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Contrast Media Administration & Adverse Reaction Management Flashcards

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  1. Which type of contrast media is preferred for cardiac catheterization due to its lower risk of adverse hemodynamic effects?

    Answer: Low-osmolar non-ionic contrast media

    Low-osmolar non-ionic contrast media is preferred because it produces fewer hemodynamic disturbances and cardiac side effects compared to high-osmolar ionic agents.

  2. Which iodinated contrast agent is classified as iso-osmolar, with osmolality approximating that of blood?

    Answer: Iodixanol (Visipaque)

    Iodixanol (Visipaque) is the primary iso-osmolar contrast agent (~290 mOsm/kg), matching blood osmolality and reducing osmotic stress on vessels and kidneys.

  3. What iodine concentration range is typically used in contrast agents for coronary angiography?

    Answer: 300–370 mg I/mL

    Coronary angiography requires contrast media with iodine concentrations of 300–370 mg I/mL to achieve adequate vessel opacification at the flow rates used.

  4. What is the primary mechanism by which contrast media causes contrast-induced nephropathy (CIN)?

    Answer: Direct tubular toxicity combined with renal medullary vasoconstriction

    CIN results from direct cytotoxic effects on renal tubular epithelial cells combined with vasoconstriction of the renal medullary vessels, causing ischemia.

  5. Which pre-procedure intervention has the MOST consistent evidence for reducing contrast-induced nephropathy risk?

    Answer: Intravenous normal saline hydration

    IV hydration with isotonic normal saline before and after contrast administration is the most consistently evidence-supported strategy for preventing CIN by maintaining renal perfusion.

  6. What is the most common hemodynamic side effect observed with intracoronary contrast injection?

    Answer: Transient bradycardia and hypotension

    Transient bradycardia and hypotension are the most common side effects of intracoronary contrast injection due to the direct depressant effects of contrast on myocardial conduction and contractility.

  7. Which property of contrast media MOST directly contributes to prolonged QT interval on ECG during coronary injections?

    Answer: High osmolality and ionicity

    High osmolality and ionicity of contrast media are associated with greater QT prolongation due to their effects on myocardial electrolyte balance and membrane potential.