What Is Iodoquinol?

This product is mainly used for various angiographic radiography examinations, including: cerebral angiography, peripheral angiography, splanchnic arteries, renal arteries and aorta angiography, and cardiovascular angiography includes coronary angiography, arterial and venous digital subtraction angiography Wait. Intravenous urography and enhanced CT (including head and body CT).

Chinese name: Ioversol
English name: Ioversol

Chemical formula: C18H24I3N3O9
Molecular weight: 807.116

Ioversol drug name

Ioversol

Ioversol drug alias

Ansura, Ansura 320, Iowsol, Ioversolum, MP-328, Optiray

Ioversol molecular formula

Chemical name: N, N 'bis (2,3-dihydroxypropyl) -5-[(hydroxyacetyl) (2-hydroxyethyl) amino] -2,4,6-triiodo-1,3- Phthalamide. Molecular formula: C18H24I3N3O9. Molecular weight: 807.116. Properties: Ioversol is an odorless, fine white amorphous powder. Its aqueous solution is transparent, colorless or light yellow, and does not crystallize at room temperature. The pH is 6.0-7.4.

Ioversol preparation specifications

Injection: iodophorol 160 Iodine content 1mL: 160mgI iodophorol 240 Iodine content 1mL: 240mgI iodophorol 300 Iodine content 1mL: 300mgI iodophorol 320 Iodine content 1mL: 320mgI iodophorol 350 Iodine content 1mL : 350 mgI.

Ioversol pharmacology and toxicology

This product is a new type of triiodine-containing hypotonic non-ionic contrast agent. After intravascular injection, due to the high iodine content, the X-rays are attenuated, and the blood vessels passing through can be clearly seen until after dilution.

Ioversol pharmacokinetics

drug After rapid intravenous injection, the iodine concentration in the blood immediately rises to a peak, and decreases rapidly within 5-10 minutes. The half-life in the blood vessel is about 20 minutes. Plasma concentrations dropped sharply. 20 minutes after the intravenous injection, it reached equilibrium with the extracellular space, and then the concentration decreased exponentially. The contrast enhancement of normal and abnormal tissues is maximized 15-120 seconds after intravenous bolus injection of contrast agent, so a dynamic CT scan performed within 30-90 seconds after injection can enhance the enhancement effect and diagnostic efficiency. This is especially useful during inspections. After intravenous injection of ioversol in normal people, its clearance pharmacokinetics showed a two-compartment model (fast alpha phase of drug distribution and slow beta phase of drug discharge). According to the analysis of blood clearance curves of 12 volunteers (6 people Receiving 50mL of irradiance 320, 6 people receiving 150mL of ioversol 320), the biological half-life was 1.5 hours in the above two dose curves. Excretion rate is independent of dose. After intravascular injection, ioversol is mainly excreted through the kidneys. In the case of normal renal function, the average half-life of urinary excretion through injection of 50 mL of ioversol is 118 minutes (105-156 minutes); if the injection of 150 mL is 105 minutes (74-141 minutes). Within 24 hours of starting the injection, more than 95% of the injected dose was discharged. The drug concentration in urine peaked at 2 hours after injection. Very little is excreted through the stool. Ioversol does not bind to plasma proteins and does not undergo metabolism. Ioversol may pass through the placental barrier in a purely diffusive manner, and excretion through milk is unknown.

Ioversol adverse reactions

Ioversol has 6 hydroxyl groups and is evenly distributed on the side chain, and has no hydrophobic fat-soluble methyl group, so it is more superior in molecular structure than other contrast agents. Adverse effects caused by contrast agents include headache, nausea, vomiting, urticaria, chest tightness, heat sensation, pain, etc., which are generally less and most of them are mild. However, like other iodine contrast agents, serious reactions such as bronchospasm and allergy shock.

Ioversol dosage

Angiography: The following doses can be repeated, the total dose generally does not exceed 200-250mL. China Medical Health Network

Cerebral angiography: It shows that the carotid or vertebral arteries require 2-12mL, which can be re-injected. Both ioversol 240 and ammonium 320 can be used.

Aortic angiography: Use ioversol 320, 60mL each time.

