Radiopharmaceuticals

RADIOPHARMACEUTICALS

Is a radioactive pharmaceutical agent

that is used for diagnostic or therapy in

a tracer quantity.

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Nuclear medicine can detect the radiation coming from inside a patient’s body. All of these other procedures expose the patient to radiation from outside the body using machines that send radiation through the body. As a result, nuclear medicine determines the cause of amedical problem based on organ function in contrast to the other diagnostic tests, that determine the presence of disease based on anatomy or structural appearance.

How is nuclear medicine different from an x-ray, a CT scan, an ultrasound, or an MRI?

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•Radioisotope

• a carrier molecule

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RADIOISOTOPE

• A version of a chemical element that has an unstable nucleus and emits radiation during its decay to a stable form.

• All isotopes are not radioisotopes.

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how does it work?

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• therapeutic• diagnosing

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Designed to deliver therapeutic dose of ionizing radiation to specific disease site, such as cancerous tumors, with high specificity in the body.

Historically, used to treat Thyroid cancer, Graves’ disease, hyperthyroidism, and bone pain pallitation associated with skeletal metastasis.

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used to derive detailed description of the morphology and dynamic functioning of the various internal organs of the body.

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• It can be used as diagnosis and treatment of patients

• It is common cure to cancers

• Can treat multiple disease sites.

• Widely available mode of treatment

• Directly treats tumor, especially useful for bone metastasis

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• Can provide fast onset of pain relief

• Single dose is effective for some patients

• Nuclear medicine tests can be performed on children

• Nuclear medicine procedures are cost effective and painless

• Nuclear medicine procedures have no side effects and are completely safe

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• Can produce some allergic reactions

• It has a radiation risk

• Myelosuppression may occur, especially with prior chemotherapy

• When multiple fractions are given, it may produce prolonged inconvenience and discomfort for patients

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• Nuclear medicine tests are not recommended for pregnant women because unborn babies have a greater sensitivity to radiation than children or adults

• Filling in patients' teeth, dental braces and permanent bridges may cause some distortion around the mouth area

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PROCUREMENTPurchasing radiopharmaceutical involves

determining product specifications, initiating purchase orders, receiving shipments, maintaining inventory and storing materials under proper conditions.

Since, some radiopharmaceutical poses a short half-life. Typically, the nuclear pharmacist would order the drug directly from the manufacturer primarily by overnight delivery

Storage of radioactive materials must incorporate appropriate radiation shielding in addition to traditional requirements for light, temperature, and humidity.

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Compounding of radiopharmceuticals requires receipt (or anticipation) of:

• a valid prescription/drug order

• appropriate components, supplies, and equipment

• a suitable environment, especially for sterile dosage forms

• appropriate recordkeeping, including witten procedures and lot-specific in formation to ensure traceability;

• Validation/verification of the compounding procedure, storage conditions, and expiration

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Involves reconstituting reagent kits, radiolabelling, and strict aseptic technique must be followed during compounding.

A kit involves pre-packed set of sterile ingredients.

The freeze-dried kit is reconstituted by aseptically transferring the necessary activity of sodium pertechnetate using a sterile syringe and needle.The reconstituted kit is aseptically subdivided to provide each patient dose with a sufficient activity after administration.

A diluent may be added to the final dose to give the desired radioactive concentration.

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Radiopharmaceuticals are generally expected to conform to specifications under the following heading:

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a. Radionuclide concentration

b.Radiochemical purity

c. Chemical purity

d.Sterilitye. Apyrogenicit

y

f. Absence of foreign particulate matterg. Particle size (if

appropriate)h. pHi. Biological distribution

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Dispensing

Recommends dosage levels based on patient history, age, weight, surface area, and/or other factors

Dispenses prescriptions in conjunction with applicable pharmacy law and keeps appropriate records

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Dispensing

Develops policies and procedures to ensure that the correct drug in the correct dosage and dosage form is received by the correct patient at the correct time via the correct route of administration

Develops policies and procedures, supervises, and reviews the activities of non-pharmacist personnel under the pharmacist's supervision


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Distribution

Complies with all applicable regulations concerning packaging, labeling, and transportation of radioactive and other materials (e.g., biohazards), demonstrating knowledge of:

DOT regulations concerning packaging, labeling, and transportation of radioactive and other materials.

Proper procedures and use of equipment necessary to verify that package meet DOT requirements.


