Ict136 - Unit2 - Ppt 2.2 - Angiographic Contrast Media

Front 1

What is the primary ingredient in angiographic contrast media?

Back 1

Iodine

Front 2

HOCM =

Back 2

High Osmolarity Contrast Media

Front 3

What does the number and type of iodine molecule in contrast media depends on?

Back 3

Manufacture and type of contrast

Front 4

What does a greater concentration of iodine in contrast media means?

Back 4

More iodine = greater osmolarity

Front 5

LOCM =

Back 5

Low Osmolarity Contrast Media

Front 6

The contrast media has a direct effect on what internal organ?

Back 6

The kidneys

Front 7

What are the 4 differences between HOCM and LOCM?

Back 7

1. HOCM cost less than LOCM,
2. HOCM causes more post injection hypotension,
3. HOCM causes more arrhythmias than LOCM,
4. HOCM causes more renal effects than LOCM

Front 8

True/False. The visualization of the arteries is better with LOCM than with HOCM

Back 8

False. Visualization between HOCM and LOCM is the same

Front 9

What are the 3 properties (chemistry) of contrast?

Back 9

1. Osmolarity,
2. Hydrophilicity,
3. Viscosity

Front 10

This property is contrast's ability to diffuse once in blood vessel. aka thickness of solution

Back 10

Viscosity

Front 11

This property determines water solubility of a contrast medium

Back 11

Hydrophilicity

Front 12

A lower osmolarity of contrast means what?

Back 12

More easily excreted into urine

Front 13

What is the osmolarity of blood?

Back 13

300 mOsm/kg

Front 14

What is generally the osmolarity of contrast?

Back 14

300 mOsm/kg - 2,100 mOs/kg

Front 15

LOCM is proven to be safer for patients with?

Back 15

1. Ongoing MI,
2. LV dysfunction,
3. Hear failure (HF),
4. Renal impairment/failure,
5. History of allergic reaction, and
6. Peripheral vascular procedures

Front 16

What are the side effects/risk of contrast media?

Back 16

1. Potential cardiovascular effects,
2. Thrombo-embolic events,
3. Allergic reactions,
4. Contrast Induced Nephropathy (CIN)

Front 17

List the Potential cardiovascular effects of contrast media

Back 17

1. Decreased cardiac output and contractility,
2. Increased right heart pressures,
3. Transient ST-segment elevation,
4. Arrhythmias,
5. Hypotension

Front 18

Is there a relationship between amount of contrast given and likelihood of an allergic event?

Back 18

No

Front 19

What are the risk factors that contrast media will induce an anaphylactic response in a patient?

Back 19

1. Prior reaction to contrast media,
2. Patient already has asthma, pre-existing cardiovascular or renal disease,
3. Patient has allergy to any substance

Front 20

True/False. True iodine allergy is very rare

Back 20

True, seafood allergy indicates general risk of allergies, not allergy to contrast

Front 21

Name signs indicative of a mild allergic response

Back 21

Cough,
Itching,
Sneezing,
Watery eyes,
Redness of skin

Front 22

What are the signs of a major allergic response?

Back 22

Hives,
Swelling of face,
Neck,
Respiratory distress

Front 23

What is the initial treatment of an allergic response

Back 23

1. Antihistamine = Benadryl/Diphenhydramine,
2. Cortico-steroids = Solu-Medral or Solu-Cortef,
3. Oxygen therapy as needed; continue to monitor,
4. Use epinephrine as last resort only

Front 24

Contrast Induced Nephropathy is defined as

Back 24

An elevation of serum creatinine 20%-50% above baseline, 48-72 hrs after procedure

Front 25

CIN is associated with increases in what?

Back 25

Morbidity and Mortality

Front 26

Contrast agents account for -blank- of all hospital-acquired renal failure cases

Back 26

Greater than 10%

Front 27

What is the incidence rate of CIN in patients with mild renal insufficiency?

Back 27

5% chance

Front 28

What is the incidence of CIN in patients with severe renal dysfunction and that are diabetics?

Back 28

50%

Front 29

Patients with the following conditions are at increased risk for CIN

Back 29

Baseline renal dysfunction patients,
Diabetes mellitus (DM),
Heart failure (CF),
Hypertension (HTN),
Low cardiac output / renal filtration

Front 30

What can be done to prevent contrast induced Nephropathy?

Back 30

Minimize contrast usage at all time,
Adequate hydration with normal saline both prior-to and after an invasive procedure,
Add sodium bicarbonate to D5W