What Is Barium Sulfate?

Barium sulfate, this product is a dual X-ray contrast agent. It is a high-density gastrointestinal contrast agent, which can be made into suspensions of different proportions and used alone, but it is usually used together with low-density gas to achieve the purpose of double contrast. Commonly used in gastrointestinal angiography. According to domestic users, uneven thickness barium sulfate is better than fine and uniform barium sulfate. Be cautiously used for intestinal fistula formation and certain intestinal diseases that are prone to perforation, such as appendicitis, diverticulum, ulcerative enteritis, parasitic infections, etc.

Drug type: Essential medicines
Drug name: Barium sulfate

English name: Barium Sulfate
Chinese alias: Berip
English alias: Barium Sulphate

Brief introduction of barium sulfate compounds

Basic information of barium sulfate

Chinese name: barium sulfate

Chinese alias: barite; natural barium sulfate

English name: Barite

English alias: Barium sulfate, natural; Barium sulphate; Einecs 236-664-5;

CAS number: 13462-86-7

Molecular formula: BaSO ₄

Molecular weight: 233.39000

Exact mass: 233.85700

PSA: 88.64000

Physical and chemical properties of barium sulfate

Properties: Odorless, tasteless powder. Soluble in hot concentrated sulfuric acid, almost insoluble in water, dilute acid and alcohol. The aqueous suspension was neutral to litmus paper.

Density: 4.25-4.5

Melting point: 1580ºC

Boiling point: 330ºC at 760 mmHg

Decomposition temperature:> 1600

Barium sulfate safety information

Customs code: 2833270000 ^[1]

Barium sulfate pharmacopoeia standard

Barium sulfate (type I)

[Identification] Take about 0.3g of this product, add 10ml of sodium carbonate test solution, boil and filter; add hydrochloric acid to the filtrate to make it acidic, and identify the sulfate (Appendix III); wash the residue with water and add dilute acetic acid It was dissolved, filtered, and the filtrate showed a differential reaction of barium salts (Appendix III).

[Inspection] Take 5.0g of the product for looseness and place it in a 50ml measuring cylinder with a stopper (the distance from the bottom of the tube to the highest scale should be 11 stoppers, shake vigorously for 1 minute to evenly suspend the powder, let stand for 15 minutes, mix The top surface of the suspension must not drop below the mark of 18ml. Take 1.0g of this product, add 20ml of water, keep stirring in a water bath for 5 minutes, filter, the filtrate is divided into two equal parts: one bromothymol blue 1 drop of indicator liquid, not blue; another drop of bromocresol green indicator liquid, should be blue. Dissolve 10.0g of the product in acid, put in beaker, add 10ml dilute hydrochloric acid and 90ml water , Boil for 10 minutes, add water to make up the evaporated water, let it cool, and filter it with filter paper washed with hydrochloric acid solution (1 40). If the initial filtrate is turbid, repeat the filtration. Take 50ml of clear filtrate and place on a water bath. Evaporate to dryness, add 2 drops of hydrochloric acid and 10 ml of hot water, stir, filter with filter paper washed with hydrochloric acid solution (1 40), wash the filter residue with 10 ml of hot water, combine the washing solution and the filtrate, and set the constant weight at 105 ° C In an evaporating dish, evaporate to dryness on a water bath and dry to constant weight at 105 ° C. The residual residue should not exceed 15mg (0.3%). Acid solubility Take the remaining residue under the dissolved matter in the salt, add 10ml of water and stir, filter with filter paper washed with hydrochloric acid solution (1 40), add 0.5ml of dilute sulfuric acid to the filtrate, and let it stand for 30 minutes without turbidity. Vulcanization Take about 10.0g of this product and check it according to law (Appendix C). The lead acetate test paper must not change color. Dry this weight and take this product at 105 ° C to constant weight. The weight loss should not exceed 1.0% (Appendix L). Heavy metals Take 4.0g of this product, add 4ml of acetate buffer solution (pH3.5) and water to 50ml. After boiling for 10 minutes, let cool, add water to 50ml, filter, take the filtrate 25ml, check according to law (Appendix ) H first method), containing no more than ten parts per million of heavy metals. Take 2.0g of arsenic salt, add 23ml of water and 5ml of hydrochloric acid, check according to law (Appendix J first method), should meet the requirements (0.0001%).

