i am allergic to iodine, what medicine should i avoid

Terminate Saying Your Patient Is Allergic to Iodine

Op-Med is a drove of original articles contributed by Doximity members.

Image: Arsenia North/Shutterstock

Permit's begin with a quiz question:

Patients may be allergic to:

A. oxygen

B. carbon

C. iodine

D. none of the higher up

If you lot answered anything but 'D', amend keep reading.

Consider this scenario: if a patient is allergic to penicillin, you would document "penicillin" in the medical records. It would never occur to you to list "antibiotics" as an allergy, and you certainly would non phone call it a "carbon" allergy for slang, simply considering penicillin contains carbon.

This not an exercise in semantics, only a patient care effect. Iodine is a mineral we all need, intentionally added to our salt supply, so that people do not get iodine-deficiency goiters as they once did. (We could boost everyone's protein intake past calculation peanut powder to the salt supply, only people might understandably object.) So while some people may be allergic to compounds that happen to contain iodine, the iodine in the molecule is not the culprit.

Iodine-based dissimilarity agents are widely used for CT and other ten-ray studies. They lite upwards blood vessels and enhance perfusing tissue. These agents are essential for diagnosing everything from clots, to tumor, to bleeding. Unfortunately, many patients practise not get contrast studies they may benefit from, due to unnecessary confusion about allergies.

The most of import step to avoiding confusion is to start calling contrast agents by their names, as yous would do for any other drug, and to remove "iodine" from your allergy vocabulary. Like antibiotics, in that location is more than 1 kind of contrast amanuensis. Radiologists routinely dictate the name of the agent used in their study reports, so if a reaction occurs, the information is readily available. The problem comes when we practise not distinguish one agent from some other. Most patients with a prior reaction were never told the name of the drug they received, and they incorrectly assume that an allergy to ane means allergy to all. Not so, just similar with other classes of medications.

Here's a cursory summary of the pertinent points regarding contrast allergy:

• Older ionic iodinated contrast agents were more than allergenic, and are no longer commonly used most places. When in that location may exist a history of a contrast allergy, always first try to determine the bodily drug name. If unattainable, and the reaction occurred earlier circa 1990, it was almost certainly an older ionic contrast agent.
• If symptoms consisted of nausea, vomiting, or a brief warm sensation, it may not take been pleasant for the patient, but those are considered physiologic effects of 4 contrast, not actual allergic reactions.
• If the reaction to an older ionic dissimilarity agent was mild, such as hives with no trouble animate, a newer nonionic agent (those commonly used today) volition unremarkably be tolerated. Oral steroid premedication may also be prescribed.
• If the former allergic reaction was astringent, including anaphylaxis, using any iodinated contrast amanuensis would be discouraged, fifty-fifty the newer less allergenic agents.

Other points to remember:

• Gadolinium based agents for MRI are completely unlike than iodinated contrast agents for CT. Allergies to gadolinium agents may occur, simply more rarely.
• Topical iodine soap sensitivity is unrelated to IV contrast allergy. If a patient is allergic to a topical soap, list the soap allergy past name, to forbid confusion with Iv contrast.
• The aforementioned goes for shellfish allergies, a reaction to the tropomyosin of the muscle protein. Like whatever other nutrient allergy, this is not associated with IV dissimilarity.

Having worked in radiology for over 25 years, I cannot count the number of patients who accept "iodine allergy" [sic] listed in their records, when they have never fifty-fifty received i of the electric current class of contrast agents. Once an allergy is posted in a medical record, people are reticent to remove information technology — but this is precisely what should be washed whenever information is inaccurate. A few questions in the history taking, and confirmation of agents used for prior injections, are unremarkably all that is required to clear a patient for a study they may need. Ameliorate to clarify now, than to wait until at that place is an immediate situation with less time to human action, like a possible pulmonary embolism, stroke, or trauma. And for anyone in the electronic medical records business, information technology would exist best if "iodine" were not allowed as an allergy choice pick. It is not only nonsensical; it may prevent someone from obtaining a prompt diagnosis when they need it most.

Dr. Cullen Ruff is in private practice, and an associate professor of radiology at Virginia Republic University in Fairfax, VA. He has no disclosures or conflicts. More than information about contrast agents can exist institute here .

All opinions published on Op-Med are the author'south and practise not reverberate the official position of Doximity or its editors. Op-Med is a condom space for free expression and diverse perspectives. For more data, or to submit your own opinion, delight see our submission guidelines or electronic mail opmed@doximity.com.

More from Op-Med

---

canadysheentaide.blogspot.com

Source: https://opmed.doximity.com/articles/stop-saying-your-patient-is-allergic-to-iodine-68d5cdbe-3a52-4bd3-aa57-10e41e60806a