McKenna's Drug Handbook for Nursing & Midwifery, 7e

1308      Miscellaneous drug categories

Contraindications Contraindicated in individuals with known hypersensitivity to the preparation or a history of serious hypersensitivity to iopamidol or iodine-containing contrast media, and in those with thyrotoxicosis or decompensated cardiac insufficiency. care considerations • Closely monitor individual for devel­ opment of anaphylactic reaction. Ensure emergency management equipment is available and in correct working order. • Monitor vital signs and renal function closely following procedure. • Ensure the person is well-hydrated before and after the procedure to avoid contrast- • Ensure safety if the person is light-headed. • Thyroid function testsmay be reduced for up to several weeks. Patient teaching • Advisepersontoreportanyadverseeffects. • Advise person to take care when standing up or getting out of bed due to potential dizziness. induced nephropathy. • Assess mental status.

Action Non-ionic iodinated radiographic contrast medium for angiographic and urographic examinations.

Route Onset

Peak

Duration

IV

Immediate Unknown 24 hrs

Adverse reactions CNS: convulsions , dizziness, dysgeusia, headache, hypaesthesia, restlessness, palpi­ tations, paraesthesia, somnolence, syncope, vasodilation, vasovagal reactions. CV: arrhythmia, bradycardia, chest pain, cardiac arrest , circulatory collapse , hyper­ tension, hypotension, lossofconsciousness , myocardial ischaemia , shock , vasodilation, thromboembolic events . Endocrine: thyroid disorder, thyrotoxic crisis . ENT: nasal congestion, rhinitis, sneezing. Eye: altered vision, blurred vision. GI: abdominal pain, anorexia, diarrhoea, dysphagia, nausea, vomiting. GU: acute renal failure , altered renal func­ tion, incontinence, contrast medium– induced nephrotoxicity , urinary retention. Musculoskeletal: asthenia, compartment syndrome, muscle cramps, myalgia, myop­ athy. Psychiatric: anxiety, confusion. Respiratory: asthma, bronchospasm , dyspnoea, laryngeal oedema , pharyngitis, pulmonary oedema, respiratory distress. Skin: angio-oedema ,clamminess,erythema, flushing, injection site pain, itching, pruritus, rash, sweating, urticaria. Other: anaphylactic reaction , fever, hyper­ sensitivityreactions, iodism,malaise,pyrexia, rigors. Interactions Drug-drug. Metformin/biguanides: Potential transient impairment of renal function with possible lactic acidosis. Should be discontinued 48 hours prior to and for 48 hours after procedure.

iopromide Ultravist Pregnancy risk category B2 Use in sport: Permitted Available forms

Solution for injection: 0.499 g iopromide/mL (240 mg iodine/mL) in 50 mL; 0.623 g iopromide/mL (300 mg iodine/mL) in 20 mL, 50 mL, 75 mL, 100 mL, 150 mL; 0.769 g iopromide/mL (370 mg iodine/mL) in 20 mL, 30 mL, 50 mL, 75 mL, 100 mL, 200 mL

Indications & dosages ➤ X-rayorCTcontrastmedium—

Adults: Individualised according to indi­ vidual factors and nature of X-ray or CT scan.

Reactions may be common , uncommon, life-threatening , or commonandlife-threatening.