Radiographic contrast agents

Table 10.10 Uses of Contrast Agents Radiographic Procedures for Visualizing Oi ans After Administration of Contrast Agents...

Close BJ, Strouse PJ (2000) MR of physeal fractures of the adolescent knee. Pediatr Radiol 30 756-762 Creasy JL, Partain CL et al. (1995) Quality of clinical MR images and the use of contrast agents. Radiographics... 

Tepel M, Van der Giet M, Schwarzfeld C, et al. Prevention of radiographic contrast agent-induced reduction in renal function by aceylcysteine. N Engl J Med 2000 343 180-184. 

Cephalosporins Aminoglycosides Antineoplastic agents Nitrosoureas Cisplatin and analogs Radiographic contrast agents Halogenated hydrocarbons Chlorotriiluoroethylene Hexafluropropene Hexachlorobutadinene T richloroethylene Chloroform Carbon tetrachloride Maleic acid Citrinin Metals Mercury Uranyl nitrate Cadmium Chromium... 

This case underlines the fact that there is still misunderstanding about the nephrotoxic potential of gadolinium-based contrast agents. They should not replace iodinated contrast agents in patients with renal insufficiency. The recommended doses of up to 0.3 mmol/kg will not give satisfactory radiographic diagnostic information in most cases. 

Systemic adverse effects of enteral contrast agents Oral radiographic contrast media can intravasate during gastrointestinal examination. Septicemia has been reported (47). 

Davidson CJ, Hlatky M, Morris KG, Pieper K, Skelton TN, Schwab SJ, BashoreTM. Cardiovascular and renal toxicity of a nonionic radiographic contrast agent after cardiac catheterization. A prospective trial. Ann Intern Med 1989 110 119-124. 

Schwab SJ, Fllatky MA, Pieper KS, Davidson CJ, Morris KG, Skelton TN, BashoreTM. Contrast nephrotoxicity a randomized controlled trial of a nonionic and an ionic radiographic contrast agent. N Engl J Med 1989 320 149-153. 

Kaufman JA, Geller SC, Waltman AC. Renal insufficiency gadopentetate dimeglumine as a radiographic contrast agent during peripheral vascular interventional procedures. Radiology 1996 198 579-581. 

No compound has all ofthc.se characteristics. Barium sulfate and a variety of iodine compound.s. however, produce txcellem radiological contrast with low patient toxicity and xiatively low cost. The use of barium and iodine compounds Biadiological contrast agents is based on their radiographic ippearance and their distribution and elimination from the bedy. Contrast media are used in very large quantities and lie usually administered over a short time. 

The majority of contrast agents used to opacify blood ves-tdv and increase contrast in solid organs such as the liver lie water-soluble organic iodides. Iodine absorbs x-rays cf-fttlively at many energy levels and produces a type of "calcific" or "bone density on radiographic studies. Its den-sily. somewhat less than that of barium sulfate, is quite icctptable. 

Levesque. L. etai (1991) The interaction of 3.5-pyrazolidinedione drugs with receptors for f-Met-Leu-Phe on human neutrophil leukocytes a study of the structure- activity relationship. Can. J. Physiol. Pharmacol., 69,419-425. Levesque. L. era (1992) Comparison of two classes of non-peptide drugs as antagonists of neutrophil receptors for f-Met-Leu-Phe. Pyrazolons and iodinated radiographic contrast agents. Biochem. Pharmacol., 43. 553-560. Derian. C.K. er at (1996) Selective inhibition of N-formylpeptide-induced neutrophil activation by carbamate-modified peptide analogues. Biochemistry, 35.1265-1269. 

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