:: SCC - Radiologic Technology Continuing Education ::


New User? Register Here...

CLICK HERE

User Name:
Password:

Forgot your password?

SUBMIT

Title

Iodinated Contrast Media, Part 2: Adverse Reactions EXP 7/1/08 (0 credit hours)

Abstract

This module offers a historical overview of iodinated contrast media and explains current methods of classifying adverse reactions. An emphasis is placed on the correlation between osmolality and the incidence of adverse reactions. Adverse physiologic reactions are described, including their association with the vasovagal response, and nonphysiologic reactions are discussed with emphasis on the differences between allergic and pseudoallergic reactions. The final lesson emphasizes the importance of patient medical histories in alerting radiologic personnel to an increased risk of adverse reaction to iodinated contrast media. Course Approval Expiration/End Date: July 1, 2008 Category A Credit

This activity may be available in multiple formats or from different sponsors. The ARRT does not allow CE activities such as internet courses, home study programs or directed readings to be repeated for CE credit in the same or any subsequent biennium.

Important Note: This module will be renewed the week of July 1. Until then, new registrations, and credit for this module for current registrants, is CLOSED.

Author

Dan Becker, DDS

Dr. Becker received his bachelor of science in zoology from Ohio University in 1968 and his doctor of dental surgery from Ohio State University in 1972. Although Dr. Becker is a dentist, his interest always centered on academia and he began teaching biology at Sinclair Community College (Dayton, OH) as a part-time instructor in the autumn of 1972. He accepted a full-time faculty position in the Dental Hygiene department in 1976, but continued his teaching within the Biology department as well.

Dr. Becker's interest in pharmacology and anesthesia attracted him to Miami Valley Hospital where he became involved with their dental residency instructing dental residents and learning from mentors during rotations within departments of anesthesia and emergency medicine. During this time, he developed and taught courses in pharmacology and pathophysiology for nursing and other allied health programs until his teaching at Sinclair became entirely devoted to these subject areas. Currently he is a full professor at Sinclair Community College and Associate Director of Education at Miami Valley Hospital. He has published in numerous scientific journals and textbooks, and lectures extensively throughout the United States and Canada.

Objectives

Recognize the impact of osmolality of a contrast medium and its correlation to adverse reaction incidence.
Identify and describe adverse physiologic reactions attributed to contrast media, including their association with the vasovagal response.
Describe clinical features of allergic or pseudoallergic reactions, and distinguish their pathogenesis.
Offer specific medical histories that should alert radiologic personnel to the potential for a patient to have adverse reactions to iodinated contrast media.
Explain the basis for concern regarding the use of iodinated contrast media in patients treated with metformin (Glucophage).

Resources

Bibliography:

Aspelin P, et al. Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med 2003;348(6):491-9.

Brasch RC. The case strengthens for allergy to contrast media [editorial]. Radiology. 1998; 20935-6.

Coakley FV, Panicek DM. Iodine allergy: An oyster without a pearl? AJR 1997;169:951-2

Cochran ST, Bomyea K, Sayre JW. Trends in adverse events after IV administration of contrast media. AJR 2001; 176:1385-88.

Herrera AM; deShazo RD. Current concepts in anaphylaxis. Pathophysiology, diagnosis, and treatment. Immunol Allergy Clin North Am. 12:517-34; 1992

Katzberg RW. The contrast media manual. Baltimore: Williams & Wilkins; 1992.

Laroche D; Aimone-Gastin I; Dubois F, and et al. Mechanisms of severe immediate reactions to iodinated contrast material. Radiology. 1998; 209(183-190).

Lasser EC. Pseudoallergic drug reactions. Radiographic contrast media. Immunol Allergy Clin North Am. 1991;11(3):645-657.

Lieberman P. Anaphylactoid reactions to radiocontrast material. Immunol Allergy Clin North Am. 1992;12(3):649-670.

Mita H, Tadodoro K, Akiyama K. Detection of IgE antibody to a radiocontrast medium. Allergy 1998; 53:1133-40.

Sandler CM. Contrast-induced acute renal dysfunction: Is iodixanol the answer? N Engl J Med 2003;348(6):551-3

Serafin WE, Austen KF. Mediators of immediate hypersensitivity reactions. N Engl J Med 1987;317(1):30-4.

Stellato C, Adkinson Jr NF. Pathophysiology of contrast media anaphylactoid reactions: new perspectives on an old problem. Allergy 1998;53:1111-13.

Webiography:
General Info
Oldnall N. xray2000 Nicks website. Contrast Media and Drugs used in the Department: A Simple Guide to the basics. March 27, 2007. Available at: http://www.xray2000.co.uk/. Accessed April 4, 2007.

Radiology InfoNet, Inc. RADIOLOGYinfonet Homepage. 2006. Available at: http://www.radinfonet.com/. Accessed April 4, 2007.

Adverse Reactions
University of Alabama Hospital Department of Radiology. FAQs. Visions Newsletter Volume 2 Numer 2 1996. Available at: http://www.rad.uab.edu/Visions/Summer96/Summer96.htm#anchor718065. Accessed April 4, 2007.

Physiologic or Chemotoxic Reactions
Society for Neuroscience. Brain Briefings. Blood-Brain Barrier. 2007. Available at: http://www.sfn.org/index.cfm?pagename=brainBriefings_bloodBrainBarrier. Accessed April 4, 2007.