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Allergies

If you will be receiving albumin in the form of radioiodinated albumin, technetium Tc 99m albumin aggregated, technetium Tc 99m albumin colloid, or technetium Tc 99m albumin for your test, tell your doctor if you have ever had any unusual or allergic reaction to products containing human serum albumin.

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Pregnancy

Radiopharmaceuticals usually are not recommended for use during pregnancy. This is to avoid exposing the fetus to radiation.

This is especially important with radiopharmaceuticals that contain radioactive iodine, which can go to the baby's thyroid gland and, in high enough amounts, may cause thyroid damage.

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Breast-feeding

Some radiopharmaceuticals pass into the breast milk and may expose the baby to radiation. If you must receive a radiopharmaceutical, it may be necessary for you to stop breast-feeding for some time after receiving it.

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Children

For most radiopharmaceuticals, the amount of radiation used for a diagnostic test is very low and considered safe.

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Side effects

When radiopharmaceuticals are used in very small doses to study an organ of the body, side effects are rare and usually involve an allergic reaction. These effects may occur almost immediately or a few minutes after the radiopharmaceutical is given.


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Are radiopharmaceuticals safe?

Absolutely. Like any medicine, with great care. Before they or tested carefully.

The quantity of the pharmaceutical part of the radiopharmaceutical is very small, generally 1/10th of a millionth of an ounce. The risk of a reaction is 2-3 incidents per 100,000 injections, over 50% of which are rashes, as compared to 2000-3000 per 100,000 injections of x-ray contrast media.

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Is the radioactivity harmful?

Although exposure to radioactivity in very large doses can be harmful, the radioactivity in radiopharmaceuticals is carefully selected by the nuclear medicine physician to be safe .

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Radioimmunoassay (RIA)/Immunoradiometricassay (IRMA)

THYROID1. TSH IRMA2. FTA RIA3. Thyroglobulin4. Anti-thyroglobulin5. Anti-TPO (Perioxidase)

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Radioactive Iodine Therapy

1. Hyperthyroidism (Grave’s Disease, solitary autonomous nodule)

2. Ablation of thyroid remnants after thyroidectomy

3. Treatment of metastatic Thyroid Carcinoma


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Imaging1. Detection of G.I Bleeding2. Hepatobiliary Imaging3. I-131 Whole Body Scintigraphy4. Kidney Investigation5. Liver and Spleen Scintigraphy6. Lung Perfusion Scintigraphy7. Lung Ventilation Scintigraphy8. Meckel’s Diverticulum Scintigraphy9. Myocardial Perfusion Imaging- Tc99m Sestamibi, Thelium20110. Parathyroid Imaging


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Urea Breath Test

UBT is currently considered to be the gold standard for non-invasive diagnosis of H.pylori. It is highly reliable- 95% sensitivity and 100% specificity, for pre- and post- treatment follow up of infection.Clinical Applications: CardiologyEndocrinologyGastroenterologyInfectionNephrologyOncologyPulmonary


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MONITORIN G POSITIVEPATIENT OUTCOME

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Prevent minimize and or rectify clinical problems associated with the use of radiopharmaceuticals or interventional medications.

Develop institutional standards for the rational and appropriate use of radiopharmaceuticals.

Prospectively screens and review patients data to assure appropriate use of radiopharmaceuticals and ancillary medicines used to enhanced their effect.

Ensure the patients are selected appropriately for radionuclied therapy and monitored after therapy to prevent compilation and/or intervene with necessary therapy.

Evaluate the safety and effectiveness of radiopharmaceuticals and ancillary medications.

Ensure proper preparation of patients prior to the administration of radiopharmaceuticals and ancillary medication.

After most nuclear medicine procedures it is generally best to drink a lot of fluids and urinate as frequently as you can. This helps to flush the remaining radioactivity out of your body. The length of time you need to do this will depend on the kind of study you had and the type of radiopharmaceutical that was used.

Do I need to do anything special after I have a nuclear medicine procedure?DEFINITION

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Bautista, Christine Hazel A.Carait, Marielle jean R.

Esmaeli, FereshtehGaviola, Lester T

Lopez, Janmaru M.Mendoza, Liberty M.Prestoza, Angelee P.

Rubio, Patricia Elace Ann M.Rustila, Richel C.

Serafico, Marie Cellcatherine A.Tambaoan, Glorialyn C.

Valencia, Ma. Antonette C.Yu, Ken Adonis S.

BSP 2

L 20

11

-20

12

Group 3

Mr. Bryan de PaduaInstructor

Radiopharmaceuticals

Education

Transcript of Radiopharmaceuticals