Table 1.
Study | Population | Risk Factors for Allergic Reactions | Prophylactic regime | Contrast agent | Reaction |
Gates 1972 [13] | 2000 adults undergoing IVP | History of allergic reactions taken, patients with positive history included | Diphenhydramine 10 mg ivi 1 minute prior to contrast | 30–60 ml Renograffin 60 (Ionic) | Not defined |
Small 1982 [14] | 220 adults undergoing IVP | Patients taking anti-histamines excluded | Chlorpheniramine 10 mg sci 15 minutes prior to contrast | Not recorded | Hives, generalised pruritis |
Bertrand 1992 [16] | 400 adults undergoing IVP, CT or lower limb venography | Patients with history of allergy, atopy, drug sensitivity or previous reactions to contrast excluded | Hydroxyzine 100 mg po 12 hours prior to contrast | Meglumine ioxaglate (Ionic) | Nausea, vomiting, hives, urticaria, flushing, facial oedema, wheezing, dyspnoea, laryngeal oedema, hypotension, death |
Ring 1985 [15] | 800 adults undergoing IVP | Patients with previous life-threatening contrast reaction excluded | 1. Prednisolone 250 mg ivi, 5 minutes prior to contrast 2. Clemastin 0.03 mg/kg ivi, 5 minutes prior to contrast 3. Clemastin 0.03 mg/kg ivi + cimetidine 5 mg/kg vi, 5 minutes prior to contrast |
100 ml meglumine amidotrizoate (ionic) | Flush, urticaria, angioedema, respiratory symptoms, vomiting, tachycardia, hypotension |
Lasser 1987 [17] | 6763 adults undergoing IVP or contrast enhanced CT |
Patients with previous severe reaction excluded. Patients with general allergies, drug allergies and previous non life threatening reactions were included | 1. Methylprednisolone 32 mg po two hours prior to contrast 2. Methylprednisolone 32 mg o the night before + two hours prior to contrast |
Various ionic contrast agents | Grade 1: emesis, nausea, sneezing, vertigo Grade II: Hives, fever, hills, Grade III: Shock, bronchospasm, laryngospasm, laryngeal oedema, loss of consciousness, angioedema |
Lasser 1994 [18] | 1155 adults undergoing IVP or contrast enhanced CT | Patients with allergies including previous reactions to contrast were included | Methylprednisolone 32 mg po the night before and two hours prior to the contrast | Iohexol, Ioversol (non-ionic) | As per Lasser 1987 |