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Heparin

Anticoagulant in vial form. Prevent hypercoagulation

Warfarin

Anticoagulant in tablet form. Prevent hypercoagulation

Lidocane

Local anesthetic

Propofol

General anesthetic

Insulin

Diabetic patients may take their usual dose of this for early morning cases or reduce their morning dose by one half for midday cases to prevent hypoglycemia

Metformin

Diabetic patients taking this oral hypoglycemic (Glucophage) are at a very small risk for severe lactic acidosis

Diuretics

Type of drug used for hypertension

2-6

Heparin is stopped for _-_ hours before interventional procedures and restarted 1-6 hours afterward

Warfarin

May be withheld for several days before elective procedures, during which time the patient is switched to heparin

Aspirin

Another antiplatelet agent that is often started on the day before possible vascular recanalization procedures. Non-steroidal anti-inflammatory drug

Lorazepam

Favored by some interventionalists for pre procedure sedation. Can be in vial or tablet form

32-50 mg; 12 and 2 hours

_-_ mg PO of prednisone given _ hours and _ hours before the procedure (mandatory)

Prednisone

Steroid or coricosteroid given 12 hours and 2 hours before the procedure

N-acetylcysteine

AN antioxidant that acts as a scavenger of oxygen free radicals and inhibitor of certain proteins implicated in kidney damage from iodine-based contrast media. Mucolytic agent

Fenoldopam (Corlopam)

A dopamine-1 agonist approved by the US FDA for treatment of severe, refractory hypertension

Sodium Bicarbonate Infusion

Found to be more effective than saline hydration in prevention of contrast nephropathy in patients with some degree of renal dysfunction undergoing cardiac catheterization

Theophylline

An antagonist of adenosine, which has been implicated in contrast-related nephropathy by a vasoconstrictor effect leading to reduced glomerular filtration. A bronchodilator

Midazolam (Versed)

A short-acting benzdiazepine that acts on GABA (gamma aminobutyric acid) receptors to cause central nervous system depression (including anxiolysis and antegrade amnesia)

Fentanyl (Sublimaze)

A short-acting narcotic opioid analgesic that also is metabolized by the liver. Large dose may be needed for major side effects to contrast media

Atropine

A muscarinic, cholinergic blocking agent that affects the heart, bronchial and intestinal smooth muscle, central nervous system, secretory glands, and iris

Sublingual Nifedipine

Was once considered the first-line agent for several reasons, including its rapid onset of action

Labetalol

Replaced sublingual nifedipine because of scattered reports of life-threatening hypotension associated with it. Nonselective beta blocker

Oral Clonidine

May be useful in the postprocedure period to treat high blood pressure

Droperidol or Prochlorperazine

Intravenous antiemetic that may treat persistent symptoms of mild contrast agent reaction

Diphenhydramine (Benadryl)

May be helpful if itching is bothersome or the rash is widespread