title: Neonatal Intensive Care Drug Manual - bet 331
text: |
  Neonatal Intensive Care Drug Manual
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  bet | 331/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Isovue
  Revision Date : 10-12-2020
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  Approved: NK, TC, KOH
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  Indication :
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  Checking placement of central catheters (i.e. {PICC lines, etc)
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  Dose :
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  0.5ml
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  Interval :
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  Once only
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  Route :
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  Intravenously instilled into the central line
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  Total Daily Dose :
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  1.5ml
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  Comments :
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  Isovue is a non ionic radioopaque contrast medium for intravascular injection1
  The patient must be well hydrated prior to the procedure.
  The contrast chouild be warmed to body temperature.
  Sterile gloving and gowning by Neonatal Registrar required. X-Ray plate needs to be in place before procedure begins. Registrar injects 0.5 ml of Isovue, and as the last 0.1ml is being injected the x-ray should be taken. Use a 1 mL syringe. Following the x-ray, flush with 1 ml of Normal Saline to prevent thromboembolic events .
  The position of the line must be confirmed before commencing maintenance infusions.
  . Fatal reactions have been associated with the administration of water soluble contrast media, most of which have been attributed to chemical, allergic or idiosyncratic effects. It is of utmost importance that a course of action be carefully planned in advance for the immediate treatment of serious reactions, and that adequate and appropriate facilities and personnel be readily available in case of a severe reaction.
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  Comments
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  Iopamidol can induce clotting iff broughtinto contact with blood in a syringe or catheter.
  Contraindicated in known hypersensitivity to iopamidol and thyrotoxicosis.
  Caution in patients with reduced renal or hepatic function. Isovue is excreted primarily by the kidneys.
  In phaechromocytoma uncontrollable hypertensive crisis can be induced.
  Can induce sickling in patients who are homozygous for sickle cell disease.
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  Supplied as :
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  Isovue-300 (iopamidol injection 61%) provides iopamidol 612 mg with trometamol 1 mg and sodium calcium edetate 0.39 mg, and contains approximately 0.037 mg (0.002 mEq) sodium and organically bound iodine 300 mg/mL
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  Dilution :
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  None required.
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  Stability :
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  Storage :
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  Store below 30 degrees C. Protect from light
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  Incompatibility :
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  Do not mix with any other iv fluids.
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  Serum Levels :
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  References:
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  https://www.ema.europa.eu/documents/scientific-guideline/draft-guideline-guideline-core-summary-product-characteristics-smpc-package-leaflet-iopamidol-370_en.pdf
  Ahmet A, et al Hypothyroidsm in Neonates post-iodinated contrast media: a systematic review
  https://www.medicines.org.uk/emc/product/3898/smpc#gref
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  Original version Date: 9/1/2014
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  Author: AK, JD
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  Current Version number: 2
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  Version Date: 7/12/2020
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  Risk Rating: Low
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  Due for Review: 7/12/2025
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  Approved by: DTC
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  Approval Date: TBA
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