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[Dysphagia] barium sulfate substitutes for MBS
I have to disagree strongly about the safety of Omnipaque. The warnings listed blow are from the manufacturers specs. and none of thises apply to barium sulphate which is inert and can actually be injected into the lung with no ill effects. The reports of allergic reactions are rare and represent fewer than .001% of the population. The potential for allergic reaction to Omnipaque is high given its iodine base. It is listed as not"expected to be inhaled" therefore it would seem to be contrindicated for studies witha risk of aspiration:
Product DescriptionA low osmolar, nonionic, iodinated contrast agent introduced in the U.S. in 1985, OMNIPAQUE has been used in more than 100 million patients worldwide. Its indications include a broad range of intravascular diagnostic procedures such as coronary angiography, spinal cord imaging, and body cavity procedures including shoulder and knee joints. (Note - not indicated for swallowing assessment )OMNIPAQUE is approved for use in adults and children, and is available in a wide variety of packagings that meet the needs of safety, convenience, and cost efficiency.
Subchronic (Target Organ Effects): The following adverse reactions have been reported:
Central Nervous System: Vertigo (including dizziness and lightheadedness), pain,
vision abnormalities (including blurred vision and photomas),
headache, and taste perversion. Other including anxiety, fever,
motor and speech dysfunction, convulsion, paresthesia, somnolence,
stiff neck, hemiparesis, syncope, shivering, transient ischemic attack,
cerebral infarction, and nystagmus were reported.
Gastrointestinal System: Nausea and vomiting. Others including diarrhea, dyspepsia,
cramp, and dry mouth were reported.
Cardiovascular System: Arrhythmias including PVCs and PACs, angina/chest, pain
and hypotension. Others including cardiac failure, asystole,
bradycardia, tachycardia, and vasovagal reaction were reported.
In controlled clinical trials, involving 1485 patients, one fatality
occurred. A cause and effect relationship between this death and
iohexol has not been established.
Respiratory System: Dyspnea, rhinitis, coughing, and laryngitis.
Skin and Appendages: Urticaria, purpura, abscess, and pruritus.
Carcinogenicity: NTP: No, IARC: No, OSHA: No.
Handling and Storage
Precautions: Store away from heat and light - these conditions may produce iodine
vapors. Keep this and all drugs out of the reach of children.
Eyes: In case of eye contact, flush eyes with plenty of water for at least 15
minutes. Seek medical attention if irritation develops.
Skin: Wash thoroughly with soap and water.
Ingestion: In case of overdosage, seek immediate medical attention or contact the Poison
Control Center for further instructions.
Inhalation: Not an expected route of entry.
WARNING: This is a pharmaceutical material available only with a prescription - use only
as directed. Persons allergic to shellfish or iodine may be allergic to iohexol.
Hazardous
Decomposition
Products: Iodine vapors
Lynnette_Chan@ttsh.com.sg wrote:
A safer contrast material to barium sulphate is Omnipaque. I'm not sure if
it's known by another name in the US. It is significantly more expensive
than barium sulphate though.
Lynnette
"Sanders, Liza"
@b9.com on
16/09/2004 23:39:30
Sent by: dysphagia-bounces@b9.com
To: "'dysphagia@b9.com'"
cc:
Subject: [Dysphagia] barium sulfate substitutes for MBS
One of our physicians is reluctant to order MBS studies due to prior
experience with an individual having a bad outcome after aspirating barium
sulfate during the MBS. I am checking with our radiology dept, but also
wanted to pose this question to the listserv. Does anyone know of any
safer contrast material that can be used?
Liza Sanders, SLP
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