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Flashcards in Iodine Compounds Deck (60)
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1

Most commonly used contrast agent

Water-soluble iodine compounds

2

Water-soluble iodine compounds aka

Aqueous Iodine Compounds

3

5 ways to administer water-soluble iodine compounds

Orally
Intrathecally
Intravenously
Intraarterially
Directly injected into structure

4

4 departments that use water-soluble iodine compounds

Cath lab
EP
OR
Radiology

5

Isovue M is given

Intrathecally

6

Isovue is given

IV
Intraarterially
Direct injection

7

water-soluble iodine compounds are... Based; and contain

Carbon
Iodine atoms and various other atoms

8

water-soluble iodine compounds molecules vary ....... And some contain more..... Than others

In size
More iodine

9

What property of iodine makes it a good positive contrast agent

High atomic number

10

Name studies that use water-soluble iodine compounds

Urinary studies - IVU, cystogram
Biliary studies- Cholangiography
Arthrography
Cardiovascular interventional exams
CT scan
Other fluoroscopic studies

11

Brand names of water-soluble iodine compounds

Optiray
Visipaque
Cystographin
Isovue M
Hypaque
Cystografin
Gastrografin
Isovue

12

Oily Iodine Compounds aka

Ethiodized oils

13

When is oily iodine compounds used

When absorption is not desired

14

3 studies that may used oily iodine compounds

Hysterosalpingograms
Bronchography
Myelography

15

What has replaced oily iodine compounds

Newer aqueous iodine agents

16

Brand names of water-soluble iodine compounds

Optiray
Visipaque
Cystographin
Isovue M
Hypaque
Cystografin
Gastrografin
Isovue

17

Oily Iodine Compounds aka

Ethiodized oils

18

When is oily iodine compounds used

When absorption is not desired

19

3 studies that may used oily iodine compounds

Hysterosalpingograms
Bronchography
Myelography

20

What has replaced oily iodine compounds

Newer aqueous iodine agents

21

Ionic means

of, relating to, or using ions.
(of a chemical bond) formed by the electrostatic attraction of oppositely charged ions.

22

Ionic contrast is ------- contrast media

Tri-iodinated

23

Ionic contrast contain-- and ----

Sodium and Meglumine salts (cation)

24

What happens once the ionic contrast is injected

It dissociates into ions called anion and cations

25

Ionic contrast contains how many iodine atoms

3

26

Anions

Negatively charged particles

27

Cations

Positively charged particles

28

What are ionic contrasts known to do

Bond to something such as blood

29

When were non-ionic contrasts introduced

1980s

30

Why are non-ionic used with pt with higher risk for reactions

Because is doesn't dissociate

31

Most departments use-- exclusively

Water-soluble Iodine Non-ionic Contrast

32

Water-soluble iodine compounds
3 features of ionic that is different than non-ionic

1. Dissociates into separate ions when injected
2. Creates hypertonic condition
3. Increases blood osmolarity

33

Water-soluble iodine compounds
3 features of non-ionic that is different than ionic

Does not dissociate when injected
Remains isotonic
No significant increase in blood osmolarity

34

Hypertonic solution

is one where the concentration of solutes is greater outside the cell than inside it.

35

Isotonic

one in which the concentration of solutes is the same both inside and outside of the cell.
Does not change blood composition

36

Osmolality

Concentration of particles in a solution

37

What is the Osmolality of blood

300 milliosmol per kg
300 mOsm/kg

38

Example of ionic monomer

Diatrizoate and sodium salt

39

Osmolality of ionic monomers

Diatrizoate is considered a high-osmolality contrast agent 1530 mOsm/kg

40

Osmolality of non-ionic dimmer Iotrolan and iodixanol

290 mOsm/kg

41

The lower the Osmolality contrast means

Less chance of reaction to contrast

42

Osmolality of isotonic

Solution has the same Osmolality as plasma

43

Osmolality of hypertonic

Greater Osmolality than plasma (ionic contrast)

44

Osmolality of hypotonic

Less Osmolality than plasma

45

Who is at risk for contrast mediA reactions ; 6

1. Hx of allergies esp shellfish, seafood,iodine products
2. Asthma, hay fever
3. Pts with previous adverse reactions
4. Over 60 y/o
5. Cardiac disease
6. African American

46

What lab levels do we check before contrast

BUN
GFR
Creatinine

47

What is SFMC premedication to prevent reactions

Prednisone 50mg orally every 6 hours;
Starting 13 hours before contrast: 1 dose at 13 hours
1 dose at 7 hours
1 dose at 1 hour
Total of 150 mg
Benedryl (Diphenhydramine). 50 mg orally 1 hours before contrast

48

Vasovagal response

When the contrast media stimulates the vagus nerve causing cardiovascular changes

49

Signs of vasovagal response

Increase in vasodilation of arterioles.
Diaphoresis, sinus bradycardia, hypotension
May be life threatening but usually not

50

Anaphylaxis or anaphylactic reaction is a

serious allergic reaction that is rapid in onset and may cause death.

51

Symptoms of anaphylaxis

itchy rash, throat or tongue swelling, shortness of breath, vomiting, lightheadedness, and low blood pressure.

52

Mild reactions that don't need tx

Warm feeling
Metallic taste in mouth
Nausea/ vomiting
Coughing/ sneezing

53

Moderate reactions

Urticaria hives
Erythema
Bronchospasm
Facial swelling

Antihistamine given orally, iv, or injection

54

Severe reactions

Laryngeal or bronchial edema
Dysphasia / difficultly swallowing
Cyanosis
Seizure
Respiratory arrest
Cardiac arrest
Death

55

What are the step if pt coded

Dial 4000, if pt is coding-code blue
Get code cart
Unplug defibrillator
Get O2
Direct traffic

56

Treatment for severe reaction

Maintain open airway
Check vital signs
Call code

Epinephrine
Solumedrol

57

Most reactions happen within

10-20 minutes
Don't leave pt unattended
Have tx stuff at hand

58

Contraindications to Water-Soluble iodine compounds

Multiple myeloma
Sickle cell disease
Allergic to iodine
Pheochromocytoma
Hepatic or renal failure
Anuria

59

Reasons why you would reject contrast - looking at the bottle

Expired
Open or seal is broken
Color change/ not clear
Chrystal's formed near top due to air getting into bottle
Manufacturer recall, check lot number on bottle, discontinue use

60

Contrast administration checklist

Select correct contrast for procedure
check expiration date
Read bottle label
Show Doctor the label
Draw up or assist in drawing up contrast
Re-check label and say name and expiration date out loud to the doctor
Save the empty bottle
Watch pt for reactions