Generic placeholder image

Current Drug Safety


ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Adverse Drug Reactions to Radiographic Contrast Media in a Teaching Hospital in North India: An Observational Study

Author(s): Deepti Chopra*, Abhinav Jain, Richa Garg and Shreya Dhingra

Volume 14, Issue 2, 2019

Page: [122 - 126] Pages: 5

DOI: 10.2174/1574886314666190122095702

Price: $65


Background: Radiocontrast media are used extensively nowadays to visualize internal organs. Currently, non-ionic iodinated contrast media are used which are generally considered to be safe but some adverse reactions have been reported. Thus, the present study was carried out to analyze the nature and incidence of adverse drug reactions (ADRs) to radiographic contrast media in a teaching hospital.

Methods: An observational study carried out for a period of six months in a teaching hospital. Contrast media induced adverse reactions were analyzed in terms of affected organs, rate, causality assessment, severity and preventability. The treatment and outcomes of adverse events were also recorded. Naranjo Probability Scale was used to evaluate the relationship between the contrast agent used and the suspected ADR. The severity of the suspected ADRs was determined using Hartwig Scale and preventability was assessed using modified Schumock and Thornton criterion.

Results: A total of 15 suspected ADRs occurred in 11 patients with an incidence of 1.4%. It included 5 (45.4%) males and 6 (54.5%) females (p < 05). The highest percentage (72.7 %) of ADRs was seen in adult patients, the mean age being 40.8 years. Vomiting (33.3%) was the most common ADR noted followed by severe nausea and rashes. 64.7 % of ADRs were categorized as probable and 35.3 % were possible. Adverse reactions required treatment in 46.6% patients. There was no fatality reported.

Conclusion: The reactions observed were mild to moderate in severity and occurred within 30 minutes of the administration of the contrast.

Keywords: Radiocontrast media, adverse drug reactions, adverse events, non-ionic iodinated contrast media, CECT, gastrointestinal efforts.

Christiansen C. X-Ray contrast media--an overview. Toxicology 2005; 206: 185-7.
Morcos SK, Thomsen HS. Adverse reactions to iodinated contrast media. Eur Radiol 2001; 11(7): 1267-75.
Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239-45.
Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm 1992; 49: 2229-32.
Safety of Medicines. Available from:. 2002/WHO_EDM_QSM_2002.2.pdf
Schumock GT, Thornton JP. Focusing on the preventability of adverse drug reactions. Hosp Pharm 1992; 27: 538.
Singh J, Daftary A. Iodinated contrast media and their adverse reactions. J Nucl Med Technol 2008; 36: 69-74.
Bottinor W, Polkampally P, Jovin I. Adverse reactions to iodinated contrast media. Int J Angiol 2013; 22: 149-54.
Thomsen HS. Contrast media safety: An update. Eur J Radiol 2011; 80: 77-82.
Mishkin D, Carpenter S, Croffie J, et al. ASGE technology status evaluation report: Radiographic contrast media used in ERCP. Gastrointest Endosc 2005; 62: 480-4.
Cochran ST, Bomyea K, Sayre JW. Trends in adverse events after IV administration of contrast media. Am J Roentgenol 2001; 176: 1385-8.
Mortele KJ, Oliva MR, Ondategui S, Ros PR, Silverman SG. Universal use of nonionic iodinated contrast medium for CT: Evaluation of safety in a large urban teaching hospital. Am J Roentgenol 2005; 184(1): 31-4.
Wang CL, Cohan RH, Ellis JH, Caoili EM, Wang G, Francis IR. Frequency, outcome, and appropriateness of treatment of nonionic iodinated contrast media reactions. Am J Roentgenol 2008; 191(2): 409-15.
Almen T. The etiology of contrast medium reactions. Invest Radiol 1994; 29: S37-45.
Palmer FJ. The RACR survey of contrast media reactions: Final report. Australas Radiol 1988; 32: 426-8.
Velasco MA, Perez GE, Cortejoso HF. Monitoring of adverse reactions to iodinated contrast media in in-patients and outpatients. Farm Clin 1996; 13: 596-609.
Dawson P. Radiological contrast agents. In: Aronson JK, ed.Side effects of drugs: Annual 21 Amsterdam. The Netherlands: Elsevier Science B.V. 1998; pp. 475-85.
Katayama H, Yamaguchi K, Kozuka T, Takashima T, Seez P, Matsuura K. Adverse reactions to ionic and nonionic contrast media: A report from the Japanese committee on the safety of contrast media. Radiology 1990; 175: 621-8.
Cutroneo P, Polimeni G, Curcuruto R, Calapai G, Caputi AP. Adverse reactions to contrast media: An analysis from spontaneous reporting data. Pharmacol Res 2007; 56: 35-41.
Jung KE, Chung J, Park BC, Jee KN, Jee YK, Kim MH. A clinical study of cutaneous adverse reactions to nonionic contrast media in Korea. Ann Dermatol 2012; 24: 22-5.
Modi N, Vaidya K, Dudhia S, Shah R, Date S. A study of adverse drug reactions to radiocontrast media in a tertiary care teaching rural hospital. Int J Med Sci Public Health 2014; 3: 133-6.
Bhowmick S, Bhat E, Panja B, et al. A study on adverse drug reactions to non-ionic contrast medium in an Indian population: A 1-year experience. Int J Basic Clin Pharmacol 2014; 3(6): 1066-71.
Subathra A, Sandhiya S, Kesavan R. An analysis of adverse drug reactions to radiographic contrast media reported during a 3 year period in a tertiary care hospital in South India. Indian J Physiol Pharmacol 2014; 58: 45-50.
Zhang B, Dong Y, Liang L, et al. The incidence, classification, and management of acute adverse reactions to the low-osmolar iodinated contrast media isovue and ultravist in contrast-enhanced computed tomography scanning medicine. Medicine (Baltimore) 2016; 95(12): e3170.
American College of Radiology. Manual on contrast media. 10th ed. Reston, VA: American College of Radiology 2015.
Motosugi U, Ichikawa T, Sano K, Onishi H. Acute adverse reactions to nonionic iodinated contrast media for CT: Prospective randomized evaluation of the effects of dehydration, oral rehydration, and patient risk factors. AJR Am J Roentgenol 2016; 207(5): 931-8.
Ha SO, Kim DY, Sohn YD. Clinical characteristics of adverse reactions to nonionic low osmolality contrast media in patients transferred from the CT room to the emergency room. Springerplus 2016; 5: 929.
Kyung EJ, Ryu JH, Kim EY. Evaluation of adverse reactions to contrast media in the hospital. Br J Radiol 2013; 86: 20130418.
Abe S, Fukuda H, Tobe K, Ibukuro K. Protective effect against repeat adverse reactions to iodinated contrast medium: Premedication vs. changing the contrast medium. Eur Radiol 2016; 26(7): 2148-54.

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy