Classification of the incidence of side effects: very often> 1/10; often from> 1/100 to <1/10; infrequently from> 1/1000 to <1/100; rarely from> 1/10000 to <1/1000; very rarely from <1/10000.
1. Common Adverse Reactions (applicable to all iodine-containing radiopaque substrates).
The following are the main possible side effects associated with the use of non-ionic monomers. Information on the side effects inherent in the methods of use is presented below.
The undesirable effects associated with the use of iodine-containing radiocontrast substances are usually mild and short-lived and occur less frequently when non-ionic than ionic radiopaque substances are used.
Serious reactions, as well as cases with a fatal outcome, are very rare.
Feelings of "heat in the whole body" or transient metalespresso "in the oral cavity.
Seldom can there be a feeling of discomfort or pain in the abdomen (<1: 1000); infrequently - gastrointestinal reactions in the form of nausea, vomiting and diarrhea (> 1: 1000 to <1: 100).
There are hypersensitivity reactions that usually manifest as mild breathing disorders (dyspnea, bronchospasm) or skin reactions such as rash, erythema,urticaria, itching; in some cases angioedema develops.
Allergic manifestations can occur either immediately after the administration of the drug, or several days later.
Often, severe skin reactions may occur in the form of Stevens-Johnson syndrome or toxic epidermal necrosis.
Severe manifestations of hypersensitivity reactions, such as laryngeal edema, pulmonary edema and anaphylactic shock are rare.
Anaphylactic reactions can occur regardless of the dose and mode of administration; a serious adverse reaction can begin with minor manifestations of hypersensitivity reactions. In this case, it is necessary to immediately stop the introduction of radiopaque and start, if necessary, appropriate therapy.
Vazovagal reactions may occur in the form of arterial hypotension and bradycardia.
Very rarely there may be an increase in temperature with the development of convulsive syndrome.
There have been cases of temporary loss of hearing or deafness after myelography, which, apparently, is associated with a decrease in the pressure of cerebrospinal fluid due to lumbar puncture.
Iodism, or "iodine pig" - a rare reaction to the introduction of iodine-containing radiocontrast agents, expressed in the increase and soreness of salivary glands lasting up to 10 days after the study.
There may be "tides" of blood to the face.
2. Adverse reactions associated with intravascular (intra-arterial and intravenous administration).
The nature of adverse reactions observed during intra-arterial administration of radiocontrast agents depends on the site of injection and dose. With selective angiography and other studies, when the radiopaque preparation enters the body under examination at a high concentration, there may be abnormalities in the functions of this organ.
Pain along the vessel or sensation of heat in peripheral angiography is very common (> 1:10).
Very often, there may be a transient increase in serum creatinine, but it usually has no clinical significance. However, patients from the high-risk group described severe manifestations, up to a lethal outcome.
Renal insufficiency develops very rarely.
When injected into the coronary, cerebral or renal arteries, an arterial spasm can develop that leads to transient ischemia in the organ being examined.
Neurological reactions are very rare and can manifest as seizures, transient disorders of sensitivity or motor function.
In some reports, the contrast agent can penetrate the blood-brain barrier, resulting in accumulation of the drug in the cerebral cortex, which allows visualization of brain tissue with CT. This phenomenon can persist throughout the day the next for research, sometimes accompanied by a transient disruption of orientation in space or cortical blindness.
Severe reactions from the cardiovascular system in the form of rhythm disturbances, reduction of myocardial contractility or ischemia myocardium are very rare.
There may be acute respiratory symptoms and signs (including dyspnea, bronchospasm, laryngospasm, noncardiogenic pulmonary edema), cough.
Thyrotoxicosis may develop. Patients at risk for thyrotoxicosis should be carefully examined before using iodinated radiocontrast.
At the injection site, local soreness and radicular pain can be felt.
Postphlebographic thrombophlebitis or thrombosis develop very rarely.
Single cases of arthralgia are described.
3. Adverse reactions associated with intrathecal administration.
Adverse reactions associated with the intrathecal administration of radiocontrast agents can be delayed, and occur within a few hours or even after the study. Their frequency approximately corresponds to the frequency of complications after lumbar punctures without the introduction of radiopaque substance.
Headache, nausea, vomiting or dizziness occur very often, and the cause of their development can be associated with a decrease in pressure in the subarachnoid space due to leakage of the cerebrospinal fluid through the puncture site. Some patients may experience a severe headache within a few days.
Often (with a frequency of <1:10, but> 1: 100), moderate local pain, paresthesia and radicular pain at the puncture site, convulsions and pain in the legs are noted.
In some cases, signs of irritation of the dura mater can be detected in the form of photophobia and meningism.
The development of meningitis to administer the drug is very rare.However, the possibility of infectious meningitis should also be considered.
Rarely there are manifestations of transient dysfunction of the central nervous system. They can be expressed at disorders of orientation, disorders of sensitivity, motor functions, convulsions. Some of these patients may experience changes in the electroencephalogram (EEG).
Short-term loss of vision.
There may be pain in the neck.
4. Adverse reactions with intracavitary injection.
General hypersensitivity reactions develop very rarely.
Endoscopic retrograde pancreatocholangiography:
There is often a slight increase in serum amylase activity. Rare cases of pancreatonecrosis are described.
Oral reception: there may be gastrointestinal disorders (diarrhea, nausea, vomiting, abdominal pain).
Hysterosalpingography (GHA): infrequent moderate and transient pain in the lower abdomen.
Arthrography: after the study, a feeling of pressure and pain at the injection site may occur. Arthritis to administer the drug is rare.There is a risk of developing infectious arthritis.
Gerniography: a mild pain reaction may occur after the study is completed.
The extravascular introduction of radiopaque preparations (extravasation) in rare cases can lead to the development of local pain and swelling, which usually pass without any consequences. Cases of inflammation and even tissue necrosis are described. As a routine therapeutic measures recommended cold and elevated position of the limb. In the case of development of compression symptoms, surgical decompression is recommended.