Deleterious synergism of a cardiac glycoside and sodium diatrizoate.
Studies were performed in mice to determine if the cardiac glycoside, Strophanthin-K, and the contrast medium, sodium diatrizoate, interact synergistically to produce death. Intravenous injections of lethal and near lethal doses of the two agents produced a significantly greater mortality than the individual agents alone. Low or near clinical doses of Strophanthin-K, when given with doses of diatrizoate in the lethal range, produced mortalities significantly greater than did the diatrizoate alone. Similarly, low or near clinical doses of diatrizoate given with doses of Strophanthin-K in the lethal range produced mortalities significantly greater than for the Strophanthin-K alone. Isotonic or hypertonic saline, when substituted for diatrizoate or Strophanthin-K did not produce synergistic increases in mortality. Thus neither the injection volume, nor agent hypertonicity or ionic strength, seem to be the primary factors in the synergism to produce death. The diatrizoate anion appears to be an important factor. Until more information is available from other animal models it appears that patients receiving cardiac glycoside should be considered to have a higher than normal risk of serious reactions to contrast media in intravenous urography.
D000818:Animals; D001810:Blood Volume / Q000187:drug effects; D003973:Diatrizoate / Q000008:administration & dosage / Q000009:adverse effects*; D004357:Drug Synergism; D005260:Female; D007928:Lethal Dose 50; D008297:Male; D051379:Mice; D013328:Strophanthins / Q000008:administration & dosage / Q000009:adverse effects*
D013328:Strophanthins; D003973:Diatrizoate