Medical Symptoms and Treatment

Adverse Reactions to Contrast Media

• Mild reactions: short duration, self-limiting, and may progress to severe reactions
• Moderate reactions: not immediately life-threatening, but may progress to severe reactions
• Severe reactions: potentially or immediately life-threatening

Symptoms of Adverse Reactions

• Mild: nausea, vomiting, altered taste, sweats, cough, itching, warmness, headache, swelling, face, dizziness, anxiety
• Moderate: tachycardia, bradycardia, hypotension, bronchospasm, hypertension, dyspnea, laryngeal edema, pulmonary edema
• Severe: severe laryngeal edema, hypotension, unresponsiveness, convulsions, clinically manifest arrhythmias, cardiopulmonary arrest

Treatment and Preventive Measures

• Mild reactions: observation and reassurance
• Moderate reactions: quick treatment with close observation
• Severe reactions: immediate treatment, hospitalization
• Preventive measures: identify patients at risk, perform examination without CM, use LOCM, pretreatment with steroids

Documenting Adverse Reactions

• Essentials to be documented: amount and type of contrast injected, signs and symptoms of the reaction, interventions or medications given, final outcome

Renal Function

• Clearance refers to the ability of the kidney to remove a substance from the blood
• Renal function can be estimated using GFR, ERPF, and serum creatinine (SeCr)
• Normal SeCr range: 0.6-1.7 mg/dL, BUN range: 7-25 mg/dL

Contrast-Induced Nephropathy (CIN)

• Definition: acute impairment of renal function after CM administration
• Risk factors: creatinine clearance less than 25 mL/min, history of diabetes mellitus, recent administration of iodinated contrast agent, anticipated large volume of CM, history of congestive heart failure

Prevention of CIN

• Patients with diabetes mellitus or other risk factors should have a recent SeCr
• Use LOCM or IOCM, minimize CM volume, ensure adequate patient hydration, allow at least 48 hours between procedures requiring CM, discontinue other nephrotoxic medications before the procedure

Dialysis and Contrast Media

• Patients on dialysis can receive CM, but should continue their routine dialysis schedule
• When renal dysfunction occurs in patients taking metformin, the drug accumulation can result in lactic acidosis, which is fatal in about 50% of patients

Effects on Thyroid Function

• No effect on patients with normal thyroid function
• Insignificant effect on patients with hypothyroidism
• CM may rapid thyroid storm in patients with hyperthyroidism

Pulmonary Effects

• Bronchospasm, pulmonary arterial hypertension, pulmonary edema
• Patients at increased risk are those with a history of pulmonary hypertension, bronchial asthma, or heart failure
• The use of LOCM significantly reduces the risk

Effects on the Central Nervous System

• Seizures in patients who have diseases that disrupt the blood-brain barrier
• The risk of seizure can be significantly reduced by a one-time oral dose of 5 to 10 mg of diazepam, 30 minutes before CM administration
• Seizures that occur can also be controlled with diazepam

Delayed Reactions

• Defined as reactions that occur between 1 hour and 1 week after CM injection
• Reactions commonly may include: skin reactions, red spots or bumps, welts-like swelling, hives, salivary gland swelling

This quiz covers the signs and symptoms of a certain medical condition, including nausea, vomiting, and altered taste, as well as the recommended treatment and interventions.