Changes to MIMS Iodine-containing compounds allergy classes – February 2024

this article describes changes around iodine containing compounds allergy classes if you use the mims ne formulary in profile for windows, please read this article download and import the attached foq at the bottom of this article changes to mims iodine containing compounds allergy classes mims have notified us that after extensive review, the editorial team has decided to delete the iodine containing compounds allergy class and replace it with the following allergy classes this is necessary because current guidelines do not support broad cross reactivity between all iodine containing compounds (e g potassium iodide vs iotroxate meglumine) also refer to detailed reasons for the change bookmark%3a// detailed reasons for section below for more information substances that were listed under “iodine containing” compounds will be reclassified under the three new allergy classes iodinated contrast media iodine and iodine compounds iodine radioisotopes (no products currently listed in mims) in addition, the following cross sensitivities have been created to support precaution on potential cross reactivities between the molecules amiodarone iodine and iodine compounds a case of allergic reaction to amiodarone was reported in a patient with a history of iodine allergy iodine and iodine compounds iodinated contrast media in one study, two patients were reported to be sensitised to povidone iodine and radiocontrast media however, another study demonstrated that iodine is rarely the eliciting agent in hypersensitivity reactions to radiocontrast media these changes have been included in the data release for february 2024 and subsequent what this means in profile/hcc what mims refers to as “allergy class” is in profile terms, a formulary group of type “specific allergen” iodine containing compounds was – up to the january formulary a specific allergen group in profile/hcc patients may have an adverse reaction to the “ iodine containing compounds ” group recorded, e g if a patient has an adverse reaction to “ iodine containing compounds ”and you are set up to be alerted for adverse reactions, an alert would have come up when prescribing any medication belonging to this group for example – before this change – this would have happened when prescribing “gastrografin 370mg iodine/ml gastroenteral solution” after importing the february mims files in the formulary, the “ iodine containing compounds ” groupno longer exists the new specific allergen groups mentioned above will be in the formulary iodinated contrast media iodine and iodine compounds iodine radioisotopes the two new cross sensitivity allergen groups mentioned above will be in the formulary amiodarone iodine and iodine compounds iodinated contrast media iodine and iodine compounds when prescribing substances that were previously included in the “ iodine containing compounds ”group (e g “gastrografin…”),no ‘adverse reaction’ warning will come up, unless an adverse reaction to one or more of the new specific allergen groupsis added to the patient impact and recommended actions we recommend you review patients with “ iodine containing compounds ” allergies and take appropriate action using your clinical judgement and appendix a bookmark%3a// appendix a as a reference actions may include replacing the adverse reaction to the obsolete specific allergen group with a more suitable candidate this may be another specific allergen group or even the actual allergen(s) or product(s) the more specific, the better if you cannot determinean appropriate replacement, you may want to add a reminder against the patient record to conduct a review during the next patient encounter if a suitable alternative candidate is available, adjust it as required open the adverse reaction to “iodine containing compounds” using your preferred method, e g double click on it from the problems view, or from an encounter, scripts or adverse panel in the code field, click on the ellipses the select disease code window will open in the look for field, search for the new appropriate specific allergen group, allergen or product the following are just examples or or press ok in the confirmation prompt, press update press ok the adverse reaction has now been updated for the patient or or appropriate warnings will now be triggered when prescribing substances belonging to the new allergen groups find objects query to assist with this task, we have provided afind objects queryto capture all patients who have an adverse reaction recorded to a group whose name is equal to “iodine containing compounds” to import it save “patients with adverse reaction to iodine containing compounds ihq” onto a suitable location go to report/stored queries , click on the import icon and navigate to the file you can adjust the query if required alternatively, you could set up a patient group with the same condition, if preferred if you have any queries about these changes, please contact our support team telephone 0508300900 e mail help\@intrahealth com mailto\ help\@intrahealth com appendix a a table of allergen groups description automatically generated detailed reasons for the change based on guidelines published by the american college of radiology (acr), the american academy of allergy, asthma and immunology (aaaai), and australasian society of clinical immunology and allergy (ascia), patients with allergies to seafood or iodine do not need to avoid iodinated contrast media (icm) moreover, there is no evidence that sensitivity to iodine predisposes patients to radiocontrast media hypersensitivity reactions the most significant risk factor for iodinated contrast media (icm) hypersensitivity is a history of icm hypersensitivity the hypersensitivity mechanism and chemical structural similarity underlying the cross reactions between iodinated contrast media has yet to be established, but there is sufficient evidence that iodine is not the causative moiety therefore, iodinated contrast media have been separated from other iodine containing compounds in a case report, a patient with previous allergic reaction to an iodinated contrast media was successfully treated with radioactive iodine the report suggests that allergy to radiocontrast media is not a contraindication to receiving radioactive iodine for scanning and/or treatment purposes therefore, radioactive iodine has been separated from other iodine containing compounds attachments