Mechanism of effect
Diatrizoate is an iodine-containing X-ray contrast agent. Iodated contrast agents were among the first contrast agents developed. Iodine is known to be particular electron-dense and to effectively scatter or stop X-rays. A good contrast agent requires a high density of electron-dense atoms. Therefore, the more iodine, the more "dense" the x-ray effect. Iodine based contrast media are water soluble and harmless to the body.
Pharmacodynamic
Diatrizoate is the most commonly used water-soluble, iodinated, radiopaque x-ray contrast medium. Radiopaque agents are drugs used to help diagnose certain medical problems. They contain iodine, which blocks x-rays. Depending on how the radiopaque agent is given, it localizes or builds up in certain areas of the body.
The resulting high level of iodine allows the x-rays to make a "picture" of the area. The areas of the body in which the radiopaque agent localizes will appear white on the x-ray film. This creates the needed distinction, or contrast, between one organ and other tissues. The contrast will help the doctor see any special conditions that may exist in that organ or part of the body.Pharmacokinetics
Absorption : Not Available
Protein binding : Not Available
Metabolism : Not Available
Route of elimination
It is not metabolized but excreted unchanged in the urine.
Half life
Not Available
Toxicity
High osmolal radiocontrast agents like diatrizoate are cytotoxic to renal cells. The toxic effects include apoptosis, cellular energy failure, disruption of calcium homeostasis, and disturbance of tubular cell polarity, and are thought to be linked to oxidative stress.treatment.
Dosage
· Radiographic Examination of Segments of the Gastrointestinal Tract
- Oral Administration:Adult oral dosage may range from 30 to 90 mL (11 to 33 g iodine), depending on the nature of the examination and the size of the patient. For infants and children less than 5 years of age, 30 mL (11 g iodine) are usually adequate; for children 5 to 10 years of age, the suggested dose is 60 mL (22 g iodine). These pediatric doses may be diluted 1:1, if desired, with water, carbonated beverage, milk, or mineral oil. When used in infants, the solution may be given in a nursing bottle. Pediatric doses may also be used in dehydrated and/or debilitated adult patients. A 1:1 dilution is also recommended when the contrast medium is used in elderly cachectic individuals.
- For very young (under 10 kg) and debilitated childrenthe dose should be diluted: 1 part MD-Gastroview (Diatrizoate Meglumine and Diatrizoate Sodium Solution) in 3 parts water is recommended.
- For Enemas or Enterostomy Instillations:the drug should be diluted
- When used as an enema, the suggested dilution for adults is 240 mL (88 g iodine) in 1,000 mL of tap water. For children under 5 years of age, a 1:5 dilution in tap water is suggested; for children over 5 years of age, 90 mL (33 g iodine) in 500 mL of tap water is a suitable dilution.
· Tomography (Body Imaging)
A usual adult dose is 240 mL of a dilute MD-Gastroview solution prepared by diluting 25 mL (9.17 g iodine) to one liter with tap water. Less dilute solutions [up to 77 mL (28.26 g iodine) diluted to one liter with tap water] may be used when indicated. The dose is administered orally about 15 to 30 minutes prior to imaging in order to permit the contrast medium to reach the pelvic loops.Drug contraindications
MyelographyInteractions
AldesleukinAlerts
- Aspiration may occur following oral administration that may result in serious complications
- Personal or family history of bronchial asthma, significant allergies, or previous reactions to contrast agents
- Iodine sensitivity
- May cause hypovolemia and hypotension due to fluid loss from hypertonic oral/rectal contrast solutions
Points of recommendation
In addition to the general warnings previously described, the inherent risks of angi ocardiography in cyanotic infants and patients with chronic pulmonary emphysema must be weighed against the necessity for performing this procedure. In pediatric angiocardiography, a dose of 10 to 20 mL may be particularly hazardous in infants weighing less than 7 kg. This risk is probably significantly increased if these infants have pre-existing right heart “strain”, right heart failure, and effectively decreased or obliterated pulmonary vascular beds.
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