 | |
 | |
| Clinical data | |
|---|---|
| Trade names | Hypaque, Gastrografin, Iothalmate, others |
| Other names | amidotrizoic acid, diatrizoic acid, 3,5-diacetamido-2,4,6-triiodobenzoic acid |
| AHFS/Drugs.com | Micromedex Detailed Consumer Information |
| ATC code | |
| Identifiers | |
| |
| CAS Number | |
| PubChemCID | |
| DrugBank | |
| ChemSpider | |
| UNII | |
| KEGG | |
| ChEBI | |
| ChEMBL | |
| CompTox Dashboard(EPA) | |
| ECHA InfoCard | 100.003.840 |
| Chemical and physical data | |
| Formula | C11H9I3N2O4 |
| Molar mass | 613.916 g·mol−1 |
| 3D model (JSmol) | |
| |
| |
Diatrizoate, also known asamidotrizoate,Gastrografin, is acontrast agent used duringX-ray imaging.[1] This includes visualizingveins, theurinary system,spleen, andjoints, as well ascomputer tomography (CT scan).[1] It is given by mouth,injection into a vein, injection into the bladder, through anasogastric tube, orrectally.[2][3]
Relatively common side effects include vomiting, diarrhea, and skin redness.[4] Other side effects include itchiness,kidney problems,low blood pressure, andallergic reactions.[1] It is not recommended in people who have aniodine allergy.[1] Diatrizoate is aniodinated ionic radiocontrast agent with highosmolality.[2]
Diatrizoate was approved for medical use in the United States in 1954.[4] It is on theWorld Health Organization's List of Essential Medicines.[5]
 | This sectionmay beconfusing or unclear to readers. Please helpclarify the section. There might be a discussion about this onthe talk page.(June 2019) (Learn how and when to remove this message) |
Diatrizoic acid may be used as an alternative tobarium sulfate formedical imaging of thegastrointestinal tract, such asupper gastrointestinal series andsmall bowel series. It is indicated for use in patients who are allergic to barium, or in cases where the barium might leak into the abdominal cavity. It does not coat the stomach/bowel lining as well as barium, so it is not used commonly for this purpose.[citation needed]
It is also used to treatAscaris lumbricoides (roundworms).[6][7]Diatrizoate may not actually killAscaris, but instead it promotesshifting of fluid in the bowel lumen due to its osmotic properties[clarify], so may relieve intestinal obstruction caused by impactedAscaris.[8]
Diatrizoate is used in suspected intestinal perforation, meconium ileus, and to identify bowel-lumen communication. It should not be used to investigate tracheo-oesophageal fistula because it can cause pulmonary oedema when aspirated into respiratory system. Diatrizoate can dislodge sticky meconium by drawing water into intestines.[9] Diatrizoate is minimally absorbed from the intestines and excreted into urinary bladder.[10] Because of its high osmolarity it can draw water from the surrounding tissues into the intestines, thus cause dehydration in people with already small plasma volume such as infants. Because of the additives and flavouring agents, diatrizoate formulated as Gastrografin must not be used intravascularly, though other formulations of diatrizoate are indicated for intravascular use. This chemical must be kept away from sunlight during storage.[11]
It is given orally oncomputed tomography of the abdomen and pelvis as 30 ml solution with 3% concentration to visualise the bowel lumen and any communications with the bowel lumen.[12]In principle, diatrizoic acid is administered by the route most appropriate and sensible to image the structure/-s of interest (e.g., IV for blood vessels through which it is distributed and kidney–ureters–bladder that excrete it; orally or per rectally as an enema for the gastrointestinal tract).[citation needed]
A history of sensitivity to iodine is not a contraindication to using diatrizoate, although it suggests caution in use of the agent. In this case, a regimen of oral or intravenous corticosteroids may be given as prophylaxis, or an alternative such asbarium sulfate may be preferable.[citation needed]
Gastrografin is contraindicated to use along with certain medications that can causelactic acidosis, such asmetformin. Concurrent use may lead tokidney failure and lactic acidosis, and a clinician may need to space the agents apart over a number of days to prevent an interaction.[13]
Gastrografin is a hypertonic solution, and therefore it should be avoided in imaging studies of the upper gastrointestinal tract in patients who are at risk of aspiration, as it will cause prompt pulmonary edema if accidentally introduced into the tracheobronchial tree.[14][15]
Urografin is not to be used for myelography, ventriculography or cisternography, since it is likely to provoke neurotoxic symptoms in these examinations.[16]
Diatrizoate is considered a high-osmolality contrast agent. Its osmolality ranges from approximately 1500mOsm/kg (50% solution)[17] to over 2000 mOsm/kg (76% solution).[18]
3,5-Dinitrobenzoic acid is reduced to 3,5-diaminobenzoic acid usingRaney nickel orpalladium on carbon. This is then reacted with potassium iodochloride oriodine monochloride to produce 3,5-diamino-2,4,6-triidobenzoic acid, which is finally acylated usingacetic anhydride and acidified withsulfuric acid to produce diatrizoate.[19]
Another synthesis pathway iodates 3,5-diacetamidobenzoic acid using iodine monochloride.[19]
Brand names include Hypaque, Gastrografin, MD-Gastroview, Iothalmate, and Urografin. Urografin is a combination of thesodium andmeglumine salts.[citation needed]
