Managing Adverse Reactions to Contrast Agents

Magn Reson Imaging Clin N Am. 2017 Nov;25(4):737-742. doi: 10.1016/j.mric.2017.06.008.

Abstract

Adverse reactions to iodinated and gadolinium-based contrast agents occur at an incidence of less than 1%. Although the exact pathophysiologic mechanisms are not completely understood, the treatment regimens are well accepted. Skin testing may be helpful in patients with a history of severe allergiclike reaction to aid in the selection of alternative contrast agents. Premedication should only be used for a history of allergiclike reaction. Imaging team members should be familiar with signs and symptoms of contrast reactions to allow for prompt assessment and treatment. A plan of action should be in place for contrast reactions and rehearsed regularly.

Keywords: Adverse; Allergic; Anaphylactoid; Contrast; Gadolinium; Iodinated; Reaction.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Contrast Media / adverse effects*
  • Diuretics / therapeutic use
  • Drug Hypersensitivity / etiology
  • Drug Hypersensitivity / therapy*
  • Fluid Therapy / methods
  • Histamine Antagonists / therapeutic use
  • Humans
  • Hypertension / chemically induced
  • Hypertension / therapy*
  • Nitroglycerin / therapeutic use
  • Oxygen Inhalation Therapy / methods
  • Pulmonary Edema / chemically induced
  • Pulmonary Edema / therapy*
  • Risk Factors
  • Syncope, Vasovagal / chemically induced
  • Syncope, Vasovagal / therapy*
  • Vasodilator Agents / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Antihypertensive Agents
  • Contrast Media
  • Diuretics
  • Histamine Antagonists
  • Vasodilator Agents
  • Nitroglycerin