scholarly journals Stratified Assessment and Warning Regimen for Comprehensive Risk Management and Improved Iodinated Contrast Media Safety

2021 ◽  
Author(s):  
Xue Li ◽  
Heng Liu ◽  
Haiyan Qiu ◽  
Lingru Wang ◽  
Junling Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Management ◽  
Contrast Media ◽  
Risk Identification ◽  
Assessment Process ◽  
Iodinated Contrast Media ◽  
Chi Square ◽  
Risk Levels ◽  
Iodinated Contrast ◽  
Assessment Period

Abstract Objectives: To determine the relationship between stratified assessment and warning (SAW) regimen for risk factors to iodinated contrast media (ICM) and adverse drug reactions (ADR) occurrence.Methods: This retrospective study included patients who underwent enhanced CT examinations in our hospital between January 2014 and March 2016 (conventional assessment group) and between April 2017 and December 2019 (SAW group). Initial risk assessment was performed by clinicians when ordering examinations in both periods. The risk re-assessment was performed by simple question-and-answer onsite just before examination in the conventional assessment period, according to the risk factors that deserve special attention in ICM guidelines. In the SAW period, the re-assessment process prior to examination was moved forward as early as possible post-appointment, and a whole-process comprehensive management integrating risk identification, stratification, early warning and prevention was performed according different risk levels. Chi-square test was performed for comparisons of rates.Results: A total of 120822 cases in the conventional assessment group and 150343 cases in the SAW group were enrolled. The total ADR incidence in the SAW period (414/150343, 0.275%) was lower than that in the conventional assessment period (506/120822, 0.419%, P<0.001), in which the proportion of patients who developed ADR decreased by about 34%. It mainly presented as decrease in mild/moderate reactions (P<0.001) and increase in the proportion of mild ADR patients (P=0.001) in the SAW period. Subgroup analysis showed lower mild/moderate ADR incidence in patients with different risk levels and with different ICM injection parameters (P<0.05) following SAW regimen.Conclusions: SAW regimen was associated with lower mild/moderate ADR incidence and alleviated ADR severity in at-risk patients, which held potential for improved risk management and ICM safety.

Safety Essentials: Acute Reactions to Iodinated Contrast Media

2013 ◽  
Vol 64 (3) ◽  
pp. 193-199 ◽  
Author(s):  
Ramesh S. Iyer ◽  
Jennifer G. Schopp ◽  
Jonathan O. Swanson ◽  
Mahesh M. Thapa ◽  
Grace S. Phillips
Keyword(s):  
Risk Factors ◽  
Contrast Media ◽  
Iodinated Contrast Media ◽  
Initial Management ◽  
Treatment Algorithms ◽  
Diagnosis And Management ◽  
Preventative Measures ◽  
Iodinated Contrast ◽  
Specific Reactions

The objectives of this article are to review the diagnosis and management of acute nonrenal reactions to iodinated contrast media. We will begin by discussing the types of contrast media and their correlative rates of reaction. The mechanism of contrast reactions, predisposing risk factors, and preventative measures will then be discussed. The remainder of the article will review the assessment of potential reactions, initial management, and treatment algorithms for specific reactions.

Development of polyclonal and monoclonal antibodies to iodinated contrast media

1988 ◽  
Vol 29 (6) ◽  
pp. 737-740 ◽  
Author(s):  
R. L. Siegle ◽  
W. L. McGuire ◽  
J. E. Peters
Keyword(s):  
Monoclonal Antibodies ◽  
Contrast Media ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast

Chemistry of Iodinated Contrast Media (ICM): A Minireview

2020 ◽  
Vol 17 ◽  
Author(s):  
Maithili Pramod Joshi ◽  
Ameya Chaudhari ◽  
Prashant S. Kharkar ◽  
Shreerang V. Joshi
Keyword(s):  
Adverse Effects ◽  
Contrast Media ◽  
Aqueous Solubility ◽  
Synthetic Methods ◽  
Essential Medicines ◽  
World Health ◽  
Iodinated Contrast Media ◽  
Environmental Aspects ◽  
Iodinated Contrast ◽  
Health Organization

: Historically, the use of Iodinated Contrast Media (ICM) for diagnostic purposes, particularly radiography and computed tomography (CT), is well-known. Many of the ICM are included in the World Health Organization (WHO)’s List of Essential Medicines. Depending on the chemotype and the presence of ionizable functional group(s), the ICM are categorized in the ionic/nonionic monomers/dimers. The lipophilicity, aqueous solubility, viscosity and osmolality are major characteristics dictating their use for one procedure versus the other. Over last several decades, substantial advancement occurred in the design and development of novel ICM, solely to reduce their propensity to cause adverse effects. Given the nature of their acute usage, some of the agents with appreciable toxicity are still used. Understanding their chemistry aspects is crucial to appreciate, acknowledge and justify the usage of these extremely important torch-bearers of diagnostic agent’s class. The present review article presents an in-depth overview of the synthetic methods, therapeutic indications, potential adverse effects along with the commercial and environmental aspects of ICM. The safety and tolerability of these agents is a field that has gained significant importance, which is given due importance in the discussion.

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