[Content determination] Precisely weigh about 0.6g of this product, put it in a platinum crucible, add 10g of anhydrous sodium carbonate, mix well, burn to melt, continue heating for 30 minutes, let cool, put the crucible in a 400ml beaker, Add 250 ml of water, stir with a glass rod, and heat until the melt elutes from the crucible. Remove the crucible from the beaker and wash it with water. The washing solution is placed in the beaker. The inside of the crucible is rinsed with 2ml of 6mol / L acetic acid solution, and then rinsed with water. The washing solution is combined in the beaker. Heat and stir until the melt disintegrates, cool in a beaker in an ice bath, and let stand until the precipitate is hard and the upper liquid is clear. Pour off the supernatant, filter, and carefully transfer the fine precipitate to filter paper. Use cold sodium carbonate ( 1 50) Rinse the contents of the beaker twice, about 10ml each time. Stir, as above, continue to pass the supernatant through the same filter paper, filter, carefully transfer the fine precipitate to the filter paper, and then hold the large pieces. Place the beaker of barium carbonate precipitation under the funnel, wash the filter paper 5 times with 3 mol / L hydrochloric acid solution, 1 ml each time, and then wash with water (Note: the solution may be slightly turbid). Add 100ml of water, 5ml of hydrochloric acid, 10ml of acetic acid hinge solution (2 5), 25ml of potassium dichromate solution (1 10) and 10g of urea, cover with a watch glass, and heat for 16 hours while drying to constant weight. Filter through the crucible, transfer all the precipitates, wash the precipitates with potassium dichromate solution (1 200), and finally wash with about 20 ml of water, dry at 105 ° C for 2 hours, let cool, weigh, and weigh the resulting precipitate by 0.9213 Is the weight of barium sulfate.

[Category] Diagnostic drugs.

[Storage] Keep sealed.

Barium sulfate (type II)

[Identification] Take about 0.3g of this product, add 10ml of sodium carbonate test solution, boil and filter; add hydrochloric acid to the filtrate to make it acidic, and then identify the sulfate reaction (Appendix III); wash the residual water and dilute The acetic acid dissolves, filters, and the filtrate shows the identification reaction of barium salts (Appendix III).

[Check] Take 2.0g of this product, add 20ml of water, stir well to make a suspension, and measure it according to law (Appendix VI H). The pH value should be 3.5 10.0g. Take 10.0g of the product dissolved in the acid, put it in a beaker, add 10ml of dilute hydrochloric acid and 90ml of water, boil for 10 minutes, add water to supplement the evaporated water, let it cool, and filter with filter paper washed with hydrochloric acid solution (1 40) If the initial filtrate is turbid, repeat the filtration. Take 50ml of the clear filtrate, evaporate to dryness in a water bath, add 2 drops of hydrochloric acid and stir with 10ml of hot water, and then filter it with filter paper washed with hydrochloric acid solution (1 40). The filter residue was washed with 10 ml of hot water, the washing liquid and the filtrate were combined, placed in a constant-temperature evaporation dish at 105 ° C, evaporated to dryness on a water bath, and dried to constant weight at 105 ° C. The residual residue should not exceed 15 mg (0.3%). The acid-soluble barium salt takes the residue left under the dissolved matter in the acid, stirs with 10ml of water, and filters it with filter paper washed with hydrochloric acid solution (1 40). Add 0.5ml of dilute sulfuric acid to the filtrate, and let it stand for 30 minutes. turbid. Take about 10.0g of sulfide and check it according to law (Appendix C). The lead acetate test paper must not change color. Take this product for drying weight loss, and dry to constant weight at 105 , and the weight loss should not exceed 1.0% (Appendix L). Take 4.0g of heavy metal, add 4ml of acetate buffer solution (PH3.5) and water to 50ml. After boiling for 10 minutes, let it cool, add water to 50ml, filter, and take the filtrate 25ml, check according to law ( Appendix H First Law), the content of heavy metals must not exceed 10 parts per million. Take 2.0g of arsenic salt, add 23ml of water and 5ml of hydrochloric acid, check according to law (Appendix J first method), and it should meet the requirements (0.0001%). For particle fineness, take 0.5g of this product, add water to 50ml, shake thoroughly to make uniform, immediately take 1 drop on the glass slide, check 3 fields of view under a 400x microscope, and the particle diameter should be 0.5 50m. More than 2 capsules.

