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PubMedDate not supplied

Saturation kinetics of iopanoate in the dog.

Experiments were carried out in dogs with a modified Thomas cannula in the duodenum through which the common bile duct could be catheterized. Constant intravenous infusion of sodium iopanoate at different infusion rates greater than the apparent excretion maximum revealed linearity of the blood concentration with time above a threshold concentration. When the slopes of the blood curves were plotted against the known infusion rates, a straight line relationship was obtained. The X axis intercept of this straight line represents an apparent transport maximum. This value obtained from the X axis intercept matched closely with the observed excretion maximum determined from bile and urine collection. The slope of this same line equals the inverse of the volume of distribution of the drug. Although previous workers have failed to appreciate an apparent transport maximum for iopanoate, the current studies clearly demonstrate that iopanoate is excreted by a saturable mechanism. Using this technique the apparent transport maximum for iopanoate was evaluated at high and low rates of taurocholate replacement to evaluate the quantitative effect of bile salt on the apparent transport maximum. A five-fold increase in taurocholate replacement led to an average 40% increase in the apparent transport maximum of iopanoate without effecting its volume of distribution significantly.

Animals↗
PubMedDate not supplied

The role of cholecystokinin in radiographic opacification of the gallbladder.

Studies of the effect of cholecystokinin (CCK) on hepatic elimination of intravenously administered iopanoate and on gallbladder opacification were performed using nonoperated dogs with intact enterohepatic circulation and normal endogenous bile salt pool. Intravenous administration of CCK (3 units/kg) resulted in a 32% increase in apparent transport maximum (maximum rate of elimination) of iopanoate and earlier and enhanced gallbladder opacification. This increase in apparent transport maximum was abolished by cholecystectomy, indicating that the increase was a result of the release of bile salts from the gallbladder rather than a direct effect of the hormone on the hepatic elimination of iopanoate. The early gallbladder opacification and increased density of contrast material in the gallbladder were related to CCK-induced emptying of the gallbladder and subsequent filling with opacified bile.

Animals↗
PubMedDate not supplied

Combined cholangiography and cholecystography using sodium iopanoate.

Cholangiography and cholecystography were performed in fasted dogs and human subjects using sodium iopanoate given intraduodenally in doses of 10 and 20 mg/kg. The same studies were performed after intraduodenal administration of fat or after intravenous administration of cholecystokinin (CCK) in dogs and after a fatty meal, to stimulate endogenous release of CCK, in human subjects. In both the animals and human subjects, peak blood iodine concentrations were reached by 30 minutes after iopanoate administration. At a dose of 10 mg/kg, radiographic visualization of both bile ducts and gallbladder was inconsistent. At 20 mg/kg (one-half the clinical dose for standard oral cholecystography,) the common bile duct was visualized within 60 minutes and the gallbladder within 90 minutes. Gallbladder density increased over the next 6 hours. Prior administration of fat or CCK led to earlier and denser gallbladder opacification. The common bile ducts opacified with the use of iopanoate were small in caliber, averaging only 3 mm. This probably reflects the fact that, unlike iodipamide, iopanoate has little or no choleretic effect. Therefore, because it would not increase the volume of bile in the duct, iopanoate would not increase duct size.

Adult↗
PubMedDate not supplied

Nephrotoxicity of sodium iopanoate in hydrated and dehydrated dogs.

The nephrotoxic effect of sodium iopanoate, infused intravenously in dosages of 1.5, 3 and 6 g over a 2-hour period in eight dogs (22--27 kg) in both the hydrated and dehydrated stages, were investigated. On biochemical, hemodynamic and morphological studies, the nephrotoxic effect was found to be clearly dose-dependent and greater in the dehydrated stage. Previously suggested mechanisms for acute renal failure, such as a direct tubular toxicity, tubular obstruction and hypotension, could not be supported as main factors in the development of acute renal failure post-cholecystography, although they might well have a contributory effect. The primary cause of renal failure post-cholecystography cannot be determined unequivocally from this investigation. However, the observed findings would appear to be consistent with a toxic effect of iopanoate in the small vessels possibly resulting in ischemic tubular necrosis.

Acute Kidney Injury↗
PubMedDate not supplied

Aspirin effect on canine iopanoate transport maximun.

