関: diatrizoate meglumine、diatrizoic acid

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/10/27 23:31:01」(JST)

wiki en

Diatrizoic acid (or its anionic form, diatrizoate), also known as amidotrizoic acid, or 3,5-diacetamido-2,4,6-triiodobenzoic acid, is a radiocontrast agent containing iodine. Trade names include Hypaque, Gastrografin and Urografin, the latter being a combination of the sodium and meglumine salts.

Diatrizoate is considered a high-osmolality contrast agent. Its osmolality ranges from approximately 1500 mOsm/kg (50% solution)^[1] to over 2000 mOsm/kg (76% solution).^[2]

Indications[edit]

Diatrizoic acid may be used as an alternative to barium sulfate for medical imaging of the gastrointestinal tract, such as upper gastrointestinal series and small bowel series. It is indicated for use in patients who are allergic to barium, or in cases where the barium might leak into the abdominal cavity. It does not coat the stomach/bowel lining as well as barium, so it is not used commonly for this purpose.

Under the trade name Urografin it is used for intravenous pyelography.

It is also used to kill Ascaris Lumbricoides (roundworms) .^[3]^[4]

Administration[edit]

It is given intravenously (under brand name Hypaque, GE Healthcare) to enhance contrast in computed tomography, to image the kidneys and related structures, and to image blood vessels.
It is given orally or by enema (Gastrografin, Gastrovist, Gastrovision, MD-Gastroview) to image the gastrointestinal tract.
It is given by Foley catheter (Cystografin) to image the urinary tract

Contraindications[edit]

A history of sensitivity to iodine is not a contraindication to using diatrizoate, although it suggests caution in use of the agent. In this case, a regimen of oral or intravenous corticosteroids may be given as prophylaxis, or an alternative such as barium sulfate may be preferable.

Gastrografin is contraindicated to use along with certain medications that can cause lactic acidosis, such as metformin. Concurrent use may lead to renal failure and lactic acidosis, and a clinician may need to space the agents apart over a number of days to prevent an interaction.^[5]

Gastrografin is a hypertonic solution, and therefore it should be avoided in imaging studies of the upper gastrointestinal tract in patients who are at risk of aspiration, as it will cause prompt pulmonary edema if accidentally introduced into the tracheobronchial tree.

Urografin is not to be used for myelography, ventriculography or cisternography, since it is likely to provoke neurotoxic symptoms in these examinations. ^[6]

References[edit]

^ Amersham Health (April 2006). "Hypaque sodium (Diatrizoate Sodium) injection, solution. Product label". DailyMed. U.S. National Library of Medicine. Retrieved 2007-03-29.
^ Amersham Health (April 2006). "Hypaque (Diatrizoate Meglumine and Diatrizoate Sodium) injection, solution. Product label". DailyMed. U.S. National Library of Medicine. Retrieved 2007-03-29.
^ Sood. Surgical Diseases in Tropical Countries. Jaypee Brothers Publishers. pp. 72–. ISBN 978-81-7179-444-7. Retrieved 11 August 2010.
^ Moshe Schein; Paul Rogers; Ahmad Assalia (2010). Schein's Common Sense Emergency Abdominal Surgery. Springer. pp. 391–. ISBN 978-3-540-74820-5. Retrieved 11 August 2010.
^ Micromedex Healthcare Series (November 2010). "DIATRIZOATE MEGLUMINE/DIATRIZOATE SODIUM". DRUGDEX. Thomson Reuters (Healthcare) Inc. Retrieved 2010-11-10.
^ Bayer New Zealand Limited (September 2007). "UROGRAFIN Urografin Corporate Core Text". Retrieved 2012-04-02.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 内視鏡による食道狭窄拡張術の合併症 complications of endoscopic esophageal stricture dilation
2. 嚢胞性線維症：消化器疾患の概要 cystic fibrosis overview of gastrointestinal disease
3. コントラスト心エコー検査：造影剤、安全性、およびイメージング技術 contrast echocardiography contrast agents safety and imaging technique
4. 鈍的外傷または穿通性外傷による食道穿孔の概要 overview of esophageal perforation due to blunt or penetrating trauma
5. 腸管閉鎖症 intestinal atresia

English Journal

Heme oxygenase-1 counteracts contrast media-induced endothelial cell dysfunction.