[Content determination] Precisely weigh about 0.6g of this product, put it in a platinum crucible, add 10g of anhydrous sodium carbonate, mix well, burn to melt, continue heating for 30 minutes, let cool, put the crucible in a 400ml beaker, Add 250 ml of water, stir with a glass rod, and heat until the melt elutes from the crucible. Remove the crucible from the beaker and wash it with water. The washing solution is placed in the beaker. The inside of the crucible is rinsed with 2ml of 6mol / L acetic acid solution, and then rinsed with water. The washing solution is combined in the beaker. Heat and stir until the melt disintegrates. Cool the beaker in an ice bath until the precipitate is hard and the upper liquid is clear. Pour off the supernatant and filter. Carefully transfer the fine precipitate to the filter paper. Use cold sodium carbonate (1 50) Rinse the contents of the beaker twice with about 10ml each time, stir, as above, continue to pass the supernatant through the same filter paper, filter, carefully transfer the fine precipitate to the filter paper, and then hold a large piece of carbonic acid Place the beaker of barium precipitation under the funnel, wash the filter paper 5 times with 3mol / L hydrochloric acid solution, 1ml each time, and then wash with water (Note: the solution may be slightly turbid, add 100ml water, 5ml hydrochloric acid, ammonium acetate solution (2 5 ) 10ml, potassium dichromate solution (1 10) 25ml and urea 10g, covered with a watch glass, heated at 80-85 ° C for 16 hours, filtered through a vertical melting crucible which has been dried to constant weight while hot, transfer all the precipitate The precipitate was washed with a potassium dichromate solution (1 200), and finally washed with about 20 ml of water, dried at 105 ° C for 2 hours, allowed to cool, and weighed. The weight of the obtained precipitate was multiplied by 0.9213, which is the weight of barium sulfate ^[2] .

[Category] Diagnostic drugs.

[Storage] Keep sealed.

Barium sulfate drug description

Barium sulfate pharmacology

This product is a dual X-ray contrast agent. It is a high-density gastrointestinal contrast agent, which can be made into suspensions of different proportions and used alone, but it is usually used with low-density gas to achieve the purpose of double contrast. Commonly used in gastrointestinal angiography. According to domestic users, uneven thickness barium sulfate is better than fine and uniform barium sulfate.

Barium sulfate indication

Applicable to upper and lower gastrointestinal angiography.

Barium sulfate dosage

Due to different dosage forms and specifications, please read the drug instructions carefully or follow the doctor's advice.

Barium sulfate adverse reactions

Generally no response, occasional difficulty in defecation (to prevent constipation, drink enough water after the test, if necessary, take laxatives or use Kailulu).

Contraindications to barium sulfate

Patients with suspected gastrointestinal perforation. Patients with intestinal obstruction. Patients with acute gastrointestinal emergence. Patients with systemic weakness. (Laxatives ban mannitol).

Barium sulfate precautions

Be cautiously used for intestinal fistula formation and certain intestinal diseases that are prone to perforation, such as appendicitis, diverticulum, ulcerative enteritis, parasitic infections, etc.

Barium sulfate preparation

Dry suspension (type , type )

^[2-5]

Barium sulfate (type ) dry suspension

Common name: Barium sulfate (type I) dry suspension

English name: Barium Sulfate for Suspension (Type )

Chinese Pinyin: Liuusuanbei (yi xing) Ganhunxuanji

The main ingredients of this product and its chemical name:

The main ingredient of this product is barium sulfate (type I). Barium sulfate is white fine particles, odorless, insoluble in water and organic solvents, and slightly soluble in acids and alkalis. This product is a dry suspension made of barium sulfate (type I) plus appropriate amount of dispersant and flavoring agent.

