Ameliorating Effects of Calcium and Magnesium Ions on the Toxicity of Isopaque Sodium

The acute intravenous toxicity (i.v. LD 50 ) of solutions of the ratio 1.5 contrast media metrizoate or diatrizoate and the ratio 3.0 contrast medium metrizamide was determined in mice with and without the addition oflocal anesthetics to the solutions. The two local anesthetics mepivacaine or lidocaine were added to final concentrations up to 2.0 mg/ml of the contrast medium solutions. This corresponds to clinically used concentrations. All additions of local anesthetics to the solutions increased the mortalities caused by the contrast medium solutions. Addition of local anesthetics to a final concentration of 2 mg/ml approximately doubled the acute intravenous toxicity of the contrast media. The ratio 3 contrast media produce less hypertonic solutions than the ratio 1.5 contrast media and should be preferred for angiography because they cause less pain and do not require the addition of local anesthetics which increase the acute toxicity of the solutions.

“…The observed LD so values for the original solutions of metrizoate, diatrizoate and lidocaine without additive correspond well to those in the literature (2,3,5,13,21).…”

Section: Discussionsupporting

confidence: 88%

Addition of Local Anesthetics to Contrast Media

Nilsson¹,

Almén²,

Golman³

et al. 1988

“…Sodium/meglumine diatrizoate (Urografin) showed a constantly higher toxicity than meglumine metrizoate (Isopaque cerebral). This may be explained by the presence of calcium in the meglumine metrizoate solution (20).…”

Section: Discussionmentioning

confidence: 99%

“…Sodium/meglumine diatrizoate has sodium EDTA as the chelating agent. Calcium has a membrane stabilizing effect; this is probably one reason for the less toxic effect of the metrizoate contrast medium formulation (20,21). Calcium has also been shown to reduce toxic effects of ioxaglate and diatrizoate in coronary arteriography (24,25).…”

Section: Discussionmentioning

confidence: 99%

Cytotoxic Effects of Six Angiographic Contrast Media on Human Endothelium in Culture

Lærum¹

1987

Human endothelial cells in cultures derived from the veins of fresh umbilical cords were incubated for 24 hours with angiographic contrast media added to the cell culture medium. The cells were preincubated with Na2e'Cr)04 for subsequent 5'Cr-release test. Four different concentrations of the contrast media were used. Cell toxicity as judged by measuring the release of 51Cr was, in decreasing order, as follows: Sodium/meglumine diatrizoate, meglumine metrizoate, ioxaglate, iopamidol, metrizamide, iohexol. The highest concentration of sodium/meglumine diatrizoate (Urografin) led to 99 per cent cell death after 24 hours, while the same concentration of iohexol (Omnipaque) induced about 40 per cent cell lysis. The assay system with human endothelial cells thus seems to be useful for evaluation of the toxicity of contrast media. The osmolality was measured in all the solutions. Hyperosmolality accounted for a major part of the cell toxicity, but additional toxic effects of the substances were observed. The strongest osmolality-independent toxic effect was caused by ioxaglate.

“…In addition to the influence of the contrast medium molecule the sodium ion, at least at higher concentrations, also causes a negative inotropic effect on the myocardium (\2, 14,29). To counteract some of the negative inotropic effect from the comparatively large amount of sodium in the ionic contrast media, they may be enriched with calcium (26,32).…”

Section: Discussionmentioning

confidence: 99%

Effect of Sodium Addition to Non-Ionic Contrast Media on Cardiac Contractile Force

Bååth¹,

Almén²,

Øksendal³

1990

Cardiac contractile force after adding NaCI to the non-ionic contrast media iohexol and iopentol was investigated in the isolated rabbit heart. Iodine concentrations of 150, 300 and 350 mg Ilml were used with sodium concentrations ranging from 0 to 154 mmol/l, From physiologic experiences of nutrient solutions it should follow that a sodium-free solution of a non-ionic contrast medium, which also has the lowest hypertonicity, should cause the smallest decrease in contractile force. However, a small amount of sodium added to the contrast medium solutions, in the range of 19.25 to 38.5 mmol/l, caused the least decrease in contractile force. The decrease in contractile force was significantly more pronounced when no sodium was added or when larger amounts of sodium were added. A small amount of sodium also decreases the risk of ventricular fibrillation. Thus there is a possibility that addition of sodium could reduce the adverse effects of cardioangiography.