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Myelograms



- Metrizamide;
    - water soluble contrast agent that is absorbed by the body, enhances definition of structures;
    - it is meningeal irritant, but has not been associated w/ arachnoiditis;

- Clinical Reactions:
    - nausea, vomiting, confusion, and seizures;
    - side effects are related to dehydration, phenothiazines, tricyclics, and migration of contrast agent into the cranial vault;
          - hence ensure adequate hydration, d/c all tricyc's & phenothiazine;
          - maintain the patients head at 30 deg until the contrast is absorbed;

- Iohexol:
    - is a nonionic contrast medium which is approved for thoracic & lumbar myelography;
    - complications include HA (20%), pain (8%), N/V (9%);
    - keep patient well hydrated and d/c all phenothiazines



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