Molecular formula: BaSO4

Molecular weight: 233.39

[Character]

This product is a white, loose, fine powder with a scent. The particle diameter is less than 2 m.

[Pharmacology and Toxicology]

The barium salt can absorb a large amount of X-rays, and enter the gastrointestinal tract or respiratory tract of the body to form a density contrast with the surrounding tissue structure on the X-ray image, thereby showing the position, contour, morphology, surface structure and Functional activity. The fine and uniform barium is mostly synthetic barium, and the particles are fine and uniform, mostly round, with a light specific gravity, slow and consistent sedimentation, suitable for single and double contrast imaging of the esophagus, stomach, duodenum, small intestine, and colon. an examination. Due to the low optimal development concentration of fine and uniform barium, the microstructure of the mucosal phase such as the gastric area is not as good as that of the uneven thickness type.

Pharmacokinetics

This product is not absorbed after oral administration or irrigation into the gastrointestinal tract, and is excreted from the feces in its original form. After entering the bronchus, most of them cough up, enter a small amount into the alveoli, deposit on the alveolar wall, or be phagocytosed and transported to the lung interstitial and lymphatic systems, but the speed is very slow, so it is not suitable for bronchography.

[Indications]

Barium sulfate dry suspension is suitable for single and double contrast examination of esophagus, stomach, duodenum, small intestine and colon, and can also be used for double contrast examination of digestive tract.

Dosage

Commonly used introduction methods are oral, small intestine enema and colon enema.

1, esophagus examination: oral barium [concentration 60 250% (W / V)] 15 60ml, can immediately observe the esophagus and its peristalsis; before taking barium, take gas-generating drugs first, which can be used for double comparison of esophagus an examination.

2. Double contrast examination of stomach and duodenum: fasting for more than 6 hours, oral gas-generating drugs, after 300 ~ 500ml of CO2 gas is generated in the stomach, barium [concentration 200 ~ 250% (W / V), Viscosity 150 300 milliPascal seconds] 70 100ml, make the patient turn several times, and allow the barium to be evenly applied to the gastric mucosa. If necessary, 150ml of barium can be added. If it is 20 minutes before the contrast examination, The patients were given hypotonic drugs (such as injection of anisodamine, or oral atropine, etc.), and gastric juice was cleaned by oral gastric enzymes, and then double-contrast examination was performed, and the surface structure of gastric mucosa could be more clearly displayed.

3. Gastrointestinal single follow-up inspection: fasting for more than 6 hours, oral morphology and peristalsis of the stomach and duodenum can be observed immediately after the oral concentration of barium is 240 to 480ml at 40 to 120% (W / V); 15 to 30 The morphology and peristalsis of the small intestine can be observed after one minute; the morphology and peristalsis of all small intestines can be observed after one and a half hours; the ileocele and the right half of the large intestine can be observed after two to six hours.

4. Small intestine enema examination: fasting for 8 to 12 hours, 800 to 2400 ml of barium agent with a concentration of 30 to 80% (W / V) is directly introduced into the duodenum or proximal jejunum through a special catheter, and the small intestine is examined step by step. If necessary, perform a double contrast check in a single contrast check.

5, colon enema examination: 1 to 3 days before the test, enter the juice or half-flow juice diet, if necessary, use an appropriate amount of laxatives, and 1 to 2 hours before the test to clean the intestine. The colon was intubated through the anus, and a contrast agent was injected to fill the entire large intestine for imaging. After injecting barium at a concentration of 20 to 60% (W / V), fluoroscopy and radiography were performed for single contrast imaging; then most of the barium was discharged, and then the gas was filled into the large intestine for double contrast imaging. When performing direct double contrast imaging of the large intestine, firstly inject 150 to 300 ml of 60-80% (W / V) barium through a catheter, rotate the position and inject gas, so that the barium and gas fill the entire large intestine, and perform double contrast imaging. For good results, hypotonic drugs such as Glucagon or anisodamine are often injected intramuscularly or intravenously before the contrast agent is injected.