Iopanoate saturation kinetics were measured in four dogs both drug free and following six days of low dose aspirin ingestion. Each animal acted as its own control. In post aspirin ingestion studies there was s significant (P less than .001) decrease in the apparent Vmax of iopanoate. The volume of distribution showed no significant change, and gallbladder visualization showed no significant change despite the decrease in Vmax. Although aspirin pretreatment decreases the control Vmax by 50%, its mechanism and significance in the clinical setting will require further study.

Administration, Oral↗
PubMedDate not supplied

Oral cholecystography in the early phase of acute alcoholic pancreatitis. A prospective, randomized comparison of Telepaque and Bilopaque.

Biliary tract disease is a major cause of acute pancreatitis. However, with traditionally employed Telepaque, radiographic visualization of the gallbladder during acute pancreatitis remains unreliable, even in patients with apparently normal gallbladders. Therefore, oral cholecystography has customarily been deferred for such patients for several weeks. Recently, successful oral cholecystography has been described during the acute episode of pancreatitis, using Bilopaque, a more water-soluble cholecystopaque. The relative intestinal absorption of Telepaque and Bilopaque and the ability of these agents to produce diagnostic oral cholecystograms of fasting patients with acute alcoholic pancreatitis were compared. Forty-five hospitalized patients were studied within 96 hours of admission. Mean peak plasma contrast concentrations for Bilopaque exceeded those for Telepaque. Thirty-one percent of the Bilopaque group achieved diagnostic single-dose oral cholecystograms, compared with to 11% of the Telepaque group (P less than 0.05).

Acute Disease↗
PubMed2002

A surface-modified chylomicron remnant-like emulsion for percutaneous computed tomography lymphography: synthesis and preliminary imaging findings.

RATIONALE AND OBJECTIVES: To assess a surface-modified emulsion as a percutaneous CT lymphographic agent in normal dogs. METHODS: An iodinated chylomicron remnant-like microemulsion was formulated with a mean particle size of 91.3 nm and an iodine concentration of 91 mg I/mL. Contrast material (2 mL) was injected into the subcutaneous tissues of the metatarsus and metacarpus of six normal dogs to enhance popliteal and cervical lymph nodes, respectively. CT images were acquired at 0, 15, 30, 45, 60, 240, 480, and 1440 minutes. RESULTS: Significant lymph node enhancement occurred in as little as 15 minutes after injection and persisted at least 8 hours. Node opacification was most pronounced at 1 to 4 hours postinjection and exceeded 200 HU in some nodes (precontrast attenuation = 45 HU). Marked enhancement of popliteal efferent lymphatics and of iliac and sacral node groups also occurred indicating distribution to second order nodes. Attenuation of enhanced nodes reverted to precontrast levels by 24 hours. CONCLUSION: The new surface-modified, chylomicron remnant-like emulsion provided marked, selective enhancement of targeted lymph nodes after subcutaneous administration. Moreover, the formulation produced significant opacification of more distant node groups from a single injection.

Animals↗
PubMed1987

Gallstones: a comparison of real-time ultrasonography and cholecystography with surgical correlation.

Real-time ultrasonography is more accurate and technically more efficient than gray scale ultrasonography in establishing the diagnosis of cholecystolithiasis. In prospective studies accuracy may be as high as 96%, and reflects the use of specific sonographic diagnostic criteria. Retrospective studies, however, reveal a lower accuracy rate of 90%, suggesting that practicing radiologists are not ready to accept these restricting criteria. On the other hand, oral cholecystography (OCG) is well tolerated and gives a reproducible, reliable result independent of technical expertise. It is 96% accurate in detecting the presence of gallstones and carries a sensitivity of .97. Both studies are prone to overinterpretation, which skews specificity and adversely affects diagnostic accuracy. In this retrospective review of 234 consecutive cases of cholecystectomy, real-time ultrasound was 90% accurate with a sensitivity of .96 in determining the presence of cholecystolithiasis. Oral cholecystography was 95% accurate with a sensitivity of .97.

Administration, Oral↗
PubMed1984

Oral cholecystographic contrast media--a comparative study.

Three oral cholecystographic contrast media have been compared, mainly with regard to their ability to outline the gall bladder and also the frequency of undesirable side-effects that they produce. No significant differences were found between the media, and the final choice of a suitable medium for use in X-ray departments may depend on their relative cost. In times of financial restraint, such a decision might increasingly involve hospital pharmacists.

Administration, Oral↗