[Adverse reactions following high-dose intravenous injection of urographic contrast media]. / Nebenwirkungen nach hochdosierter intravenöser Injektion nierengängiger Kontrastmittel.

The frequency and type of side effects from high-dose renographic contrast media correspond with those quoted in the literature for injections of small doses of contrast. In addition to the usual contra-indications against injection of renographic contrast, one should also consider the effect of short-lived increase in circulating volume in patients with left heart insufficiency.

Pharmacochemical profile of iopromide.

Iopromide (Schering, Berlin) is a new nonionic, monomeric contrast medium containing three different substituents on the triiodinated benzene ring. Iopromide exhibits low osmolality and viscosity in aqueous solutions of high concentrations. It has been shown to have a remarkably low intravenous toxicity in mice and rats. Neural tolerance was found to be equal to or better than that of metrizamide when injected in rats intracisternally and intracerebrally, respectively. The effects of iopromide after selective peripheral and cerebral arterial injections in rats were demonstrated to be very moderate at high dosages. The interaction of iopromide with proteins and membranes was found to be considerably low due to its hydrophilicity. Excretion of iopromide is fast and predominantly by the renal route. On the basis of the preclinical profile iopromide is a very promising contrast agent, being most suitable for all angiographic indications, including digital subtraction angiography, urography, and computed tomography.

Ioglucomide: a new nonionic myelographic agent. Preclinical studies.

Ioglucomide, a new iodinated nonionic contrast medium directed primarily toward myelographic use, was subjected to an extensive toxicological examination in animals. In the majority of studies, ioglucomide was compared directly with metrizamide. In some respects, including freedom from production of arachnoiditis, ioglucomide and metrizamide were comparable. However, acute toxicity after intravenous injection or instillation into cerebrospinal fluid was significantly less for ioglucomide. Also, in contrast to metrizamide, ioglucomide produced no evidence of any type of convulsive activity after subarachnoid administration. The improved safety of ioglucomide could not be related to osmolality; therefore, the importance of osmolality for nonionic myelographic agent safety is questioned.

The hazards of myelography.

The history of myelography and reactions to various contrast media is reviewed. Air is completely absorbed without producing long-term side effects. Lipiodol and Pantopaque are not absorbed and residual medium in the spinal canal can cause arachnoiditis. Other agents as Diodrast and Thorotrast never gained widespread acceptance. The water-soluble Dimer-X and Conray 60 have come into prominence but they are not totally without reactions. Recently a new water-soluble nonionic contrast medium has been developed in Norway. Metrizamide (Amipaque) has the same overall density as other water-soluble media but produces fewer reactions.