The Toxicity of Iodinated Radiographic Contrast Agents in the Clinical Practice - The Toxicity of Iodinated Radiographic Contrast Agents in the Clinical Practice - Open Access Pub

Iodinated radiographic contrast agents (IRCA) are pharmaceutical agents used to improve the visibility of internal organs and structures in X-ray based imaging techniques. However, IRCA may have adverse unwanted effects, ranging from a mild inconvenience, such as itching, to a life-threatening emergency. The adverse effects of IRCA include delayed allergic reactions, anaphylactic reactions, and/or cutaneous reactions. But exposure to IRCA may be associated also with the development of either hyperthyroidism or hypothyroidism, presumably due to the effect of free, biologically active elemental iodine ions present in these agents. Among the side effects associated with the use of intravascular injection of IRCA, Contrast-induced nephropathy (CIN) is undoubtedly their most important and frequent well known adverse reaction. The pathogenesis of CIN is discussed in detail including the factors that increase the incidence of CIN, the main ones being pre-existing renal impairment, particularly when associated with diabetes mellitus. Finally, the measures to reduce the nephrotoxicity of IRCA are suggested beginning with monitoring renal function, discontinuation of potentially nephrotoxic drugs, use of either iodixanol or iopamidol at the lowest dosage possible. The main procedure for prevention of CIN is an adequate hydration of the patient with either isotonic sodium chloride or sodium bicarbonate solutions. A long list of references is provided that will enable readers a deep appreciation of the topic. DOI10.14302/issn.2574-4488.jna-14-601 Iodinated radiographic contrast agents (IRCA) are commonly administered pharmaceutical agents very useful for improving the visibility of internal organs and structures (Iodine is an important element used in contrast media because it possesses high-contrast density) in X-ray based imaging techniques, such as radiography, angiography and contrast-enhanced computed tomography (CT) scans, and to perform cardiac catheterizations and percutaneous coronary interventions. They have been in use for over 60 years and their use for imaging and intravascular intervention keeps increasing, particularly in less healthy and older patients, with one or more comorbid conditions, such as advanced vascular disease, severe long-standing hypertension, diabetes and impairment of renal function 1. All currently used X-ray contrast media are based on the tri-iodinated benzene ring, acetrizoate being the parent tri-iodinated contrast medium first in clinical use 2. Side Effects of Iodinated Radiographic Contrast Agents (IRCA) We know that any