drug adverse effects of contrast agents

Adverse effects

• anaphylactoid
  • occur with 2-6% of procedures
  • may have the clinical appearance of anaphylaxis, but are more appropriately termed anaphylactoid, because they do not involve IgE
  • low ionic strength contrast agents are less likely to result in an adverse reaction
  • previously, patients with a history of contrast reaction coud be pretreated with the following protocol:
    • 50 mg of prednisone every 6h for 3 doses
    • last dose 1 hour before procedure
    • 50 mg of diphenhydramine (Benadryl) at time of last dose
  • current guidelines (2023) recommend proceeding with non-ionic, low ionic or iso-osmolar contrast with consideration of premedication with glucocorticoid & antihistamine
• nephrotoxicity (see contrast nephropathy)
  • selection of alternative diagnostic procedure
    • radionuclide scintigraphy
    • ultrasonography
  • generally low morbidity & mortality

More general terms

• drug adverse effect(s)