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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/02/26 02:58:10」(JST)

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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

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1. 造影剤に対する即時型過敏反応：再発反応の予防 immediate hypersensitivity reactions to radiocontrast media prevention of recurrent reactions
2. 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
3. CTコロノグラフィー computed tomographic colonography
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5. 成人における機械的小腸閉塞の疫学、臨床的特徴、および診断 epidemiology clinical features and diagnosis of mechanical small bowel obstruction in adults

English Journal

Valsartan protects HK-2 cells from contrast media-induced apoptosis by inhibiting endoplasmic reticulum stress.

Peng PA1, Wang L1, Ma Q1, Xin Y2, Zhang O1, Han HY1, Liu XL1, Ji QW1, Zhou YJ1, Zhao YX1.
Cell biology international.Cell Biol Int.2015 Aug 6. doi: 10.1002/cbin.10521. [Epub ahead of print]
Contrast-induced acute kidney injury (CI-AKI) is associated with increasing in-hospital and long-term adverse clinical outcomes in high-risk patients undergoing percutaneous coronary intervention (PCI). Contrast media (CM)-induced renal tubular cell apoptosis is reported to participate in this proce
PMID 26248489

Vitamin D deficiency is a potential risk factor for contrast-induced nephropathy.

Luchi WM1, Shimizu MH2, Canale D2, Gois PH2, de Bragança AC2, Volpini RA2, Girardi AC3, Seguro AC2.
American journal of physiology. Regulatory, integrative and comparative physiology.Am J Physiol Regul Integr Comp Physiol.2015 Aug 1;309(3):R215-22. doi: 10.1152/ajpregu.00526.2014. Epub 2015 Jun 3.
Vitamin D deficiency (VDD) is widespread in the general population. Iodinated (IC) or gadolinium-based contrast media (Gd) may decrease renal function in high-risk patients. This study tested the hypothesis that VDD is a predisposing factor for IC- or Gd-induced nephrotoxicity. To this end, male Wis
PMID 26041113

Ozone preconditioning attenuates contrast-induced nephropathy in rats.

Kurtoglu T1, Durmaz S2, Akgullu C3, Gungor H3, Eryilmaz U3, Meteoglu I4, Karul A5, Boga M2.
The Journal of surgical research.J Surg Res.2015 May 15;195(2):604-11. doi: 10.1016/j.jss.2015.01.041. Epub 2015 Jan 29.
BACKGROUND: Contrast-induced nephropathy (CIN) is an important complication of vascular interventions. Ozone therapy can induce tolerance to ischemic insults, a phenomenon known as ozone oxidative preconditioning (OOP). The aim of this study was to investigate the effects of OOP on CIN.MATERIALS AND
PMID 25770741

Japanese Journal

術前診断しえたS状結腸間膜内ヘルニアの1例

五十嵐章,奥田康一,西脇真,辻塚一幸,清野徳彦,住山正男
日本消化器外科学会雑誌 31(7), 1816-1820, 1998-07-01
症例は60歳の男性.腹部膨満, 左下腹部痛を主訴に来院.腹部手術, 外傷などの既往はなく, 腹部X線でniveauを認めイレウスの診断で入院となった.イレウス管を挿入し保存的治療を試みるも症状軽快せず, イレウス管造影と注腸造影を同時に施行したところS状結腸ループ内に回腸の先細り完全閉塞像を認めた.また, 腹部CT上S状結膜間膜と思われる部分に回腸の狭窄部を認めた.以上よりS状結腸間膜による内ヘル …
NAID 110001330276

イオン性および非イオン性造影剤のイヌの血管造影における循環動態ならびにX線造影能に及ぼす影響

中村裕之,倉田昌明,春田耕一,武田敬介
日本獣医学雑誌 56(1), 91-96, 1994-02-15
… イオン性造影剤であるdiatrizoateと非イオン性造影剤であるioxilan, iohexolおよびiopamidolを用いてビーグル犬の脳血管, 四肢血管ならびに左心室大動脈系を造影し, 各造影剤の循環動態に対する影響とそのX線造影能を比較検討した. … 造影時には降圧, 徐脈, 頻脈, 左室内圧およびdP/dt低下, P-QならびにQ-T間隔の延長がみられたが, diatrizoateの作用は全ての造影領域で非イオン性造影剤の作用を上回っていた. …
NAID 110003915995

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★リンクテーブル★

リンク元	「ジアトリゾ酸メグルミン」「ジアトリゾ酸」「Gastrografin」「amidotrizoic acid」「diatrizoic acid」
関連記事	「diatrizoate」

「ジアトリゾ酸メグルミン」

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 (77 °F), 100 kPa)
	Infobox references