The incensed and vicious tone these arguments have taken in is worrisome, another symptom of the seemingly widening cultural rift in our country. The emotions on both sides run hot.
This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Radiocontrast media RCM are medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques.
They may have side effects ranging from itching to a life-threatening emergency, known as contrast-induced nephropathy CIN. We define CIN as acute renal failure occurring within 24—72 hrs of exposure to RCM that cannot be attributed to other causes.
It usually occurs in patients with preexisting renal impairment and diabetes. The mechanisms underlying CIN include reduction in medullary blood flow leading to hypoxia and direct tubule cell damage and the formation of reactive oxygen species.
Identification of patients at high risk for CIN is important. We have reviewed the risk factors and procedures for prevention, providing a long list of references enabling readers a deep evaluation of them both. The first rule to follow in patients at risk of CIN undergoing radiographic procedure is monitoring renal function by measuring serum creatinine and calculating the eGFR before and once daily for 5 days after the procedure.
It is advised to discontinue potentially nephrotoxic medications, to choose radiocontrast media at lowest dosage, and to encourage oral or intravenous hydration.
In high-risk patients N-acetylcysteine may also be given. Introduction Radiographic contrast media are a group of medical drugs used to improve the visibility of internal organs and structures in X-ray based imaging techniques such as radiography and computed tomography CT.
The currently used contrast media are based on the chemical modification of a 2,4,6-tri-iodinated benzene ring and are indispensable in the practice of radiology, for both diagnostic and therapeutic purposes.
Iodine-based contrast media are usually classified as ionic or nonionic and as monomeric and dimeric and are commonly used to visualize vessels, tissues, organs, and the urinary tract.
They are helpful in differentiating between normal and pathological areas. They are usually safe, and adverse effects are generally mild and self-limited. Side effects of radiographic contrast media range from a mild inconvenience, such as itching, to a life-threatening emergency [ 1 ].
Contrast-induced nephropathy CIN is a well known adverse reaction associated with the use of intravenous or intra-arterial contrast material. Other forms of adverse reactions include delayed allergic reactions, anaphylactic reactions, and cutaneous reactions.
Previous allergic reactions to contrast material increase the risk of developing adverse reactions to contrast agents. Pretreatment of patients who have such risk factors with a corticosteroid and diphenhydramine decreases the chance of allergic reactions, including anaphylaxis or life-threatening emergency.
Of the former either prednisone 50 mg orally, 13, 7, and 1 h before contrast injectionor hydrocortisone mg intravenously, 1 h before contrast injectionor methylprednisolone 32 mg orally, 12 and 2 h before contrast media injection is used.
Awareness of different risk factors and screening for their presence before the use of contrast agents allow for early recognition of adverse reactions and their prompt treatment.
The most important adverse effects of contrast media include hypersensitivity reactions, thyroid dysfunction, and contrast-induced nephropathy [ 3 ]. Mortality is less than one death per patients [ 3 ].
Asthma, history of multiple allergies, and therapy with beta blockers increase the risk of bronchospasm. As soon as a reaction occurs, infusion of the contrast media should be ceased immediately and treatment with antihistamine immediately started.ADVERTISEMENTS: Positive Effects of Electronic Media on Society and Culture!
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