In all cases, you must be prepared, if necessary, to provide emergency relief to the patient.
In the event of hypersensitivity reactions the introduction of a contrast agent should be discontinued immediately and, if necessary, start the appropriate therapy, preferably intravenously.Therefore, intravenous contrast agent is advisable to use a flexible catheter. That in case of emergency to be able to take emergency measures, it is necessary to have ready the appropriate drugs, endotracheal tube and a device for mechanical ventilation. Note that patients taking beta-blockers may be resistant to treatment with drugs hypersensitivity reactions having beta-agonist activity. Care should be taken when using iodine-containing contrast agents in patients receiving beta-blockers.
During the premedication is recommended to use phenyl propionate steroids.
- Disorders of the thyroid gland
Especially carefully weigh the risk / benefit ratio should be in patients with established or suspected hyperthyroidism or goitre, as iodinated contrast agents can cause them to hyperthyroidism or thyrotoxic crisis. the need for the evaluation function should be considered thyroid to Ultravist administration and / or appoint a preventive measure thyrostatic therapy in patients with established or suspected hyperthyroidism.
Vascular pathology and neurological disorders commonly found in elderly people, increase the risk of adverse reactions to iodinated contrast media.
- the patient’s serious condition
The need for research should be carefully phenyl propionate evaluated in patients with severe general condition.
- kidney damage
All patients administered with Ultravist should ensure adequate hydration before administration of the contrast agent, preferably by intravascular infusion before and after the procedure, while contrast agent will be displayed by the kidneys.
Before removing the contrast agent by the kidneys is necessary to exclude the additional strain on the kidneys in the form of nephrotoxic drugs, oral holetsistograficheskih funds, arterial blood flow restriction in the kidney, renal artery angioplasty, major surgery etc.
It is necessary to postpone the introduction of a new study of the contrast agent to the recovery of renal function to baseline.
Patients on dialysis administered contrast agents are excreted in the process of dialysis.
- CNS Diseases
The presence of intracranial tumors or metastases, as well as epilepsy, may increase the frequency of occurrence of convulsive episodes after injection of contrast agents. Neurological complications occur more frequently during cerebral angiography or similar studies.
Care must be taken during the study in patients with alcoholism and drug addiction in connection with the possibility of lowering the seizure threshold.
One of the properties of non-ionic contrast agents is their extremely low impact on normal physiological functions. That is why non-ionic contrast agents have less anticoagulant activity in vitro, than ionic. A number of factors, in addition to the properties of the contrast agent, such as the duration of the study, the number of injections, catheter and syringe properties, the state of the disease and treatment, it can affect the development of thromboembolic complications. Therefore, during the catheterization of the vessel must take into account these factors and to focus on the implementation of angiography techniques, and wash the catheter with saline (if necessary with the addition of heparin) and minimize the timing of the procedure, to minimize the risk of thrombosis and embolism.
The use of plastic syringes in place of glass can reduce, but not eliminate the likelihood of in vitro clotting of blood.
Care should be taken in the study of patients with homocystinuria because of the risk of thrombosis and embolism.
- Introduction under the lining of the brain
Most adverse reactions after myelography develops within a few hours after the administration of contrast agent. During this period, should be monitored for the patient’s condition. Patients with epilepsy or a history of receiving anticonvulsant therapy should continue treatment with appropriate drugs during the study with the introduction of a contrast agent under the lining of the brain.
Care should be taken in the study of patients with alcoholism and phenyl propionate drug addiction in connection with the possibility of lowering the seizure threshold.
The more the patient moves or straining your muscles after injection of contrast medium, the more likely it is mixed with body fluids other areas not related to the surveyed area. As a result, contrast density decreases faster than usual.
To eliminate the discomfort caused by the loss of cerebrospinal fluid, the patient should rest for about 18 hours. During this period, should ensure the possibility of adverse reactions. Patients with reduced threshold for seizure activity should be under particularly close supervision for a few hours.
in protected from light , at a temperature no higher than 30 ° C. Keep out of the reach of children.
Ultravist Injection 240 mg iodine / ml: In 10 or 50 mL vials of neutral glass , sealed with rubber stoppers phenyl propionate, rolled aluminum caps and plastic lids closed. 10 vials with the instruction on use is placed in a cardboard box.