Cholecystography

Those affecting both Cholecystography—Telepaque, Priodax... 

When the OCAs are used for these purposes, they are administered at much lower doses than when used for cholecystography. At the higher doses, the major adverse effects of these compounds are acute renal failure, thrombocytopenia, and athrombocytosis possible minor adverse reactions include diarrhea, nausea, vomiting, and dysuria. 

Iopanoic acid is as potent a uricosuric agent as probenecid and this effect might explain some renal complications aspirin reduces the uricosuric effect but can also impair X-ray visualization because of competition at plasma protein-binding sites. Fluctuations of serum urate after oral cholecystography can interfere with diagnostic tests and even precipitate an attack of gout (578). 

In the case of diet, medication and water soluble radio-diagnostic agents, interference with thyroid function will cease 2-4 weeks after stopping the source, but with agents used for cholecystography it may last for 6 months or more (tissue binding). 

Prior to percutaneous liver biopsy, it is not necessary to perform either a chest-X-ray or a cholecystography, or to determine the blood group. These examinations are of no practical significance. 

Ceruletide is a synthetic decapeptide that resembles cholecystokinin and causes contraction of the gallbladder. It has sometimes been used instead of the traditional fatty meal in cholecystography. After intramuscular injection, nausea, vomiting, diarrhea, and cramps have been reported. 

Sargent EN, Boswell W, Hubsher J. Cholecystokinetic cholecystography efficacy and tolerance studies of ceruletide. Am J Roentgenol 1978 130(6) 1051-5. 

Insausti CL, Lechin F, van der Dijs B. Severe thrombocytopenia following oral cholecystography with iocetamic acid. Am J Hematol 1983 14(3) 285-8. 

Muller K, Jorge A. Rezidive akuter Pankreatitis nach Cholezystographie. [Recurrent acute pancreatitis following cholecystography.] Med Klin 1965 60(42) 1693-7. 

Therapeutically, emulsions containing peanut oil have been used in nutrition regimens, in enemas as a fecal softener, and in otic drops to soften ear wax. It is also administered orally, usually with sorbitol, as a gall bladder evacuant prior to cholecystography. 

Trade names Bilivist Oragrafin Indications Cholecystography Category Iodine-containing radiocontrast medium Half-life N/A... 

Rotor syndrome is another form of conjugated hyperbilirubinemia similar to Dubin-Johnson syndrome but without pigment in the liver. The gallbladder is seen on intravenous cholecystography. Total urinary coproporphyrins are elevated, with about two thirds being coproporphyrin I. The prognosis is excellent. 

Cole WH, Copher GH, Graham EA. 1928. Simultaneous cholecystography and determination of hepatic function. JAMA 90 111 -113. 

In the following sections, selected examples of synthesis for ionic and nonionic, and monomeric and dimeric contrast agents are given to illustrate the general synthetic approach. The synthesis of an ionic monomer iocetamic acid (6a), atriiodoanilideofthe NNHtype, used for oral cholecystography (240), is shown in Equation 10.4. 

Intravascular contrast agents should have low viscosity and low osmolality as close as possible to those of body fluids, to improve tolerance and minimize adverse reactions. Contrast agents intended for oral cholecystography should possess hydrophilic and lipophilic properties, so that the compoundcan be orally absorbed, should be excreted from the liver and bile ducts in sufficient amount to provide radiopacity, and should have no adverse side effects. Because each of these properties is associated with certain molecular features and not all of them are structurally compatible, the best radiopaques represent a compromise of a maximum of these desirable qualities. 

---