Iohexol

Chemical name

5-[Ацетил(2,3-дигидрокси пропил)амино]-N,N'-бис(2,3 -дигидроксипропил)- 2,4,6-трийод-1,3-бензолди��арбоксамид

Gross

C19-H26-I3-N3-O9

Characteristics

Yodsoderjaschee neine rentgencontrastnoe resort. Sterilized aqueous solution of flint or bledno-jeltogo color is 6,8-7,6 pH, osmollnosti in 1,1-3 times higher osmollnosti plasma.

Of drugs

The drugs-rentgencontrastnoe. In a intratekalnom absorbed from the spinal fluid in the bloodstream, and fully display memory (about 88% during the first days), in an unmodified form. Kidney Cl-99 ml / min, the total Cl-109 ml / min. C_max achieved through 2-6 h is about 119 µ g / J The distribution of 157 ml / kg T_1/2 - 3.4 hours The maximum рентгеноконтрастност и during normal mielografii up to 30 minutes (after one hour is not visualized). The computer tomography imaging contrast in breast Division possible in the course of one hour, top department about two hours, bazalnah tanks, 3-4 p.m. After the on / in the distribution of vnekletocna liquid and excreted by clubockova filtering unchanged to (about 90% for 24 h). C_max notes immediately after introduction. T_1/2 first phase is approximately 20 minutes, and within vnesosudistaya equalized concentration for 10 minutes, then reduce the concentration is exponentially with T_1/2 about 2 hours Kidney Cl-120 ml / min, the total Cl-131 ml / min, the volume of the 165-ml / kg Quickly accumulate in the kidneys : contrast renal passage begins in 1 min after in / with injections and reaches optimum through 5-15 min. To a small extent, is associated with plasma proteins and spinal fluid. Penetrates through the placental barrier by simple diffusion. Not a GEB uncorrupted. Several lowers blood out. Tranzitorno KISR increases pressure plasma cutting interval Q-t.pri ingestion to visualize blood and little skin (with urine excreted 0.1-0.5%), absorption is greatly enhanced if bowel perforation or intestinal obstruction. Contrast joint cavities, the cavity of the uterus, fallopian tubes, peritoneal vpachivani, pancreatic and biliary ERCP, bladder achieved by direct injection.

Indications

Angiocardiografia (ventrikulografia, selective koronarnaya arteriografia) aortografia (including study and root cause rivers and the same blood arteries, abdominal arteries and branches), G lungs, head, neck, brain, abdomen, kidneys; Kollateralnogo study blood circulation, flebografia, exkrethornaya urografia, mielografia (psoas, chest, neck, the general), increases in the resolution of computed tomography (CT) head, torso and abdomen, Kt-mielografiah, tisternografii, ventrikulografii, retrogradna endoscopic pankreatoholangiorentgenografii, artrografii, gisterosalpingografii, zistouretrografii, gerniografii, X syndrome.

Restrictions on the use of

Epilepsy, dehydration, severe cardiovascular disease, asthma heart failure, pulmonary hypertension, severe violations of the kidneys and liver, chronic alcoholism, multiple sclerosis, multiple mieloma etc. paraproteinemicakie gemoblastozy, feohromotsytoma, thyrotoxicosis and sickle cell anemia, a disease Burger, acute throm, trombofilicescie condition, allergic diseases (bronchial asthma, pollinoz, food allergy) expressed arteriosclerosis, old age.

Contraindications

Гиперчувствительност ь (including from other yodsoderjasim drugs), local or systemic infection, pregnancy.

Side-Effects

The feeling itself, a breach of heart rhythm, pain in the chest, gipotenzia, heart failure, aetiology / tachycardia, asistolia, headache, dizziness, back pain, neck rigidity, nevralgia, parestesia, convulsions, reduced appetite, the taste, nausea, vomiting, gipotenzia / hypertension, sweating, weakness, fotofobia, allergic reactions (fever, chills, profuzny diarrhea, skin disease, skin type Urticaria, zalojennosti nose, adults, the 19c91 syndrome Giyena-Barre), the pain at the injection.

Specific guidance

It may distort the results of radionuclide studies of the thyroid gland in the weeks after injection.

Patient interaction

Inconsistent (with a intratekalnom) with korticosteroidami. Farmatsevticeski inconsistent (in one sprite) with antihistamines and many other drugs. Derivative fenotiazina etc. neiroleptiki, MAO inhibitors, Tricyclic antidepressants, central nervous system stimulants, analeptiki, antipsihoticalkie drugs sudorozhny lower the threshold and increase the risk of seizures. Beta-adrenoblokatora etc. gipotenzivee to increase the likelihood of hypotension. Усиливает нефротоксические свойства др. препаратов.

Overdosing

Симптомы: цианоз, брадикардия, ацидоз, легочные кровотечения, остановка сердца, бессонница или сонливость, слабость, утомляемость, ступор, судороги, кома, нарушения психической деятельности: галлюцинации, деперсонализация, страх, дезориентация, эхолалия, депрессия, амнезия, психоз, амблиопия, диплопия, фотофобия, гипестезия, зрительные, слуховые или речевые нарушения, изменения ЭЭГ, менингизм, гиперрефлексия или арефлексия, гемиплегия, паралич, квадриплегия, тремор, кровоизлияния в мозг.Лечение: monitoring and maintaining the vital functions of symptomatic therapy.

