CCI Registered Cardiovascular Invasive Specialist (RCIS) Practice Exam

Premedication to prevent contrast reactions relies on blocking histamine effects and damping inflammation before exposure. The standard approach uses an H1 antihistamine to reduce immediate histamine-driven symptoms, an H2 blocker to provide additional suppression of histamine’s effects on the vasculature, and a corticosteroid to lessen the inflammatory response that can contribute to a reaction. The combination of an H2 blocker (famotidine), an H1 blocker (diphenhydramine), and a glucocorticoid (Solu-Medrol, methylprednisolone) fits this strategy, making it the best choice. The other options mix drugs that are not used together for premedication in this scenario: epinephrine is reserved for treating acute reactions, not prophylaxis; sodium bicarbonate is mainly used for nephroprotection rather than allergy prevention; and while an older H2 blocker like cimetidine could be used, famotidine is preferred in current practice.