Chang CF1, Liu XM2, Peyton KJ2, Durante W3.Author information 1Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan.2Department of Medical Pharmacology and Physiology, School of Medicine, University of Missouri-Columbia, Columbia, MO, USA.3Department of Medical Pharmacology and Physiology, School of Medicine, University of Missouri-Columbia, Columbia, MO, USA. Electronic address: durantew@health.missouri.edu.AbstractEndothelial cell (EC) dysfunction is involved in the pathogenesis of contrast-induced acute kidney injury, which is a major adverse event following coronary angiography. In this study, we evaluated the effect of contrast media (CM) on human EC proliferation, migration, and inflammation, and determined if heme oxygenase-1 (HO-1) influences the biological actions of CM. We found that three distinct CM, including high-osmolar (diatrizoate), low-osmolar (iopamidol), and iso-osmolar (iodixanol), stimulated the expression of HO-1 protein and mRNA. The induction of HO-1 was associated with an increase in NF-E2-related factor-2 (Nrf2) activity and reactive oxygen species (ROS). CM also stimulated HO-1 promoter activity and this was prevented by mutating the antioxidant responsive element or by overexpressing dominant-negative Nrf2. In addition, the CM-mediated induction of HO-1 and activation of Nrf2 was abolished by acetylcysteine. Finally, CM inhibited the proliferation and migration of ECs and stimulated the expression of intercellular adhesion molecule-1 and the adhesion of monocytes on ECs. Inhibition or silencing of HO-1 exacerbated the anti-proliferative and inflammatory actions of CM but had no effect on the anti-migratory effect. Thus, induction of HO-1 via the ROS-Nrf2 pathway counteracts the anti-proliferative and inflammatory actions of CM. Therapeutic approaches targeting HO-1 may provide a novel approach in preventing CM-induced endothelial and organ dysfunction.
Biochemical pharmacology.Biochem Pharmacol.2014 Jan 15;87(2):303-11. doi: 10.1016/j.bcp.2013.11.002. Epub 2013 Nov 15.
Endothelial cell (EC) dysfunction is involved in the pathogenesis of contrast-induced acute kidney injury, which is a major adverse event following coronary angiography. In this study, we evaluated the effect of contrast media (CM) on human EC proliferation, migration, and inflammation, and determin
PMID 24239896

Removal of the X-ray contrast media diatrizoate by electrochemical reduction and oxidation.

Radjenovic J, Flexer V, Donose BC, Sedlak DL, Keller J.Author information Advanced Water Management Centre, The University of Queensland , Queensland 4072, Australia.AbstractDue to their resistance to biological wastewater treatment, iodinated X-ray contrast media (ICM) have been detected in municipal wastewater effluents at relatively high concentrations (i.e., up to 100 μg L(-1)), with hospitals serving as their main source. To provide a new approach for reducing the concentrations of ICMs in wastewater, electrochemical reduction at three-dimensional graphite felt and graphite felt doped with palladium nanoparticles was examined as a means for deiodination of the common ICM diatrizoate. The presence of palladium nanoparticles significantly enhanced the removal of diatrizoate and enabled its complete deiodination to 3,5-diacetamidobenzoic acid. When the system was employed in the treatment of hospital wastewater, diatrizoate was reduced, but the extent of electrochemical reduction decreased as a result of competing reactions with solutes in the matrix. Following electrochemical reduction of diatrizoate to 3,5-diacetamidobenzoic acid, electrochemical oxidation with boron-doped diamond (BDD) anodes was employed. 3,5-Diacetamidobenzoic acid disappeared from solution at a rate that was similar to that of diatrizoate, but it was more readily mineralized than the parent compound. When electrochemical reduction and oxidation were coupled in a three-compartment reactor operated in a continuous mode, complete deiodination of diatrizoate was achieved at an applied cathode potential of -1.7 V vs SHE, with the released iodide ions electrodialyzed in a central compartment with 80% efficiency. The resulting BDD anode potential (i.e., +3.4-3.5 V vs SHE) enabled efficient oxidation of the products of the reductive step. The presence of other anions (e.g., chloride) was likely responsible for a decrease in I(-) separation efficiency when hospital wastewater was treated. Reductive deiodination combined with oxidative degradation provides benefits over oxidative treatment methods because it does not produce stable iodinated intermediates. Nevertheless, the process must be further optimized for the conditions encountered in hospital wastewater to improve the separation efficiency of halide ions prior to the electrooxidation step.
Environmental science & technology.Environ Sci Technol.2013 Dec 3;47(23):13686-94. doi: 10.1021/es403410p. Epub 2013 Nov 21.
Due to their resistance to biological wastewater treatment, iodinated X-ray contrast media (ICM) have been detected in municipal wastewater effluents at relatively high concentrations (i.e., up to 100 μg L(-1)), with hospitals serving as their main source. To provide a new approach for reducing the
PMID 24261992

