Adverse drug reactions – Term Paper

5.1. Body Parts Affected by Iodinated Contrast Media

The issue of acute adverse reactions following the administration of iodine-based contrast drugs in the examination of patients with CT-scan has been of interest in the society and this is apparent in the manner in which researchers have done studies on the same to help address effects of such drugs through wither suggesting alternative ways or mitigating the effects (Menegatti, Pirisi & Bellan, 2016). The study focusses on Sweden, or the greater northern European countries with the view of highlighting the degree of effects of such type of contrast drugs. To help in understanding the effects of iodine-based contrast drugs among the Swedish population, there is a need to highlight the imaging exams that employ the use of contrast materials as it would help in addressing the challenge of such drugs. It is apparent that such drugs are mostly used to improve images from x-rays and CT-scans of the gastrointestinal (GI) tract that includes the esophagus, pharynx, stomach, the small intestine, and the large intestine (Davenport, Cohan & Ellis, 2015).

The use of iodine-based contrast drugs is very common in Sweden as evident in the high numbers of CT-scans in the population proving the need to analyze the effects. Intravenous iodine-based contrast materials are used to improve the quality of images during CT-scans and are employed for various purposes among them being the examination of internal body organs such as the liver, heart, lungs, adrenal glands, pancreas, kidneys, gall bladder, bladder, spleen and uterus (Kuo, Hsieh, Hung, Lin, Lo & Hu, 2016). Iodine-based contrast drugs are also used in the analysis of gastrointestinal tract which includes the small intestines, the stomach and the large intestines. The arteries and the veins of the body are also examined through the use of CT-scans and these include blood vessels in various body parts such as chest, brain, abdomen, neck, pelvis and legs. Moreover, the soft tissues of the body such as fat, muscles and skin are also examined through the same process; this is in addition to the breast and the brain (Thomsen & Morcos, 2014).

5.2. Iodinated Contrast Media Precautions 

Although there is a very low likelihood of adverse reactions resulting from iodine-based contrast drugs, prevention of such reactions requires patients to prepare for the imaging process in various ways. Proper preparation leads to a reduction in the risks from the such drugs and one way of preparing is to avoid using substances that are allergic to the contrast materials, such materials include food, drugs, dyes, animals and preservatives (Namasivayam, Kalra, Torres & Small, 2006). Avoiding substances that are allergic to the contrast drugs help in reducing cases of allergic, hence adverse reactions of such drugs. Besides, patients need to check the effects of herbal supplements on the human body and ensure that negative effects of herbal medicines, it is also advisable not to take iodine-based contrast drugs when the patient has undergone surgery, has been recently ill or has other medical conditions that affect their welfare. Patients with asthma and hay fever also need not take contrast drugs with iodine as the same would increase the degree of adverse reactions from the contrast drugs. Finally, there are special conditions that increase adverse reactions in a big way proving the need for the society and specifically the medical practitioners to take more attention regarding the same (Hayashi, Narumi, Takagi, Takehara, Arai, Kuwatsuru & Fukuda, 2011). Some of such conditions include kidney diseases, heart diseases, diabetes, thyroid problems and sickle cell anemia.

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Although mild effects from iodine-based contrast drugs are less alarming, there are occasions when such mild reactions become severe thereby necessitating the need of the population to combat address such with urgency (Jakobsen, 2007). Mild conditions that could become severe upon using contrast drugs include stomach cramps, diarrhea, nausea, vomiting and constipation. Emergency cases can be detected when patients develop conditions such as red skin, hives, itching, swelling of the throat, difficulty in breathing or swallowing, agitation, confusion, hoarseness, bluish skin color and fast heartbeat. Pregnant women need to take additional care to protect the health of their babies making it prudent for such women to inform the physician of their conditions before carrying out CT-scan (Stacul, 2007). It is because iodine-cased contrast drugs might cause problems to the baby.

For mothers who are breastfeeding, it is advisable to stop breastfeeding for between 24 to 48 hours after using iodine-based contrast drugs on the occasions when such drugs are used intravenously (Palomäki, Muuronen, Raininko, Piilonen & Kaste, 2003). Such is because it is toxic for an infant baby to ingest even a small amount of the drug breastfeeding. However, when a breastfeeding mother takes iodine-based contrast drugs orally, there are no toxic effects to the baby and it is safe for the mothers to continue breastfeeding their children. Additionally, mothers are advised that during the period of suspending breastfeeding, they are advised to discard of the breastmilk from both breast during that period; this helps in eliminating any toxic substances from the breast (Palomäki, Muuronen, Raininko, Piilonen & Kaste, 1994). Taking such initiatives helps in reducing effects of contrast drugs on the human body and helps in improving health conditions in the population.

5.3. CT Scan Contrast Side Effects Prevention

Although researchers submit that prevention of adverse effects of iodine-based contrast drugs can be done through the use of corticosteroids either with or without the use of antihistamines, a section of research disagree with such a thought. Credible sources however prove that the use of prednisolone is very effective in the prevention of adverse effects even on patients that are at a high risk. In this case, the drug should be given at a quantity of 150 mg 13, 7 and this should be done 1 hour before injection of the contrast media (Namasivayam, Kalra, Torres, & Small, 2006). Namasivayam, Kalra, Torres, and Small, (2006) submit that a combination of steroids with other drugs proves to be a very effective means of preventing the side effects as the same proves to be a very effective prophylaxis. A combination of steroids and antihistamines is a very effective methods of prevention of adverse effects, moreover, such a pretreatment needs to include prednisone. Forms of prophylaxis involving prednisone should be given at 50 mg orally, and for every six hours in doses of three up to one hour before injection of the contrast drug. On the other hand, a combination involving diphenhydramine should be given intramuscularly with the amount being 50 mg, and this should be done one hour before injection of the contrast media (Kanny et al., 2005).

As Hainfeld, Slatkin, Focella, and Smilowitz, (2014), posit, the administration of such combination of drugs lead to the reduction of adverse reactions to ionic media from between 17 and 35 percent to 5 percent. There in inconclusive evidence on the effectiveness of the use of either antihistamine alone or corticosteroid alone as prevention methods. Preventive methods are of great importance to the patients as they help in eliminating life-threatening conditions that result from the use of contrast media. Moreover, it is advisable not to leave the patients alone for the first 20 minutes after injection with contrast media as both severe and fatal effects of contrast media take place within such a duration.