Total femoral artery: 40 mL each time.

Subclavian artery brachial artery: 20mL each time.

Celiac artery: 45mL each time.

Mesenteric artery: 45mL each time.

Renal artery: 9 mL each time.

Coronary artery and left ventricular angiography: Use ioversol 320, 8 mL of left coronary artery; 6 mL of right coronary artery; 40 mL of left ventricular angiography.

Arterial Digital Subtraction Angiography (IA-DSA)

The amount of IA-DSA should be less than 50% of the conventional dose, depending on the injection site. The general dose is: 6-10mL of carotid artery; 4-8mL of vertebral artery; 25-50mL of aorta; 2-10mL of subclavian artery; 2-20mL of main branch of abdominal aorta, if necessary, it can be injected repeatedly, and the total dose should not exceed 200- 250mL.

CT enhanced scan

Head CT: The general dose is ioversol 320, 50-150mL or ioversol 240, 100-250mL, which can be scanned immediately after the injection.

CT of corpus callosum: 25-75mL of iodophorol in 320 groups, infusion of 50-150mL or 35-100mL of iodophorol in 240 groups, and 70-200mL.

Digital Subtraction Angiography (IV-DSA)

According to the examination site, each injection dose is usually 30-50mL, and the injection can be repeated, and the total dose does not exceed 200-250mL.

Intravenous urography

Use 50-75mL of ioversol 320 or 75-100mL of ioversol 240.

Pediatric angiography

The prerequisites for this inspection are professional participation, ECG monitoring equipment, and immediate resuscitation and heart rate conversion conditions. With ioversol 320, the general single injection dose is 1.25mL (range 1-1.5mL) / kg. For multiple injections, the total amount should not exceed 5 mL / kg.

CT enhanced scan of children

Head CT: 1 mL (1-3 mL) / kg of ioversol 320 is generally used. Scanning can be performed immediately after injection.

Carcass CT: 1 mL (1-3 mL) / kg with ioversol 320.

Digital Subtraction Angiography in Children (IV-DSA)

Use ioversol 320 1-1.5mL / kg each time, the total dose does not exceed 3mL / kg.

Instructions for taking ioversol

Overdose should be treated symptomatically immediately. The product does not bind to plasma, so it can be removed by dialysis.

Do not use if the product is frozen or crystallized.

If corticosteroids are used as preventive drugs, contrast agents and corticosteroids are contraindicated chemically, so they cannot be mixed in a syringe.

This product is a non-ionic contrast agent, which has a weaker effect on inhibiting blood clotting than ionic type. However, when performing angiography, attention should be paid to the operation steps, length of time, number of injections, catheter and syringe materials, and minimize blood Contact time with syringe and catheter to prevent possible clotting.

Keep enough water in the patient's body before imaging.

In case of severe side effects, in addition to symptomatic treatment, anti-allergic drugs, epinephrine and oxygen inhalation are given. Tracheal intubation can be given when bronchospasm causes dyspnea. Usually, you should agree with the emergency department, and take part in the rescue at any time. Preventive medication (dexamethasone) is also helpful in high-risk patients.

Ioversol notes

When a patient has a history of iodine allergy, caution is required when injecting the product, although it is not a contraindication. Elderly or young children with high risk factors, bronchial asthma, heart or liver and kidney dysfunction, hyperthyroidism, etc., or patients with serum creatinine exceeding 3mg / dL with caution.

Patients should be observed for 1 hour after the angiography, due to occasional delayed reactions. The arteries injected by peripheral arteriography must be pulsating. For occlusive thrombotic vasculitis or severe ischemic disease with upward spread infection, angiography should be extremely cautious. Aortic angiography may cause damage to adjacent organs, pleural rupture, and kidney damage. The use of lumbar techniques may lead to retroperitoneal hemorrhage, spinal cord injury, and transverse spinal cord inflammation. Coronary angiography should monitor the electrocardiogram and vital signs. In patients with thrombosis, phlebitis, severe ischemia, local infection, or complete blockage of the venous system, it is recommended to perform fluoroscopy to prevent the contrast medium from overflowing the blood vessels during injection.