In some cases, after the introduction of contrast media, such as Urografin may combination testosterone estrogenolit occur allergic like hypersensitivity reactions.
These reactions usually appear as not severe respiratory and skin symptoms: shortness of breath, skin redness (erythema), urticaria, itching, or swelling of the face. Possible serious reactions: vascular edema, swelling of the throat below the folds of the glottis, bronchospasm and allergic shock. Typically, these reactions occur within one hour after the administration of contrast agent. However, in rare cases delayed reactions may occur (after a few hours – days)
Patients with hypersensitivity or those who have previously had a reaction to iodinated contrast media are at increased risk to develop serious reactions.
The frequency of adverse reactions is higher in patients with a history of allergy (eg seafood allergy, hay fever, hives), sensitivity to iodine or contrast media and bronchial asthma. In this regard, prior to administration of the contrast agent should be questioned the patient for presence tendency to allergy. In such cases, you should consider the need to prevent use antihistamines and / or corticosteroids.
Patients with asthma have an increased risk of developing bronchoconstriction or hypersensitivity reactions.
Hypersensitivity reactions can be enhanced in patients taking beta-blockers, especially in the presence of asthma. Furthermore necessary to take into account that patients taking beta-blockers may be resistant to standard therapy of hypersensitivity reactions with beta-agonists.
With the development of hypersensitivity reactions administration of the contrast agent should be discontinued immediately and, if necessary, to start specific treatment through the venous access. To carry out emergency treatment must be prepared to appropriate drugs, an endotracheal tube and apparatus for artificial respiration.
- Thyroid function
A small amount of inorganic iodine. iodine present in the solution of the contrast agent. It may affect thyroid function. Therefore special care should assess the need for X-ray contrast studies in patients with latent hyperthyroidism or goitre.
- Cardiovascular combination testosterone estrogenolit diseases
There is an increased risk of reactions expressed in patients with severe heart disease, especially in those who suffer from heart failure and coronary artery disease.
- Elderly age
Older people are often found pathological changes in vascular and neurological disorders that increase the risk of adverse reactions to iodinated contrast media.
- General poor health
The need examination with contrast should be very carefully weighed in patients with general poor health.
- kidney failure
In rare cases, failure can occur in renal function. The following preventive measures should be taken to prevent acute renal failure when administered contrast agent:
To identify patients with risk factors, such as kidney disease history, existing renal insufficiency, kidney failure after administration of contrast medium in the history of diabetes with nephropathy, multiple myeloma, age greater than 60 years, advanced vascular disease, paraproteinemia, severe hypertension , gout, or repeated administration of large doses.
Before the introduction of a contrast agent to carry out adequate hydration in patients with an increased risk. Preferably it should be done by intravascular infusion before and after the study. The infusion should be continued until complete elimination of the contrast agent of the kidneys.
Prior to complete removal of the contrast agent should exclude additional load on the kidneys in the form of nephrotoxic drugs, oral administration holetsistograficheskih preparations overlay arterial clamp, renal artery angioplasty or a large surgery.
Defer new radiopaque research to full recovery of renal function.
Patients on dialysis can be carried out X-ray study using contrast agent, so kakliysoderzhaschie contrast agents are excreted by dialysis.
- Treatment with metformin
The use of kidneys excreted intravascular X-ray contrast agents may lead to transient renal dysfunction. As a result, patients taking biguanides cause lactic acidosis may (as a precaution receiving biguanides should be stopped 48 hours prior to the study with contrast and do not take them but at least within 48 hours after it).
- Cardiovascular diseases
In patients with valvular heart disease and pulmonary hypertension contrast medium administration may lead to pronounced haemodynamic changes. In elderly patients and patients of heart disease more likely to occur in the history of ischemic ECG changes and arrhythmias.
In patients with heart failure, intravascular contrast agents may cause pulmonary edema.
- CNS disorders
With extreme caution should be intravascular contrast agents in patients with acute cerebral infarction, acute intracranial hemorrhage and other diseases involving the blood-brain barrier integrity violation, cerebral edema or acute demienilizatsiey. The frequency of seizures after administration of iodinated contrast agents higher in patients with intracranial tumors or metastases with a history of epilepsy. The introduction of a contrast agent may contribute to the appearance of neurological symptoms in diseases of the brain vessels, the presence of intracranial tumors or metastases, degenerative or inflammatory diseases of the central nervous system. Intra-arterial combination testosterone estrogenolit injection of contrast agents may lead to the phenomena of vasospasm and subsequent cerebral ischemia. The risk of neurological complications is higher in patients with symptomatic cerebrovascular diseases, recent stroke or frequent transient ischemic attacks.
- Severe hepatic dysfunction
In the case of severe renal insufficiency concomitant severe impairment of liver function can significantly slow down the excretion of contrast medium and lead to the need for dialysis.
- Multiple myeloma and paraproteinemia
Multiple myeloma or paraproteinemia can contribute to a violation of renal function when administered to a contrast agent. In this case, special attention should be paid to adequate hydration.