Precautions

Diagnostic procedures utilizing yogexola can be carried out only in patients with the intensive-care wards by specially trained personnel with sufficient experience of this kind of research; To monitor for 30-60 min after the injection of the preparation. There is a need to lift neirolepticalkie drugs at least 48 hours before the mielografii. Before the introduction of injection needs to be carefully considered for the presence of inclusions and changes color. The caution should be used when iohexol risk dehydration and the development of acute renal failure and cardiovascular diseases, diabetes, in older patients with kidney disease (possible osmoticeski dioreticeski effects); Prior to the study, patients in these categories should be sufficiently gidratirovana. Be wary appoint elderly and children because of the high risk of severe adverse reactions (including aseptic meningitis) and the potential for dehydration. Should be avoided mielografii with epilepsy and high sudorojna preparedness. Not recommended re mielografia immediately following the failed before (risk of overdose); Most safely prevented study in 5-7 days. Be wary give / in patients with парапротеинемическим и gemoblastozami (risk of irreversible acute renal failure as a result of precipitation in paraprotein kidney Channel). The angiocardiografii a thorough selection of doses to patients with phenomena pravojeludockova failure and pulmonary hypertension (risk taking changes in hemodynamics get drugs in the right heart divisions). The angiography with obstruction aortopodwzdoshnogo segment and / or femur artery pressure increase in the abdominal cavity Hypotension and hypertension requires careful monitoring at the time of the study because of the high risk of neurological complications, including paraplegiu.

Dosing and Administration

Intratekalno in / and, in / in, vnutrisustavno, inwards intrauteralno, transurethral, intraperitonealno. Mielografia : intratekalno slowly (within 1-2 minutes); Dose for adults : psoas - iohexol-180 10-17 ml, iohexol 240 7-12,5 ml; Thorax (translumbalno or tranczerwickalno) - iohexol 240 6-12,5 ml, iohexol 300 6-10 ml; Cervical (translumbalno) - iohexol 240 6-12,5 ml, iohexol 300 6-10 ml; Cervical (through C_1-C_2) - iohexol-180 7-10 ml, iohexol 240 6-12,5 ml, iohexol 300 4-10 ml; total mielografia (translumbalno) - iohexol 240 6-12,5 ml, iohexol 300 6-10 ml; dose for children : up to 3 months iohexol-180-2-4 ml, iohexol-210 - 2-3 ml; 36 months iohexol-180-4-8 ml, iohexol-210-3-6 ml; 3-7 years iohexol-180-10 ml, iohexol-210-5-8 ml; 7-13 years iohexol-180-12 ml, iohexol-210-10 ml; 13-18 years iohexol-180-15 ml, iohexol-210-14 ml. B / a : ventrikulografia-adult iohexol-350 (30-250 ml), children iohexol-350 (1.0-1.5 ml / kg), iohexol 300 (1.5-5 ml / kg), selective koronaroangiografia - iohexol-350 (3-14 ml in each koronarnuu artery), a study of the root and arch-predator iohexol-350 (75 ml), pulmonary angiography Children iohexol-350 (1 ml / kg), aortografia and selective arteriografia internal organs-imposed iohexol 300 children (1 to 5 ml / kg) and adults for the study of primitive (50-80 ml), the major powers, including crevny barrel and mezenteriale artery (30-60 ml), renal arteries (15 ml) with a total of not more than 291 ml; 63:02 artery (6-12 ml), pozvonocna artery (6-10 ml). In order to improve the resolution of CT, in the study of head / in adults struino iohexol-300-150 ml, iohexol-350-80 ml or / in the iohexol drip-240-250 ml, children iohexol 240 or iohexol 300 in the dose of 1-2 ml / kg; From the exploration of the body in / in struino iohexol-300-200 ml, iohexol-350-100 ml. Peripheral angiography : aortobedrenny station-iohexol-350 (70 ml), iohexol 300 (30-90 ml) бедренные/подвздошны�� selective arteriogramma - iohexol-350 (10-30 ml); flebografia - iohexol-240 (150 ml), iohexol 300 (40-100 ml). Exkrethornaya urografia in / in adults iohexol 300 or iohexol-350 in dose (350 mg iodine / kg children iohexol 300 1-1.5 mg / kg, the total dose should not exceed 3 mg / kg). Income study blood-inside, adults iohexol-350-100 ml, for children up to 3 months iohexol-180-30 ml, after 3 months iohexol 240 or iohexol-300 dose : up to three years, not more than 60 ml, 10 years - not more than 80 ml over 10 years - not more than 100 ml. Zistouretrografia-standard solution yogexola (240, 300, 350) diluted with sterile water for injection to the concentration of 100 mg of iodine in 1 ml transurethral being in the amount of 300 ml. Artrografia - vnutrisustavno, in the knee joint iohexol-240, iohexol-300-15 ml, iohexol-350-10 ml; In the shoulder joint iohexol 300, iohexol-240-3 ml, iohexol-210-10 ml; Iohexol 300-odd Jr. Retrogradnaya панкреатохолангиогра фия - endoskopiceski depressions in 10-50 ml yogexola-240. Гистеросальпингограф ия - intrauteralno 15-20 ml yogexola-240 or yogexola-300. Gerniografia - intraperitonealno yogexola-240-50 ml.

Directory → Diagnostic tools → Edgy funds → Iohexol