Clinical data | |
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Trade names | Isovist |
AHFS/Drugs.com | International Drug Names |
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Pharmacokinetic data | |
Protein binding | Negligible |
Excretion | 99% via kidneys |
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Chemical and physical data | |
Formula | C37H48I6N6O18 |
Molar mass | 1626.242 g·mol−1 |
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Iotrolan (trade name Isovist) is an iodine-containing radiocontrast agent, a substance used to improve the visibility of body structures on images obtained by X-ray techniques. [1]
As of 2021 [update] , it is unknown whether it is still marketed anywhere in the world.
It is particularly used to image spaces surrounding the central nervous system, such as the ventricles, after injection into the cerebrospinal fluid; and also for angiography (imaging of blood vessels), urography (imaging of the urinary tract) and hysterosalpingography (imaging of uterus and fallopian tubes). [2] [3] It can also be used to image joint spaces and in endoscopic retrograde cholangiopancreatography (ERCP).[ citation needed ]
Hysterosalpingography is contraindicated during pregnancy and during acute inflammation in the pelvic region. [2]
The most common side effects are nausea and vomiting. Redness and a hot feeling of the skin is relatively common when the medication is injected into a vein. When injected into the cerebrospinal fluid, headache is among the most common adverse effects, and sometimes confusion or hallucinations can occur. Allergy-like reactions such as fever, hypotension (low blood pressure) and shock have also been observed. [2]
Drug interactions are similar to other iodine-containing contrast agents. Iodine-131, a radioactive isotope used for thyroid imaging (scintigraphy) and therapy of thyroid cancers, can be less effective when used within two to six weeks after application of iotrolan because of residual iodine in the body. Iotrolan can slow down the excretion of the diabetes drug metformin, potentially resulting in lactic acidosis. [2]
Chemically, the substance is a dimer of a triiodinated isophthalic acid derivative. The iodine atoms readily absorb X-rays, improving the contrast in X-ray images of the body. It is non-ionic but water soluble. [2]
Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates.
Iodine is a chemical element; it has symbol I and atomic number 53. The heaviest of the stable halogens, it exists at standard conditions as a semi-lustrous, non-metallic solid that melts to form a deep violet liquid at 114 °C (237 °F), and boils to a violet gas at 184 °C (363 °F). The element was discovered by the French chemist Bernard Courtois in 1811 and was named two years later by Joseph Louis Gay-Lussac, after the Ancient Greek Ιώδης 'violet-coloured'.
Radiocontrast agents are substances used to enhance the visibility of internal structures in X-ray-based imaging techniques such as computed tomography, projectional radiography, and fluoroscopy. Radiocontrast agents are typically iodine, or more rarely barium sulfate. The contrast agents absorb external X-rays, resulting in decreased exposure on the X-ray detector. This is different from radiopharmaceuticals used in nuclear medicine which emit radiation.
Scintigraphy, also known as a gamma scan, is a diagnostic test in nuclear medicine, where radioisotopes attached to drugs that travel to a specific organ or tissue (radiopharmaceuticals) are taken internally and the emitted gamma radiation is captured by gamma cameras, which are external detectors that form two-dimensional images in a process similar to the capture of x-ray images. In contrast, SPECT and positron emission tomography (PET) form 3-dimensional images and are therefore classified as separate techniques from scintigraphy, although they also use gamma cameras to detect internal radiation. Scintigraphy is unlike a diagnostic X-ray where external radiation is passed through the body to form an image.
Potassium iodide is a chemical compound, medication, and dietary supplement. It is a medication used for treating hyperthyroidism, in radiation emergencies, and for protecting the thyroid gland when certain types of radiopharmaceuticals are used. In the third world it is also used for treating skin sporotrichosis and phycomycosis. It is a supplement used by people with low dietary intake of iodine. It is administered orally.
Iodinated contrast is a form of water-soluble, intravenous radiocontrast agent containing iodine, which enhances the visibility of vascular structures and organs during radiographic procedures. Some pathologies, such as cancer, have particularly improved visibility with iodinated contrast.
Lugol's iodine, also known as aqueous iodine and strong iodine solution, is a solution of potassium iodide with iodine in water. It is a medication and disinfectant used for a number of purposes. Taken by mouth it is used to treat thyrotoxicosis until surgery can be carried out, protect the thyroid gland from radioactive iodine, and to treat iodine deficiency. When applied to the cervix it is used to help in screening for cervical cancer. As a disinfectant it may be applied to small wounds such as a needle stick injury. A small amount may also be used for emergency disinfection of drinking water.
