Thursday, September 8, 2011

Radio-imaging contrast- allergy and nephropathy

steroid prophylaxis for patients at risk of contrast reactions:

PO pred 30mg 12 hrs and 2 hrs before

if urgent: as soon as scan confirmed : IV hydrocortisone 200mg
IV benadryl 50mg (slow bolus or IM or PO)- not faster than 25mg/min

contrast nephropathy : PO acetylcysteine: bioavailability of glutathione higher. STart 600mg BD on day before until day after scan.
If scan decided stat: IV acetylcysteine
bolus 150mg/kg in 500ml NS 30-60min before scan then 50mg/kg in 500ml over 4hours after scan

IV risk of hypersensitivity

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