Home Drug Guide Diatrizoate meglumine and diatrizoate sodium

Drug Guide

Generic Name

Diatrizoate meglumine and diatrizoate sodium

Brand Names Renografin-76, Renografin-60, Renovist II, Renovist, Hypaque-M 90%, Hypaque-M 75%, Gastrografin, Md-76r, Hypaque-76, Md-76, Md-60, Md-Gastroview, Angiovist 370, Angiovist 292, Gastrovist, Diatrizoate-60, Renocal-76

Classification

Therapeutic: Diagnostic radiocontrast agent

Pharmacological: Iodinated contrast media

FDA Approved Indications

X-ray and CT imaging of the gastrointestinal tract, urinary tract, blood vessels, and other diagnostic procedures where iodine contrast enhancement is necessary

Mechanism of Action

Increases radiopacity of bodily structures by blocking X-rays, allowing detailed imaging. It contains iodine, which absorbs X-ray photons, enhancing contrast on radiologic images.

Dosage and Administration

Adult: Dose varies depending on the procedure, typically 30-100 mL via IV or oral routes; consult specific protocols.

Pediatric: Doses are weight and age-dependent; consult pediatric dosing guidelines.

Geriatric: Use with caution; start with lower doses due to risk of renal impairment.

Renal Impairment: Adjust doses and ensure adequate hydration; avoid in severe impairment.

Hepatic Impairment: No specific adjustments generally needed.

Pharmacokinetics

Absorption: Minimal systemic absorption when used intra-luminally; rapid absorption when administered intravenously.

Distribution: Distributes in blood and tissues subject to extracellular fluid volume.

Metabolism: Not metabolized; excreted unchanged.

Excretion: Primarily via kidneys in urine.

Half Life: Approximately 2 hours, but varies with renal function.

Contraindications

Known hypersensitivity to iodine or contrast media.
Thyroid dysfunction.

Precautions

Use with caution in patients with asthma, renal impairment, or dehydration. Pre-procedure hydration recommended. Monitor thyroid function in susceptible patients.

Adverse Reactions - Common

Taste disturbance, nausea, vomiting (Common)
Warm sensation during injection (Common)

Adverse Reactions - Serious

Anaphylactic shock (Rare)
Nephrotoxicity (Uncommon in high doses or in renal impairment)
Thyroid dysfunction, including hypothyroidism or hyperthyroidism (Rare)

Drug-Drug Interactions

Medications that are nephrotoxic (e.g., aminoglycosides, NSAIDs)
Medications affecting thyroid function

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for allergies, renal function, thyroid status, and hydration.

Diagnoses:

Risk for renal impairment
Allergy risk

Implementation: Ensure proper hydration, monitor vital signs and renal function post-procedure, and observe for adverse reactions.

Evaluation: Monitor for adverse reactions, renal function, and patient's response to imaging.

Patient/Family Teaching

Inform about possible warm sensation or taste changes during administration.
Report any allergic reactions, chest pain, difficulty breathing.
Maintain hydration before and after the procedure.

Special Considerations

Black Box Warnings:

Risk of allergic reactions including anaphylaxis.

Genetic Factors: Thyroid disease may influence response.

Lab Test Interference: Can cause interference with thyroid function tests.

Overdose Management

Signs/Symptoms: Signs of overdose may include significant renal impairment, allergy, or adverse cardiovascular effects.

Treatment: Manage symptoms supportively; ensure hydration; provide emergency treatment for allergic reactions.

Storage and Handling

Storage: Store at room temperature, protect from light.

Stability: Stable under recommended storage conditions.