Adverse Drug Reactions of Ionic & Nonionic Contrast Media and Rationale for Use / 介入放射学杂志

ABSTRACT

In this paper,adverse drug reaction(ADRs)of two groups using ionic contrast media(ICM)and nonionic contrast media(NICM)respectively for conventional an- giography(CA),DSA and contrast enhanced CT(CTE)were analysed and compared with the recent literature. The results of this study indicated that(1)using ICM for CA,DSA and CTE,the in- cidence of ADRs is higher than that of NICM because of its high osmolarity,the effect of electric charge and chemotoxicity;however,even in the at-risk patients the incidence of ADRs; can be significantly decreased by using NICM.(2)the incidence of ADRs in patients with rapidly intraarterial injection is higher than that of intravenous injection;(3)the patients with ADRs to ICM previously could be reexamined by using NICM without inducing the ADRs (4)using lower concentration or/and volume of NICM than that of ICM may obtain superior images than the equivalent ICM because of the little influence of NICM on the plasma volume and the concentration of intravascular contrast midia;and(5)though NICM is surely a safe and ideal contrast midia,it still must be careful to use in at-risk patients. Because of its high cost limiting its universal use,a selective use in at-risk patients for the intavenous examinations is proposed by us.Excluding the usual high risk factors describ- ed in literature,we suggested that if the patients with the following factors,NICM should be the preferred choice for the angiography and CTE(1)the post-operative patients of biain disease;(2)the patients with coma or shock;(3)the patients with peripheral aterial of ve- nous thrombosis and(4)the patients for interventional procedures of cardioascutlar system (CVIR). In addition to,the authors pointed out that some new problems concerning with the con- trast media(CM)must be noticed in the procedures of CVIRthe overdose of CM,he ad- verse effects resulted from the mixing of CM with other pharmaceutical products injected and the evaporated hyperc oncentatian decomposition,or carbonization of the CM resulted from the interaction within high energy equipment or under high temperature.