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PubMed1982

Adverse reactions at intravenous cholegraphy with ioglycamide. Correlation with the level of circulating sex hormones.

Intravenous cholegraphy with ioglycamide was performed in 861 cases. The patients were divided into hormonally disparate age groups. The phase of the menstrual cycle was recorded. A correlation was demonstrated between the incidence of side effects and the level of circulating sex hormones at the time of examination. The possible mechanisms for these adverse reactions are discussed.

Adolescent↗
PubMed1982

Release of protein bound progesterone in human serum by ioglycamide.

With the use of an aqueous two-phase system the influence of ioglycamide on the serum protein binding of progesterone was investigated. Ioglycamide was found to cause a decrease in the association constants for the binding of progesterone to both albumin and transcortin. The binding capacity for the progesterone binding to transcortin was also decreased. The decreased progesterone binding was discussed in terms of clinical relevance in connection with adverse reactions at cholegraphy with intravenous injection of ioglycamide.

Blood Proteins↗
PubMed1982

Ioglycamide induced release of testosterone and estradiol from protein bound stores.

With the use of an aqueous two-phase system the effect of ioglycamide (Bilivistan) on the binding of testosterone and estradiol to albumin and testosterone-estradiol-binding globulin was investigated using whole human serum. Reduced binding capacity was recorded for TeBG and a reduced apparent association constant for the testosterone-albumin binding was recorded in the presence of ioglycamide in high concentration. The significance of reduced binding of testosterone and estradiol to albumin and TeBG was discussed in relation to side-effects of radiographic contrast media.

Estradiol↗
PubMed1983

Increased content of saliva cortisol following infusion of ioglycamate.

The release of steroid hormones from protein bound stores by ioglycamide has previously been confirmed by clinical and experimental findings. Increased saliva cortisol levels were observed following intravenous infusion of ioglycamate. Saliva cortisol content was measured before and after ioglycamide infusion in routine clinical examinations. The saliva steroid level has been shown to concur well with the serum level of free steroids. Thus, the increase of cortisol in saliva would indicate the release of cortisol from serum proteins by ioglycamate.

Cholangiography↗
PubMed1984

Intravenous computed tomographic cholangiography in acute cholecystitis. A comparison with conventional cholangiography.

Forty-nine patients with clinical signs of acute cholecystitis underwent conventional and computed tomographic cholangiography. Among 39 patients with signs of contrast medium in the biliary system at both examinations there was a diagnostic discrepancy in only one patient. Conventional radiography demonstrated cholecystopathy in this patient while contrast medium in the gallbladder and an acute pancreatitis were found at computed tomography. Ten patients with an indeterminate conventional cholangiography had a conclusive computed tomographic examination. Twenty of 30 patients with an abnormal computed tomographic cholangiography underwent cholecystectomy and all had diseased gallbladders. All 17 patients with histopathologically confirmed acute cholecystitis had signs of subserosal edema and/or changes in the omental fatty tissue adjacent to the gallbladder at computed tomography. A layer of tissue of water-density adjacent to the gallbladder and/or changes in omental fatty tissue were also seen in one patient with congestive heart failure and in one with a penetrating duodenal ulcer. None of the 19 patients with a normal computed tomographic cholangiography had a proven acute cholecystitis.

Acute Disease↗
PubMed1975

Prolonged drip-infusion cholangiography.

Previous experimenttal work in animals has shown that the hpatic excretion of iodipamide and ioglycamide is subject to a transport maximum (TM). Doses in excess of this TM are largely excreted in the urine. In the present study the TM for man was estimated in three subjects with indwelling T-tubes: figures of 19-23 mg/minute for ioglycamide were obtained. It was thought that prolonged administration of contrast at levels slightly above the TM might have advantages in patients with impaired liver function. In obstruction the gradual excretion of contrast could improve the chances of filling the ducts completely, while in hepato-cellular disease the gall bladder might have time to concentrate the contrast. Ioglycamide was therefore given by slow overnight infusion, equivalent to 35 mg/minute, to patients in whom standard cholangiography had been unsuccessful. The overall success rate was 75 per cent with similar improvement in obstructive and hepatocellular disease.

Adult↗
PubMed1976

Levels of ioglycamate (Biligram) in the bile of the rhesus monkey following intravenous infusion at different dose-rates.

The maximun rate of excretion of ioglycamate in the bile of the rhesus monkey was achieved when the rate of adminstration was at least twice the rate of excretion. A maximum concentration of ioglycamate in the bile was also established, and this is more important to the visualization of the bileducts than the quanity of ioglycamate excreted. The maximum concentration was obtained at the same rate of infusion as that which produced the maximum rate of excretion. The peak concentration was sustained longer with an infusion lasting two hours than with one lasting 36 minutes, althought the same quanity of ioglycamate had been administered. It is concluded that an infusion at a rate equal to twice the maximum excretory rate and continued for two hours or longer is a rational approach to intravenuous cholangiography particularly in those patients where there has been some diffculty in bile-duct visulization.

Animals↗
PubMed1977

The concentration maximum concept in intravenous cholangiography.

The excretion of ioglycamate in the bile of the rhesus monkey was measured at 5% and at 100% bile diversion following an intravenous bolus injection of ioglycamate. At 100% diversion the bile volume was reduced and the concentration of ioglycamate was increased, but the quantity excreted was unchanged. A similar study using iodipamide reported previously gave the same result. When the ioglycamate was given by intravenous infusion, the effect of 100% bile diversion was quite different. The concentration of ioglycamate in the bile was unchanged by the bile diversion but the excretion was reduced. These results indicate that the transport maximum for the excretion of ioglycamate in bile is not a constant and is reduced by interruption of the enterohepatic circulation of bile salts. The maximum concentration of ioglycamate in bile was constant and was independent of the reduction in bile salt output produced by 100% bile diversion. Following a single bolus injection however, the reduction in bile flow produced by 100% bile diversion increased the biliary concentration of ioglycamate. These results suggest that the excretion of ioglycamate is limited by a maximum concentration rather than a transport maximum. The maximum rate of transport (Tm) is dependent on two factors--the maximum concentration of ioglycamate in the bile and the rate of bile flow. The maximum concentration is achieved by an infusion technique and not by a single bolus injection and this supports the view that an infusion technique should be used for intravenous cholangiography.

