Emergency administration of radiocontrast media in high-risk patients

Paul A. Greenberger*, J. Michael Halwig, Roy Patterson, Carl B. Wallemark

*Corresponding author for this work

Research output: Contribution to journalArticle

67 Scopus citations

Abstract

Patients with previous anaphylactoid reactions to radiographic contrast media (RCM) are at increased risk for subsequent reactions on repeat exposure. The most efficacious pretreatment regimens require administration of medications up to 13 hours before the anticipated procedure. Emergency administration of RCM in patients requiring essential procedures precludes prolonged pretreatment. We report results of pretreatment in nine patients requiring emergency administration of RCM. We recommend hydrocortisone, 200 mg intravenously, immediately, and every 4 hours until the procedure is completed, and diphenhydramine, 50 mg intravenously, 1 hour before the procedure. No reactions occurred in these patients, suggesting that this pretreatment regimen may be valuable in prophylaxis for patients requiring emergency administration of RCM who have experienced previous anaphylactoid reactions. Although used in only one additional patient, ephedrine, 25 mg orally, 1 hour before the procedure may also be valuable.

Original languageEnglish (US)
Pages (from-to)630-634
Number of pages5
JournalThe Journal of allergy and clinical immunology
Volume77
Issue number4
DOIs
StatePublished - Apr 1986

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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