An arthrogram is a series of images of a joint after injection of a contrast medium, usually done by fluoroscopy or MRI. The injection is normally done under a local anesthetic such as Novocain or lidocaine. The radiologist or radiographer performs the study using fluoroscopy or x-ray to guide the placement of the needle into the joint and then injects around 10 ml of contrast based on age. There is some burning pain from the anesthetic and a painful bubbling feeling in the joint after the contrast is injected. This only lasts 20 – 30 hours until the Contrast is absorbed. During this time, while it is allowed, it is painful to use the limb for around 10 hours. After that the radiologist can more clearly see what is going on under your skin and can get results out within 24 to 48 hours.
A contrast agent is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, which is different from radiopharmaceuticals, which emit radiation themselves. In x-ray imaging, contrast agents enhance the radiodensity in a target tissue or structure. In magnetic resonance imaging, contrast agents shorten the relaxation times of nuclei within body tissues in order to alter the contrast in the image.
Myelography is a type of radiographic examination that uses a contrast medium to detect pathology of the spinal cord, including the location of a spinal cord injury, cysts, and tumors. Historically the procedure involved the injection of a radiocontrast agent into the cervical or lumbar spine, followed by several X-ray projections. Today, myelography has largely been replaced by the use of MRI scans, although the technique is still sometimes used under certain circumstances – though now usually in conjunction with CT rather than X-ray projections.
Iohexol, sold under the trade name Omnipaque among others, is a contrast agent used for X-ray imaging. This includes when visualizing arteries, veins, ventricles of the brain, the urinary system, and joints, as well as during computed tomography. It is given by mouth, injection into a vein, or into a body cavity.
An antithyroid agent is a hormone inhibitor acting upon thyroid hormones.
A CT pulmonary angiogram (CTPA) is a medical diagnostic test that employs computed tomography (CT) angiography to obtain an image of the pulmonary arteries. Its main use is to diagnose pulmonary embolism (PE). It is a preferred choice of imaging in the diagnosis of PE due to its minimally invasive nature for the patient, whose only requirement for the scan is an intravenous line.
Ioflupane (123I) is the international nonproprietary name (INN) of a cocaine analogue which is a neuro-imaging radiopharmaceutical drug, used in nuclear medicine for the diagnosis of Parkinson's disease and the differential diagnosis of Parkinson's disease over other disorders presenting similar symptoms. During the DaT scan procedure it is injected into a patient and viewed with a gamma camera in order to acquire SPECT images of the brain with particular respect to the striatum, a subcortical region of the basal ganglia. The drug is sold under the brand name Datscan and is manufactured by GE Healthcare, formerly Amersham plc.
Iopentol is a pharmaceutical drug that was used as a radiocontrast agent for X-ray imaging in Europe.
Iomeprol is a pharmaceutical drug used as a radiocontrast agent in X-ray imaging. It is sold under the trade names Imeron and Iomeron.
Iobitridol is a pharmaceutical drug used as an iodine-based radiocontrast agent in X-ray imaging. It is injected into blood vessels, joints, or body cavities such as the uterus, and filtered out by the kidneys. Its most common adverse effect is nausea. Severe allergic reactions are rare.
Metrizoic acid is a pharmaceutical drug that was used as an iodinated contrast medium for X-ray imaging. Its uses included angiography and urography, but it has been discontinued, at least in the US.
Ioxaglic acid is pharmaceutical drug used as an iodinated contrast medium for X-ray imaging. It has low osmolality, typically resulting in fewer side effects than high-osmolality media. It is manufactured by Guerbet, but marketing in the US has been discontinued. As of 2021, it may still be available in some European countries.
Contrast CT, or contrast enhanced computed tomography (CECT), is X-ray computed tomography (CT) using radiocontrast. Radiocontrasts for X-ray CT are generally iodine-based types. This is useful to highlight structures such as blood vessels that otherwise would be difficult to delineate from their surroundings. Using contrast material can also help to obtain functional information about tissues. Often, images are taken both with and without radiocontrast. CT images are called precontrast or native-phase images before any radiocontrast has been administered, and postcontrast after radiocontrast administration.