Adverse reactions are common in patients who receive radiographic contrast media (RCM) for diagnostic procedures. The agents used are iodinated, aromatic compounds that are administered as a salt with varying amounts of sodium or methylglucamine. The incidence of such adverse reactions, according to various sources in the literature,1-4 varies from 5% to 8%. These adverse reactions are anaphylactoid in l-2%.3-6 The incidence of fatality appears to be about 1:40,000,7 although various studies have reported mortality rates as high as 1:10,0001 and as low as 1:116,000.8 Types of adverse reactions to RCM vary and the etiologies are unclear; thus, the approaches to prevention and treatment require an understanding of the diversity. It is useful to classify adverse RCM reactions into one of four types-chemotoxic, hemodynamic, vagal, or anaphylactoid-each of which has different clinical manifestations. Very importantly, the underlying physiology and the appropriate therapeutic and preventive interventions also vary. Anaphylactoid reactions are the most serious adverse RCM reactions.
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