Acetrizoic acid explained

Acetrizoic acid is a pharmaceutical drug that was used as an iodinated contrast medium for X-ray imaging.[1] [2] It was applied in form of its salt, sodium acetrizoate, but is no longer in clinical use.[3]

Chemistry and mechanism of action

The substance has high osmolality and is water-soluble. The three iodine atoms in the molecule readily absorb X-rays and are therefore responsible for its usability as a contrast medium.

History

Acetrizoate was developed by V.H. Wallingford of Mallinckrodt, and introduced in 1950;[4] it was employed as a contrast agent for several radiographic studies, including pyelography,[5] [6] angiography of the brain, carotid arteries and the aorta,[7] [8] and cholecystography.[9] [10] It was soon found to be highly toxic to the kidneys and nervous system—work urging caution in its administration was published as early as 1959,[11] after reports of adverse reactions ranging from hypersensitivity to brain damage—and was eventually replaced by other agents with higher efficacy and lower toxicity, such as sodium diatrizoate, a closely related compound.[4]

Trade names

Trade names include Urokon, Triurol and Salpix, as well as Gastrografina and Urografina in Portugal.

Notes and References

  1. Acetrizoic acid.

  2. 20641966. 2004. Cheng. K. T.. 5-3-Hydroxy-2-hydroxymethyl-propionamido)-N,N´-dimethyl-N,N´-bis-(2,3-dihydroxypropyl)-2,4,6-triiodoisophthalamide.
  3. Web site: Acetrizoate sodium . March 5, 2000 . 2007-11-14 . . Online Medical Dictionary.
  4. McClennan BL . Preston M. Hickey memorial lecture. Ionic and nonionic iodinated contrast media: evolution and strategies for use . AJR. American Journal of Roentgenology . 155 . 2 . 225–33 . 1990 . 2115244 . 10.2214/ajr.155.2.2115244.
  5. NESBIT RM, LAPIDES J . Preliminary report on urokon, a new excretory pyelographic medium . J Urol . 63 . 6 . 1109–12 . 1950 . 10.1016/s0022-5347(17)68871-2 . 15422724 .
  6. EYLER WR, DREW DR, BOHNE AW . A comparative clinical trial of urographic media: renografin, hypaque, and urokon . Radiology . 66 . 6 . 871–3 . 1956 . 13323329 . 10.1148/66.6.871.
  7. LIU P, MURTAGH F, WYCIS HT, SCOTT M . Report of one hundred carotid angiograms taken with the new contrast medium acetrizoate (urokon) on Chamberlain's biplane stereoscopic angiographic unit . AMA Archives of Neurology & Psychiatry . 69 . 5 . 651–2 . 1953 . 13039633 .
  8. SEAMAN WB, SCHWARTZ HG . Cerebral arteriography with sodium acetrizoate (urokon sodium) 30% . AMA Archives of Surgery . 67 . 5 . 741–5 . 1953 . 13103941 . 10.1001/archsurg.1953.01260040752012.
  9. ORLOFF TL . Intravenous cholecystography with a new medium; experience with sodium acetrizoate (urokon sodium) seventy per cent . AMA Archives of Surgery . 71 . 4 . 620–2 . 1955 . 13258064 . 10.1001/archsurg.1955.01270160146019.
  10. WOOLLEY IM, KEIZUR LW, MAYERHARNISCH G . Gallbladder visualization following the use of 70 per cent sodium acetrizoate (urokon sodium) for intravenous pyelography . Radiology . 69 . 4 . 576–7 . 1957 . 13485425 . 10.1148/69.4.576.
  11. LANCE EM, KILLEN DA, SCOTT HW . A plea for caution in the use of sodium acetrizoate (urokon) for aortography . Ann Surg . 150 . 1 . 172 . 1959 . 13661846 . 10.1097/00000658-195907000-00022 . 1613496.

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