X-ray contrast media--an overview.

X-ray contrast media are chemically inert drugs which are given intravascularly in very high amounts within a very short time period. Although they are regarded as relatively safe drugs, adverse reactions can occur: these are normally divided into immediate and delayed reactions. The latter appear hours to days after injection. Immediate reactions have been drastically reduced since the introduction of non-ionic monomers and non-ionic dimers. However, the delayed reactions still occur in a frequency of 1-3% in X-ray contrast media exposed patients. The majority of these reactions are mild and manifest as skin eruption, but severe reactions can also occur. Further improvement of the safety of these drugs is only possible with a better understanding of etiologies behind the observed adverse reactions.

[1]  P. Aspelin,et al.  Frequency of late allergy-like adverse reactions following injection of intravascular non-ionic contrast media , 1998, Acta radiologica.

[2]  Y. Sugai,et al.  Delayed adverse reactions to iodinated contrast media and their risk factors. , 2000, Radiation medicine.

[3]  K. Sugimura,et al.  A prospective survey of delayed adverse reactions to iohexol in urography and computed tomography , 2002, European Radiology.

[4]  P. Choyke,et al.  Delayed reactions to contrast media after interleukin-2 immunotherapy. , 1992, Radiology.

[5]  F. Palmer The RACR survey of intravenous contrast media reactions. Final report. , 1988, Australasian radiology.

[6]  H. Munechika,et al.  Delayed adverse reactions to nonionic monomeric contrast-enhanced media. , 1998, Investigative radiology.

[7]  A. Cross,et al.  A prospective trial of ionic vs nonionic contrast agents in routine clinical practice: comparison of adverse effects. , 1989, AJR. American journal of roentgenology.

[8]  A. Reiss,et al.  Late allergy-like reactions following vascular administration of radiography contrast media , 1998, Acta radiologica.

[9]  T. Kozuka,et al.  Adverse reactions to ionic and nonionic contrast media. A report from the Japanese Committee on the Safety of Contrast Media. , 1990, Radiology.

[10]  P. Jolliet,et al.  An Overview of the Clinical Pharmacokinetics of X-Ray Contrast Media , 1997, Clinical pharmacokinetics.

[11]  W. Pichler,et al.  Delayed allergy-like reactions to X-ray contrast media: mechanistic considerations , 2000, European Radiology.

[12]  S. Ghosh,et al.  Fatal Stevens-Johnson syndrome following urography with iopamidol in systemic lupus erythematosus. , 1988, Postgraduate medical journal.

[13]  D. Hohl,et al.  Severe Stevens–Johnson syndrome induced by contrast medium iopentol (Imagopaque®) , 2004, The British journal of dermatology.

[14]  H. Thomsen,et al.  Contrast media and the kidney: European Society of Urogenital Radiology (ESUR) guidelines. , 2003, The British journal of radiology.

[15]  G. Cantó,et al.  Toxic epidermal necrolysis after repeated injections of iohexol. , 2001, AJR. American journal of roentgenology.

[16]  P. Davies,et al.  A large trial of intravenous Conray 325 and Niopam 300 to assess immediate and delayed reactions. , 1989, The British journal of radiology.

[17]  T. Almén The etiology of contrast medium reactions. , 1994, Investigative radiology.