Chemistry of Iodinated Contrast Media (ICM): A Minireview

2020 ◽  
Vol 17 ◽  
Author(s):  
Maithili Pramod Joshi ◽  
Ameya Chaudhari ◽  
Prashant S. Kharkar ◽  
Shreerang V. Joshi
Keyword(s):  
Adverse Effects ◽  
Contrast Media ◽  
Aqueous Solubility ◽  
Synthetic Methods ◽  
Essential Medicines ◽  
World Health ◽  
Iodinated Contrast Media ◽  
Environmental Aspects ◽  
Iodinated Contrast ◽  
Health Organization

: Historically, the use of Iodinated Contrast Media (ICM) for diagnostic purposes, particularly radiography and computed tomography (CT), is well-known. Many of the ICM are included in the World Health Organization (WHO)’s List of Essential Medicines. Depending on the chemotype and the presence of ionizable functional group(s), the ICM are categorized in the ionic/nonionic monomers/dimers. The lipophilicity, aqueous solubility, viscosity and osmolality are major characteristics dictating their use for one procedure versus the other. Over last several decades, substantial advancement occurred in the design and development of novel ICM, solely to reduce their propensity to cause adverse effects. Given the nature of their acute usage, some of the agents with appreciable toxicity are still used. Understanding their chemistry aspects is crucial to appreciate, acknowledge and justify the usage of these extremely important torch-bearers of diagnostic agent’s class. The present review article presents an in-depth overview of the synthetic methods, therapeutic indications, potential adverse effects along with the commercial and environmental aspects of ICM. The safety and tolerability of these agents is a field that has gained significant importance, which is given due importance in the discussion.

scholarly journals A comparison of national essential medicines lists in the Americas

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
Liane Steiner ◽  
Darshanand Maraj ◽  
Hannah Woods ◽  
Jordan Jarvis ◽  
Hannah Yaphe ◽  
...  
Keyword(s):  
Public Health ◽  
Adverse Effects ◽  
World Health Organization ◽  
Interquartile Range ◽  
Essential Medicines ◽  
World Health ◽  
Regulatory Body ◽  
Essential Medicines Lists ◽  
Pan American ◽  
Health Organization

Objectives. To compare national essential medicines lists (NEMLs) from countries in the Region of the Americas and to identify potential opportunities for improving those lists. Methods. In June of 2017, NEMLs from 31 countries in the Americas were abstracted from documents included in a World Health Organization (WHO) repository. The lists from the Americas were compared to each other and to NEMLs from outside of the Americas, as well as with the WHO Model List of Essential Medicines, 20th edition (“WHO Model List”) and the list of the Pan American Health Organization (PAHO) Regional Revolving Fund for Strategic Public Health Supplies (“Strategic Fund”). Results. The number of differences between the NEMLs from the Americas and the WHO Model List were similar within those countries (median: 295; interquartile range (IQR): 265 to 347). The NEMLs from the Americas were generally similar to each other. While the NEMLs from the Americas coincided well with the Strategic Fund list, some medicines were not included on any of those NEMLs. All the NEMLs in the Americas included some medicines that were withdrawn due to adverse effects by a national regulatory body (median: 8 withdrawn medicines per NEML; IQR: 4 to 12). Conclusions. The NEMLs in the Americas were fairly similar to each other and to the WHO Model List and the Strategic Fund list. However, some areas of treatment and some specific medicines were identified that the countries should reassess when revising their NEMLs.

scholarly journals Avaliação das reações adversas ao uso de contrastes em exames de diagnóstico por imagem

Cinergis ◽  
2017 ◽  
Vol 18 (4) ◽  
Author(s):  
Adriane Pozzobon ◽  
Fernanda Rocha da Trindade
Keyword(s):  
Adverse Effects ◽  
Contrast Media ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast

Para maior precisão e diferenciação de estruturas anatômicas, os contrastes são amplamente usados em exames de diagnóstico por imagem, contudo seu uso indiscriminado pode favorecer o aparecimento de reações adversas no organismo. Objetivo: realizar uma revisão sistemática sobre os efeitos adversos relacionados ao uso de contrastes utilizados em exames de tomografia computadorizada e ressonância magnética. Método: foi realizada uma busca nas bases de dados PubMed e SciELO. Os termos descritores empregados foram: efeitos adversos (adverse effects), meio de contraste iodado (iodinated contrast media), meio de contraste (medium contras) e gadolínio (gadolinium) cruzados aleatoriamente. Foram incluídos artigos originais disponíveis na íntegra, publicados entre 2005 e 2016. Resultados: foram selecionados 21 artigos em que, verificou-se maior prevalência de efeitos adversos associados ao uso de contrastes, contudo, tanto nos contrastes iodados, quanto à base de gadolínio, a maioria das reações adversas foi classificada como leve, incluindo principalmente manifestações cutâneas. Considerações finais: apesar da maioria dos efeitos adversos estarem associados aos contrastes iodados, os mecanismos envolvidos no desenvolvimento dos efeitos adversos permanecem desconhecidos.

Development of polyclonal and monoclonal antibodies to iodinated contrast media

1988 ◽  
Vol 29 (6) ◽  
pp. 737-740 ◽  
Author(s):  
R. L. Siegle ◽  
W. L. McGuire ◽  
J. E. Peters
Keyword(s):  
Monoclonal Antibodies ◽  
Contrast Media ◽  
Iodinated Contrast Media ◽  
Iodinated Contrast

scholarly journals Pharmacologic and non-pharmacologic interventions to prevent hypersensitivity reactions of non-ionic iodinated contrast media: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033023
Author(s):  
Hiroyasu Umakoshi ◽  
Takashi Nihashi ◽  
Hironori Shimamoto ◽  
Takehiro Yamada ◽  
Hiroaki Ishiguchi ◽  
...  
Keyword(s):  
Contrast Media ◽  
Assessment Tools ◽  
Average Risk ◽  
Cochrane Central Register ◽  
Hypersensitivity Reactions ◽  
Iodinated Contrast Media ◽  
Preventive Interventions ◽  
Validity Assessment ◽  
Iodinated Contrast ◽  
Standard Design

IntroductionIodinated contrast media are commonly used in medical imaging and can cause hypersensitivity reactions, including rare but severe life-threatening reactions. Although several prophylactic approaches have been proposed for severe reactions, their effects remain unclear. Therefore, we aim to review systematically the preventive effects of pharmacologic and non-pharmacologic interventions and predictors of acute, hypersensitivity reactions.Methods and analysisWe will search the PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases from 1 January 1990 through 31 December 2019 and will examine the bibliographies of eligible studies, pertinent review articles and clinical practice guidelines. We will include prospective and retrospective studies of any design that evaluated the effects of pharmacological and non-pharmacological preventive interventions for adverse reactions of non-ionic iodinated contrast media. Two assessors will independently extract the characteristics of the study and intervention and the quantitative results. Two independent reviewers will assess the risk of bias using standard design-specific validity assessment tools. The primary outcome will be reduction in acute contrast media-induced hypersensitivity reactions. The secondary outcomes will include characteristics associated with the development of contrast media-induced acute hypersensitivity reactions, and adverse events associated with specific preventive interventions. Unique premedication regimens (eg, dose, drug and duration) and non-pharmacological strategies will be analysed separately. Average-risk and high-risk patients will be considered separately. A meta-analysis will be performed if appropriate.Ethics and disseminationEthics approval is not applicable, as this will be a secondary analysis of publicly available data. The results of the analysis will be submitted for publication in a peer reviewed journal.PROSPERO registration numberCRD42019134003

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