Adverse reactions

Oral barium can cause symptoms such as nausea, constipation, and diarrhea; improper use can also cause intestinal perforation, followed by peritonitis, adhesions, granulomas, and severe cases can cause death. After a large amount of barium enters the lung, it can cause mechanical stimuli and inflammatory reactions, causing early foreign body giant cells, epithelioid cells, and monocytes to infiltrate. Later, fibrosis occurs around the deposited barium inflammation, forming barium nodules.

Contraindications

This product is prohibited for oral gastrointestinal examination in the following cases:

1. Acute gastrointestinal perforation

2.Esophageal tracheal fistula and suspected congenital atresia

3. Major hemorrhage of esophageal vein rupture in the near future

Colonic obstruction

5. Pharyngeal palsy

Precautions

1. Barium sulfate must be inspected strictly in accordance with the pharmacopoeia, and it must not contain soluble barium salts.

2. This product is prohibited for oral gastrointestinal examination in the following cases:

1) Acute gastrointestinal perforation; 2) Esophageal tracheal fistula and suspected congenital esophageal atresia; 3) Major hemorrhage of esophageal vein rupture in the near future; 4) Colonic obstruction; 5) Pharyngeal paralysis

3. Use this product with caution for oral gastrointestinal examination in the following cases:

1) Acute gastric and duodenal bleeding; 2) Small bowel obstruction; 3) Habitual constipation

4. Use the product for colonic enema examination with caution in the following cases:

1) Colonic obstruction; 2) Habitual constipation; 3) Megacolon; 4) Severe ulcerative colitis; 5) Colonic intussusception.

5. Barium enema can be performed 1 to 2 weeks after the colon biopsy has been performed to avoid colon perforation.

[Medication for pregnant and lactating women] Pregnant women are prohibited. Data on the safety of lactating women are lacking.

[Child medication]

Esophageal radiography; swallow with a small amount of paste. Gastrointestinal angiography: use 100-200g of this product and 200-500ml of water and mix thoroughly. Barium Enema: Mix 200g of this product with 1000ml of water and mix thoroughly.

[Medication for elderly patients]

Elderly patients use this product as a barium enema with caution.

medicine interactions

1. Banning high atomic weight medicines such as bismuth and calcium 3 days before the examination; banning medicines that affect the gastrointestinal tract 1 day before the examination, such as atropine, antacids and laxatives

[Drug overdose]

Overdose can cause bowel obstruction and bowel perforation.

specification

Dry suspension: 100% (w / v)

[Validity Period]

Storage

Keep away from light and keep tightly closed. ^[6]

Barium sulfate (type II) dry suspension

Drug Name

Common name: Barium sulfate (type II) dry suspension

Previous name:

Product name:

English name: Barium Sulfate (Type) for Suspension

Chinese Pinyin: Liusunbei (er xin) Gnhunxunji

The main ingredients of this product are: Barium sulfate type II. Its chemical name is: barium sulfate. This product is a dry suspension made of barium sulfate (type II) with appropriate dispersants and flavoring agents.

Molecular formula: BaSO4

Molecular weight: 233.39

[Character]

It is white loose and fine powder with fragrance.

[Pharmacology and Toxicology]

Barium salt can absorb a large amount of X-rays, and enter the gastrointestinal tract or respiratory tract of the body to form a density contrast with the surrounding tissue structure on the X-ray image, thereby showing the position, contour, morphology, surface structure and function of these cavities Activities. The uneven thickness type shows a good microstructure of the mucosal phase such as the gastric area.

Pharmacokinetics

[Indications]

Barium sulfate dry suspension is suitable for single and double contrast contrast examination of esophagus, stomach, duodenum, small intestine and colon.

Dosage

Commonly used introduction methods are oral, small intestine enema and colon enema.

(1) Esophageal examination Oral barium [concentration 60% ~ 250% (W / V)] 15 60ml, can immediately observe the esophagus and its peristalsis; before taking barium, take gas-generating drugs first, which can be used as esophagus double Contrast check.

