Premediction for Contrast
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þ Immediate Dye Reactions
 - at least 50% decrease if low-osmolality agents used instead.

þ N-Acetylcysteine (Mucomyst)
 - effective at preventing contrast reactions
 - 600 mg PO BID day before and day of contrast per Mercy non-emergency
   protocol
 - [NEJM 2000;343:180-4]

þ Basic premed (Mercy Hospital) for those with contrast allergy:
 - Medrol 32 mg PO 12 hours and again 2 hours prior to contrast
 - Some places also add Benadryl 50 mg 2 hours prior to contrast (Magee)
 - use nonionic contrast

þ Medications to be stopped if giving contrast:
 - glucophage (metformin):  stop for 48 hours at time of contrast and have
   BUN/Cr rechecked by family doctor before restarting.
 - used to be said to stop 48 hours prior, but that recommendation's
   changed now

þ Bicarb is better:
 - <CTBicarb.TXT>