Drug Guide

Generic Name

Iopamidol

Brand Names Isovue-m 200, Isovue-300, Isovue-370, Isovue-m 300, Isovue-128, Isovue-200, Isovue-250, Iopamidol-200 In Plastic Container, Iopamidol-250 In Plastic Container, Iopamidol-300 In Plastic Container, Iopamidol-370 In Plastic Container, Iopamidol-300, Iopamidol-250, Iopamidol-370, Iopamidol-200, Scanlux-300, Scanlux-370

Classification

Therapeutic: Imaging contrast agent

Pharmacological: Nonionic iodinated contrast media

FDA Approved Indications

Enhancement of diagnostic imaging (CT scans) of blood vessels and organs.

Mechanism of Action

Iopamidol enhances the contrast of structures or fluids within the body during imaging by increasing radiopacity due to the presence of iodine, which absorbs X-rays.

Dosage and Administration

Adult: Administer as per the specific imaging procedure, typically 50-150 mL for CT angiography or as ordered by the radiologist.

Pediatric: Dosage determined based on weight and age, usually 1-2 mL/kg, adjusted by the clinician.

Geriatric: Use with caution; reduce dose if necessary, considering renal function.

Renal Impairment: Adjust dose or consider alternative imaging in patients with impaired renal function.

Hepatic Impairment: No specific adjustment; use caution.

Pharmacokinetics

Absorption: Not absorbed systemically; administered intravenously.

Distribution: Distributes into blood plasma, extracellular fluid.

Metabolism: Not metabolized; largely unchanged.

Excretion: Primarily excreted unchanged in urine.

Half Life: Approximately 2 hours in patients with normal renal function.

Contraindications

Known allergy or hypersensitivity to iodinated contrast media.
History of allergic reactions to contrast media.

Precautions

Use with caution in patients with asthma, renal impairment, or thyroid disorders. Pre-medication may be necessary for hypersensitivity risk.

Adverse Reactions - Common

Warm sensation or feeling of flushing (frequent)
Nausea or vomiting (common)

Adverse Reactions - Serious

Anaphylactic reactions (rare)
Contrast-induced nephropathy (CIN) (rare, especially in patients with pre-existing kidney disease)

Drug-Drug Interactions

Other nephrotoxic drugs (e.g., NSAIDs, aminoglycosides) increase risk of renal impairment.
Metformin: Increased risk of lactic acidosis in the setting of contrast-induced nephropathy.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for allergies to contrast media, renal function, and thyroid function.

Diagnoses:

Risk for allergic reaction
Risk for impaired renal function

Implementation: Administer IV contrast as ordered; ensure emergency medications are available for hypersensitivity.

Evaluation: Monitor for adverse reactions, renal function, and effectiveness of imaging.

Patient/Family Teaching

Inform the patient about possible sensations during injection (warmth, flushing).
Report any symptoms of allergic reaction immediately.
Maintain adequate hydration before and after the procedure.

Special Considerations

Black Box Warnings:

Risk of serious allergic reactions, including anaphylaxis.
Risk of nephropathy; hydrate properly.

Genetic Factors: None established.

Lab Test Interference: May interfere with thyroid function tests due to iodine content.

Overdose Management

Signs/Symptoms: Excessive contrast administration may lead to nephrotoxicity, allergic reactions, or other adverse effects.

Treatment: Supportive care; hydration; in severe cases, antihistamines, corticosteroids, or emergency interventions for anaphylaxis may be required.

Storage and Handling

Storage: Store at room temperature (20-25°C), away from light and moisture.

Stability: Stable until the expiration date on the packaging.