(2) Double contrast examination of stomach and duodenum, fasting for more than 6 hours, oral gas-generating drugs, after 300 ~ 500ml of CO2 gas is generated in the stomach, barium [concentration 200% ~ 250% (W / V) can be taken orally first. , Viscosity 150 ~ 300 milliPascal seconds] 70 ~ 100ml, make the patient turn a few times, so that the barium can be evenly applied to the gastric mucosa, if necessary, 150ml of barium can be added; if 20 minutes before the contrast examination , To patients with hypotonic drugs (such as injection of anisodamine, or oral atropine, etc.), and oral gastric cleansing enzymes to clean the gastric juice, and then double contrast examination, the gastric mucosa surface structure can be more clearly displayed.

(3) Gastrointestinal single contrast follow-up inspection for fasting for more than 6 hours, oral morphology and peristalsis of the stomach and duodenum can be observed immediately after the oral concentration of 40% to 120% (W / V) barium 240-480ml; 15 The morphology and peristalsis of the small intestine can be observed after 30 minutes; the morphology and peristalsis of all small intestines can be observed after 1 and a half hours; the ileocele and the right half of the large intestine can be observed after 2 to 6 hours.

(4) Small intestine enema examination Fasting for 8 to 12 hours, 800 to 2400 ml of barium agent with a concentration of 30% to 80% (W / V) is directly introduced into the duodenum or proximal jejunum through a special catheter, and the small intestine is examined step by step. . If necessary, perform a double contrast check in a single contrast check.

(5) Colonic enema examination: Enter the juice or half-juice diet 1 to 3 days before the test. If necessary, use an appropriate amount of laxative, and clean the intestine 1 to 2 hours before the test. The colon was intubated through the anus, and a contrast agent was injected to fill the entire large intestine for imaging. After injecting barium at a concentration of 20% to 60% (W / V), fluoroscopy and radiography were performed for single contrast imaging; then most of the barium was discharged, and then the gas was filled into the large intestine for double contrast imaging. For direct large intestine double contrast imaging, first inject 150 to 300 ml of barium agent at a concentration of 60% to 80% (W / V) through a catheter, rotate the position and inject gas, so that the barium agent and gas fill the entire large intestine, and perform double contrast imaging. For good results, hypotonic drugs such as Glucagon or anisodamine are often injected intramuscularly or intravenously before the contrast agent is injected.

Adverse reactions

[Taboo]

This product is prohibited for oral gastrointestinal examination in the following cases: acute gastrointestinal perforation; esophageal tracheal fistula and suspected congenital esophageal atresia; major hemorrhage of esophageal vein rupture in the near future; colonic obstruction; paralysis of the throat.

Precautions

1. Barium sulfate must be inspected strictly in accordance with the Pharmacopoeia and must not contain soluble barium salts.

2. This product is prohibited for oral gastrointestinal examination in the following cases: acute gastrointestinal perforation; major bleeding of esophageal vein rupture in the near future; colonic obstruction; pharyngeal palsy.

3 Use this product with caution for oral gastrointestinal examination in the following cases: acute gastric and duodenal bleeding; small bowel obstruction; habitual constipation

4 Use this product for colon enema examination with caution: Colon obstruction; Habitual constipation; Megacolon; Severe ulcerative colitis; Colonic intussusception.

[Medication for pregnant and lactating women]

Disable pregnant women. Data on the safety of lactating women are lacking.

[Child medication]

Esophageal radiography is swallowed with a small amount of paste. For gastrointestinal imaging, take 100-200g of this product and add 200-500ml of water. Barium enema with 200g of this product and 1000ml of water and mix thoroughly.

[Medication for elderly patients]

Elderly patients use this product as a barium enema with caution.

medicine interactions

High atomic weight medicines such as bismuth and calcium are banned 3 days before the test; medicines affecting the gastrointestinal tract such as atropine, antacids and laxatives are prohibited 1 day before the test.

[Drug overdose]

Overdose can cause bowel obstruction and bowel perforation.

specification

Barium sulfate (type II) dry suspension: 100% (w / v) ^[7] .