Iodine contrast agent for the prevention and treatment of adverse reactions: In 44 patients, there were symptoms such as facial and throat itching. Among them, 3 patients had urticaria, 9 cases experienced chest tightness, shortness of breath, rapid and weak pulse, and systemic measles. Two cases presented with pallor, cold sweat, cold limbs, decreased heart rate and blood pressure indicative of anaphylactic shock. Out of 628 patients who underwent non-ionic contrast agent procedures, 5 cases had adverse reactions, with an incidence rate of 0.8%. There were 3 cases of fever, 1 case each of urticaria and vomiting, but no severe reactions occurred.
Treatment of side effects: Mild side effects such as fever and numbness usually resolve on their own without special treatment, allowing the examination to continue. Moderate side effects like urticaria can be treated by orally administering chlorpheniramine at 4mg and advising the patient to drink hot water to accelerate the excretion of the contrast agent. After completing the examination and treatment, allow the patient to rest for half an hour until the symptoms are relieved before leaving. Severe reactions require immediately stopping the injection of the contrast agent, providing oxygen, establishing intravenous access quickly, subcutaneously injecting adrenaline at 1mg (not 25mg), spraying 1:1000 adrenaline in the pharynx, intravenously infusing 10ml of 10% calcium gluconate along with hydrocortisone at 200mg IV drip. For asthma, aminophylline at 0.25g plus 50% glucose should be slowly injected intravenously. Shock patients may also need dopamine at 20~80mg and al-amin at 0.375~1.5g instillation. After treatment, the patient's symptoms gradually disappear.
Discussion: Iodine contrast agents can be divided into ionic and non-ionic types. The physicochemical properties that cause side reactions include high osmotic pressure, solubility, viscosity, lipophilicity, and charge. Non-ionic contrast agents have significantly lower osmotic pressure compared to ionic ones when containing the same amount of iodine, resulting in lower chemical toxicity and overall toxicity, making it a revolutionary advancement in contrast agents. Previous research indicates that under the same conditions, both ionic and non-ionic contrast agents can achieve ideal effects. However, non-ionic contrast agents cannot fundamentally solve idiosyncratic reactions caused by iodine itself. Recent studies show no difference in mortality rates caused by non-ionic and ionic agents. Most fatal side effects result from allergic reactions. Medically speaking, using non-ionic agents reduces adverse reactions significantly, but they are expensive. Rational screening of high-risk patients for non-ionic use while opting for ionic agents can reduce side reactions and mortality rates while saving considerable funds for society.
Prevention of iodine allergy: Screening high-risk populations is crucial before using iodine contrast agents, which requires performing an iodine allergy test. A test dose of only 1ml can screen out patients prone to allergic reactions, avoiding more serious reactions caused by high-concentration, high-dose intravenous injections. Children, the elderly, those with poor renal function, diabetes, asthma, hay fever, urticaria, eczema, or heart disease, and individuals with a history of drug allergies often benefit from using non-ionic contrast agents as a key step in preventing severe adverse reactions. Psychological nursing involves explaining the procedure patiently to patients to gain their cooperation, alleviate emotional tension and anxiety, thereby reducing side reactions. Prophylactic administration involves actively administering preventive medications such as antihistamines, adrenal cortical hormones, hydration treatments, and sedatives before injecting the contrast agent, effectively reducing the occurrence of side reactions.