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Contrast > Iodine Compounds > Flashcards

Iodine Compounds Flashcards

1
Q

Most commonly used contrast agent

A

Water-soluble iodine compounds

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2
Q

Water-soluble iodine compounds aka

A

Aqueous Iodine Compounds

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3
Q

5 ways to administer water-soluble iodine compounds

A 
Orally
Intrathecally
Intravenously 
Intraarterially
Directly injected into structure
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4
Q

4 departments that use water-soluble iodine compounds

A

Cath lab
EP
OR
Radiology

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5
Q

Isovue M is given

A

Intrathecally

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6
Q

Isovue is given

A

IV
Intraarterially
Direct injection

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7
Q

water-soluble iodine compounds are… Based; and contain

A

Carbon

Iodine atoms and various other atoms

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8
Q

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

A

In size

More iodine

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9
Q

What property of iodine makes it a good positive contrast agent

A

High atomic number

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10
Q

Name studies that use water-soluble iodine compounds

A 
Urinary studies - IVU, cystogram
Biliary studies- Cholangiography 
Arthrography
Cardiovascular interventional exams
CT scan
Other fluoroscopic studies
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11
Q

Brand names of water-soluble iodine compounds

A 
Optiray
Visipaque
Cystographin
Isovue M
Hypaque
Cystografin
Gastrografin
Isovue
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12
Q

Oily Iodine Compounds aka

A

Ethiodized oils

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13
Q

When is oily iodine compounds used

A

When absorption is not desired

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14
Q

3 studies that may used oily iodine compounds

A

Hysterosalpingograms
Bronchography
Myelography

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15
Q

What has replaced oily iodine compounds

A

Newer aqueous iodine agents

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16
Q

Brand names of water-soluble iodine compounds

A 
Optiray
Visipaque
Cystographin
Isovue M
Hypaque
Cystografin
Gastrografin
Isovue
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17
Q

Oily Iodine Compounds aka

A

Ethiodized oils

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18
Q

When is oily iodine compounds used

A

When absorption is not desired

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19
Q

3 studies that may used oily iodine compounds

A

Hysterosalpingograms
Bronchography
Myelography

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20
Q

What has replaced oily iodine compounds

A

Newer aqueous iodine agents

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21
Q

Ionic means

A

of, relating to, or using ions.

(of a chemical bond) formed by the electrostatic attraction of oppositely charged ions.

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22
Q

Ionic contrast is ——- contrast media

A

Tri-iodinated

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23
Q

Ionic contrast contain– and —-

A

Sodium and Meglumine salts (cation)

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24
Q

What happens once the ionic contrast is injected

A

It dissociates into ions called anion and cations

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25
Q

Ionic contrast contains how many iodine atoms

A

3

26
Q

Anions

A

Negatively charged particles

27
Q

Cations

A

Positively charged particles

28
Q

What are ionic contrasts known to do

A

Bond to something such as blood

29
Q

When were non-ionic contrasts introduced

A

1980s

30
Q

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

A

Because is doesn’t dissociate

31
Q

Most departments use– exclusively

A

Water-soluble Iodine Non-ionic Contrast

32
Q

Water-soluble iodine compounds

3 features of ionic that is different than non-ionic

A
  1. Dissociates into separate ions when injected
  2. Creates hypertonic condition
  3. Increases blood osmolarity
33
Q

Water-soluble iodine compounds

3 features of non-ionic that is different than ionic

A

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

34
Q

Hypertonic solution

A

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

35
Q

Isotonic

A

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

36
Q

Osmolality

A

Concentration of particles in a solution

37
Q

What is the Osmolality of blood

A

300 milliosmol per kg

300 mOsm/kg

38
Q

Example of ionic monomer

A

Diatrizoate and sodium salt

39
Q

Osmolality of ionic monomers

A

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

40
Q

Osmolality of non-ionic dimmer Iotrolan and iodixanol

A

290 mOsm/kg

41
Q

The lower the Osmolality contrast means

A

Less chance of reaction to contrast

42
Q

Osmolality of isotonic

A

Solution has the same Osmolality as plasma

43
Q

Osmolality of hypertonic

A

Greater Osmolality than plasma (ionic contrast)

44
Q

Osmolality of hypotonic

A

Less Osmolality than plasma

45
Q

Who is at risk for contrast mediA reactions ; 6

A
  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
Q

What lab levels do we check before contrast

A

BUN
GFR
Creatinine

47
Q

What is SFMC premedication to prevent reactions

A

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
Q

Vasovagal response

A

When the contrast media stimulates the vagus nerve causing cardiovascular changes

49
Q

Signs of vasovagal response

A

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

50
Q

Anaphylaxis or anaphylactic reaction is a

A

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

51
Q

Symptoms of anaphylaxis

A

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

52
Q

Mild reactions that don’t need tx

A

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

53
Q

Moderate reactions

A

Urticaria hives
Erythema
Bronchospasm
Facial swelling

Antihistamine given orally, iv, or injection

54
Q

Severe reactions

A 
Laryngeal or bronchial edema
Dysphasia / difficultly swallowing
Cyanosis
Seizure
Respiratory arrest
Cardiac arrest 
Death
55
Q

What are the step if pt coded

A 
Dial 4000, if pt is coding-code blue
Get code cart
Unplug defibrillator 
Get O2
Direct traffic
56
Q

Treatment for severe reaction

A

Maintain open airway
Check vital signs
Call code

Epinephrine
Solumedrol

57
Q

Most reactions happen within

A

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

58
Q

Contraindications to Water-Soluble iodine compounds

A 
Multiple myeloma
Sickle cell disease 
Allergic to iodine
Pheochromocytoma
Hepatic or renal failure
Anuria
59
Q

Reasons why you would reject contrast - looking at the bottle

A

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
Q

Contrast administration checklist

A 
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

Contrast (2 decks)

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