insufficient to make any recommendations and it is suggested that maternal milk directly from the breast shoulds be held for 24 hours.
 
9
Web references
Radiology Life Support Arnold Publishers

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