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Nonionic Dimer
A nonionic dimer consists of 2 joined nonionic monomers. Nonionic dimers are used as x-ray and CT contrast media.
Nonionic dimers have the lowest osmolarity. These contrast materials contain 6 iodine atoms for every 1 particle in solution (CM ratio=6). Modern CT techniques require fast bolus injections and thus low-viscosity, high-concentration, well-tolerated contrast agents. Nonionic dimers have the highest viscosity, which limits the clinical usefulness. Examples of nonionic dimers are iotrolan (Isovist®) and iodixanol (Visipaque).

See also Contrast Agents.
Nonionic Monomer
Nonionic monomers are used as x-ray contrast agents. To create a nonionic monomer, the tri-iodinated benzene ring is made water soluble by the addition of hydrophilic hydroxyl groups to organic side chains (CM ratio=3). Nonionic monomers have an intermediate osmolarity, intermediate viscosity and elevated hydrophilicity with three atoms of iodine per molecule. Lacking a carboxyl group, nonionic monomers do not ionize in solution. A nonionic monomer is potentially less chemotoxic than an ionic monomer.
Common nonionic monomers are iohexol (Omnipaque), iopamidol (Isovue®), ioversol (Optiray®), and iopromide (Ultravist®). Nonionic monomers are contrast agents with a wide range of indications due to their nonionic nature and lower osmolalities.
Adverse Reaction
Adverse reactions on contrast agents are rare, but like all other pharmaceuticals, contrast media are not completely without side effects.
Adverse effects to contrast media include allergic symptoms, anaphylactoid reactions, chemotoxic reactions, idiosyncratic reactions, contrast-induced nephropathy, iodide-induced hyperthyroidism and local tissue damage. An adverse reaction can be related to dose, the toxicity, and the physio-chemical properties of the contrast agent, for example osmolality, viscosity, and hydrophilicity.
Side effects such as a metallic taste in the mouth, generalized warmth or flushing, nausea and vomiting, increase with rapid flow and large volume of the injected agent. Although venous tolerance is usually good, there have been reports of sensation like burning, stinging or numbness and of venospasm.

Characterization of adverse reactions include:
Allergic drug reactions never occurs on the first exposure, but it can occur even with small amounts.
Chemotoxic reactions result from the properties and characteristics of the used drug, the dose, speed of injection, etc. Hemodynamic disturbances and injuries to organs or vessels perfused by the contrast agent are included.
Idiosyncratic reactions can occur on first exposure to the contrast medium. And unlike a side effect, the reaction occurs only in susceptible individuals, probably due to a genetic or metabolic abnormality.
Amersham Health
www.amershamhealth.com

Amersham Health, now GE Healthcare was the imaging diagnostics and therapy business of Amersham plc. The imaging business produced contrast agents that are injected into the body to improve pictures obtained through medical imaging scans.

Contact Information
MAIL
Amersham Health
Amersham Place
Little Chalfont, Buckinghamshire HP7 9NA
UNITED KINGDOM
PHONE
+44 (0) 1494-544000
FAX
+44 (0) 1494-542266
Barium Sulfate
Barium sulfate (BaSO4) is an inert and insoluble white powder with high density. Barium belongs chemically to the group of heavy metals. Mixed with water and additional ingredients (e.g., sweetening agents), barium sulfate is the preferred positive contrast agent for abdominal x-ray and computed tomography examinations. The extremely low solubility of barium sulfate protects patients from absorbing harmful amounts of the metal (water soluble metal compounds are often highly toxic). The high density in x-ray examinations is related to the high atomic number, since large nuclei absorb x-rays much better than smaller nuclei.
Barium sulfate agents for opacification of the gastrointestinal tract are not absorbed or metabolized and are resistant to dilution. These contrast agents are opaque white suspensions and usually swallowed or administered as an enema. They provide better delineation of mucosal details and are less expensive than water-soluble iodinated contrast media. The elimination rate is a function of gastrointestinal transit time. After GI application, it leaves the body with the feces.

Contraindications of barium sulfate products in case of known or suspected:
obstruction of the colon;
gastrointestinal tract perforation;
tracheoesophageal fistula;
obstructing lesions of the small intestine;
inflammation or neoplastic lesions of the rectum;
hypersensitivity to barium sulfate formulations;
recent rectal biopsy;
pyloric stenosis.
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