Renal Excretion of Water-Soluble Contrast Media after Enema in the Neonatal Period.

Kim HS, Je BK, Cha SH, Choi BM, Lee KY, Lee SH.Author information Department of Radiology, Korea University Hospital, Ansan, Gyeonggido, Republic of Korea.AbstractBACKGROUND: When abdominal distention occurs or bowel obstruction is suspected in the neonatal period, a water-soluble contrast enema is helpful for diagnostic and therapeutic purposes. The water-soluble contrast medium is evacuated through the anus as well as excreted via the kidneys in some babies. This study was designed to evaluate the incidence of renal excretion after enemas using water-soluble contrast media and presume the causes.
Pediatrics and neonatology.Pediatr Neonatol.2013 Nov 29. pii: S1875-9572(13)00187-3. doi: 10.1016/j.pedneo.2013.07.012. [Epub ahead of print]
BACKGROUND: When abdominal distention occurs or bowel obstruction is suspected in the neonatal period, a water-soluble contrast enema is helpful for diagnostic and therapeutic purposes. The water-soluble contrast medium is evacuated through the anus as well as excreted via the kidneys in some babies
PMID 24295782

Japanese Journal

ヒト腎臓尿酸トランスポーターURAT1と水溶性ヨード系造影剤iodipamideの相互作用

Dokkyo journal of medical sciences 43(1), 73-78, 2016-03-25
NAID 110010019135

Long-term Taenia saginata Infection Successfully Treated with Meglumine/Diatrizoate Sodium

Internal Medicine 51(2), 177-179, 2012
NAID 130002062070

Helical CT With Oral Contrast Material for Imaging of Suspected Appendicitis and the Role of Mechanical Bowel Preparation for Appendectomy

Shimane journal of medical science 26, 27-31, 2009-12-01
NAID 110008755212

Related Pictures

★リンクテーブル★

リンク元	「アミドトリゾ酸」「ジアトリゾ酸」「diatrizoic acid」

「アミドトリゾ酸」

Diatrizoic acid
	IUPAC name 3,5-bis(acetylamino)-2,4,6-triiodobenzoic acid
Identifiers
CAS number	737-31-5
PubChem	2140
ChemSpider	2055
DrugBank	DB00271
KEGG	D02240
ChEBI	CHEBI:53691
ChEMBL	CHEMBL1201220
ATC code	V08AA01
Jmol-3D images	Image 1; Image 2
	SMILES CC(=O)NC1=C(C(=C(C(=C1I)C(=O)O)I)NC(=O)C)I Ic1c(c(I)c(c(I)c1NC(=O)C)C(=O)O)NC(=O)C ;
	InChI InChI=1S/C11H9I3N2O4/c1-3(17)15-9-6(12)5(11(19)20)7(13)10(8(9)14)16-4(2)18/h1-2H3,(H,15,17)(H,16,18)(H,19,20) ; Key: YVPYQUNUQOZFHG-UHFFFAOYSA-N InChI=1/C11H9I3N2O4/c1-3(17)15-9-6(12)5(11(19)20)7(13)10(8(9)14)16-4(2)18/h1-2H3,(H,15,17)(H,16,18)(H,19,20); Key: YVPYQUNUQOZFHG-UHFFFAOYAT ;
Properties
Molecular formula	C11H9I3N2O4
Molar mass	613.91 g mol−1
	(verify) (what is: /?); Except where noted otherwise, data are given for materials in their standard state (at 25 °C, 100 kPa)
	Infobox references