Animals↗
PubMed1978

Ioglycamide (Biligram) studies in man--relation between plasma concentration and billary excretion.

Plasma ioglycamide concentration was linearly related to the rate of intravenous infusion over a dose range of from 1 to 4 mg per kg per min. The relation between plasma and biliary concentration of ioglycamide was studied in 15 anicteric patients with a T-tube in situ. Peak biliary concentrations and excretory rates of ioglycamide were seen when the plasma concentration was greater than 1500 micrograms per ml. The mean biliary transport maximum (Tm) for ioglycamide in man was 31.6 mg/min (range 22.0-40.4). The results suggest that near optimal concentrations of iodine in the bile duct can be obtained during intravenous cholangiography if ioglycamide is infused for one hour at a rate of about 4 mg per kg per min.

Bile↗
PubMed1978

Ioglycamide (Biligram) studies in man. Radiological opacification of the bile duct. A comparison of a number of different methods.

Intravenous cholangiography was carried out in 80 anicteric patients using ioglycamide (Biligram). Twenty patients were given a 30 ml ampoule of 35% ioglycamide as a slow hand injection over ten minutes; the remainder were given ioglycamide by one hour slow drip infusion at a rate of 2, 3, or 4 mg per kg body weight per minute. The radiological opacification of the bile duct was then assessed independently by two radiologists. There was a statistically significant difference between the bile duct opacification found in patients given either 3 or 4 mg/kg/min of ioglycamide for one hour compared with those given ioglycamide either by ten minute injection or by 2 mg/kg/min drip infusion.

Adult↗
PubMed1978

Ioglycamide (Biligram) studies in man--plasma binding, renal and biliary excretion studies in jaundiced and anicteric patients.

When five patients with varying degrees of hepatic impairment and a T-tube in situ were given intravenous ioglycamide at a rate of 2 mg/kg/min for two hours the mean biliary excretion in the first two hours was only 3.2% of the administered dose. In contrast, in five T-tube patients with relatively normal liver function the mean biliary excretion over the same time interval was 20.6%. The mean plasma concentration of ioglycamide achieved at the end of a two-hour intravenous infusion at 2 mg/kg/min was 1427 +/- 187 microgram/ml in six anicteric patients and 1262 +/- 82 in six jaundiced patients. Despite these very similar plasma levels the 24-hour urinary excretion of ioglycamide was 42.3 +/- 3.8% of the administered dose in the patients with jaundice compared with only 18.1 +/- 2.4% in the anicteric group. These differences probably reflect the fact that the percentage of unbound contrast agent in the plasma of the jaundiced group (11.9 +/- 1.9%) was significantly higher than that of the anicteric group (6.4 +/- 0.9%). It is suggested that bilirubin and possibly other substances in the plasma are competing with ioglycamide for binding sites on albumin. These factors need to be borne in mind when performing intravenous cholangiograms on jaundiced patients.

Aged↗
PubMed1979

Intravenous cholangiography in childhood.

Intravenous cholangiography (IVC) was performed on 102 children aged between one and 13 years. Eighty of the patients who were non-icteric were divided into four groups and received contrast medium containing either 53, 75, 106 or 150 mg iodine/kg body weight by intravenous injection over ten minutes. Complete demonstration of the common bile duct (CBD) was achieved in 85% of patients and in a similar proportion of all age groups. There was some delay in opacification of the CBD in young children but this was not of practical significance. The two higher dosage regimen gave significantly better results than the two lower dosages (p less than 0.001) and this improvement was evident in the young and older age groups. Nausea and vomiting occurred as side effects in 6%. In eight patients in whom there was inadequate demonstration by the standard IVC, an infusion technique over 3--8 hours was carried out. This improved the demonstration in three children with diagnostic results in two.

Adolescent↗
PubMed1980

Drip infusion cholangiography using iotroxamide. Double blind comparison with ioglycamide.

A double blind clinical trial was carried out in 200 unselected patients to compare the efficacy and tolerance of ioglycamide and iotroxamide as contrast media for intravenous cholangiography. The two agents were administered by slow infusion at a rate of 2.6 mumoles/kg bodyweight/minute for one hour. Radiological opacification of the bile duct was assessed independently by two radiologists. In patients with serum bilirubin levels of less than 34 mumoles/litre visualization of the bile duct was significantly better with iotroxamide than with ioglycamide (P < 0.001). Toxic side effects were observed in 8% of patients receiving ioglycamide and in only 3% of the patients given iotroxamide.

Adult↗
PubMed1984

Contrast media reactions: experimental evidence against the allergy theory.

In order to clarify whether adverse reactions to radiographic contrast media may be allergic in nature, it is essential to show that contrast media can act as haptens and induce antibody formation in vivo. Experiments in Hooded Lister rats have been carried out using techniques specifically designed to produce favourable conditions for the production of antibodies. No evidence of any antibody formation was found in any of the experiments. These experiments suggest that radiographic contrast media in their native form do not act as haptens, contrary to previously published data, and it therefore seems unlikely that the majority of adverse reactions to radiographic contrast media are allergic in nature.

Animals↗