Pharmacology & Treatment Protocols Flashcards

According to ACR guidance, metformin should be held after iodinated contrast in patients with:

Answer: eGFR below 30 or acute kidney injury

Reduced renal function raises the risk of contrast nephropathy and metformin-associated lactic acidosis.

Premedication to prevent a repeat contrast reaction typically includes:

Answer: A corticosteroid plus an antihistamine

Steroid and antihistamine regimens reduce breakthrough reactions in patients with prior moderate or severe reactions.

What is the first-line drug for contrast-induced anaphylaxis in an adult?

Answer: Intramuscular epinephrine

IM epinephrine (0.3-0.5 mg of 1 mg/mL) is the immediate treatment for anaphylaxis.

Nephrogenic systemic fibrosis is a concern with which type of agent?

Answer: Certain gadolinium-based MRI contrast agents in severe renal impairment

Less stable linear gadolinium agents in patients with severe kidney disease are linked to NSF.

Palifermin (keratinocyte growth factor) is used to:

Answer: Reduce oral mucositis in patients receiving TBI-based conditioning

Palifermin stimulates epithelial cell growth to lessen severe mucositis in hematologic malignancy patients receiving myeloablative therapy.

Barium sulfate is contraindicated when which condition is suspected?

Answer: Gastrointestinal perforation

Barium leaking into the peritoneum or mediastinum causes severe inflammation, so water-soluble contrast is used instead.

Which medication is appropriate for mild urticaria after contrast injection?

Answer: Diphenhydramine

Antihistamines such as diphenhydramine treat mild, self-limited urticarial reactions.