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Nuclear pharmacy part 1
1.
2. It is a subspeciality of pharmacy deals with
receiving, preparation, quality control, storage
and dispensing of radiopharmaceuticals.
Radiopharmacy also deals with
Disposal of radioactive wastes
Documentaion
Research
Designing
Development of new radiopharmaceuticals
3. WHAT IS RADIOPHARMACEUTICALS?
It is derived from two words radioactive and
pharmaceuticals.
It is a medicinal product containing :
Radiotracer: present in minute quantity,not
intended for pharmacological action.
Radionuclide: an unstable species ,containing
specific atomic no. and responsible for
emission of rays
4. The service and unit form where the
radiopharmaceuticals are provided is called
radiopharmacy and hot labortary.
The person who rendered this service is
called radiopharmacist.
ORGANIZATION
the radiopharmacy service is rendered from a
division of hospital pharmacy or by a section
under nuclear medicine department.
6. A radiopharmaceutical has the following
discriminatory features
1. Presence of radioactivity
2. Scarcity of pharmacologic effect
3. Having short half life
4. Usual route of administration
5. Dose measurement in terms of radioactive units
6. Half life
7. Practice regulations
8. Restrictions on quantity used
7. PHYSICAL HALF LIFE: time necessary for the
radioactive atoms to decay one half of their
original number.
BIOLOGIC HALF LIFE: time required for the
body to eliminate one half of the
administered dose.
EFFECTIVE HALF LIFE: time required for an
administered radiopharmaceutical dose to be
reduced by one half due to both physical
decay and biological elimination.
9. Gamma emitting radiopharmaceuticals are
used to probe physiologic and
pathophysiological functions of human body.
Large no of radiopharmaceuticals are
available to trace one or more particular
functions of human body
For optimal detection efficiency by gamma
camera, gamma energies of between 100keV
and 200keV are desirable.
Examples: technetium-99m, iodine-123,
indium-111, thallium-201 and gallium-67
10. Radiation emitted from them cause selectively
damage to neoplastic cell of the body.
They normally contain a radioneuclide that
decays by emitting a B-particle
B-particle should be ideally within the range
0.5-1.0MeV
Half life is normally of several days to provide
reasonable time of action.
EXAMPLES: iodine-131 and phosphorous-32
11. Used to improve quality of life but cannot
eradicate a disease.
EXAMPLE: strontium-89 and phosphorous-32
are used to relieve the pains due to cancer
metastasis in bone at terminal cancer stage
patients
12. It requires following aspects and pharmacists have a
promount role in this aspect
1. Feasibilty of an isotope section
2. Layout and designs for a radioactive branch
3. Allocation of space and equipment for isotopes
labortaries and
4. Information concerning facilities and equipment for
isotope programs
5. Procurement procedures for radioactive materials.
6. Radiation protection measures necessary for their
handling.
7. Organization and training of the hospital staff for the
utilization of radioactive materials.
8. Licensure requirements
9. Suggestions for special courses for hospital pharmacists
13. Following are the legal requirements for the establishment
of radiopharmacy section in a hospital
Licensure
Facilities
1. LICENSURE
Radioactive are also potentially dangerous. Therefore their
use is subjected to control and supervision of Atomic
Energy Commission, a federal government agency.
Radioisotopes can be used only by duly licensed
individuals in premises
In addition, the regulations require that an institutional
license have a medical isotope committee to evaluate all
proposals for research, diagnostic, and therapeutic uses of
isotopes within the hospital.
14. SPACE
Nuclear pharmacy must have an adequate space.
Radioactive storage and product deacy area must be
separarted from compounding, dispensing, quality
assurance anf office area.
EQUIPMENTS
Isolators or laminar flow hood
Fume hood
Dose calibrator
Refrigerator (lead lined)
Class A prescription handling
Gamma scintillation counter
Microscope
Radiochemical hood or filter system
15.
16. “A person responsible for formulating and
dispensing prescribed radioactive tracers and
for clinical aspects of radio pharmacy.”
Radio pharmacist must have trained in
following areas:
RADIO PHARMACY
Elementary aspects of structure of matter
Modes of radioactive decay of radionuclide
Technology and quality control
Applications of radiopharmaceuticals
Research methodology
17. INSTRUMENTATION:
Principles of radiation detection and detectors
Dose calibrators
Gamma cell counter
Function QC of dose calibrator
MATHs, STATISTICS and COMPUTER SCIENCE:
Fundamental concepts
Compartmental analysis and mathematical model
of physiologic system
18. RADIATION BIOlOGY and RADIATION PROTECTION:
Safe handling
Formulations
Pharmacokinetics
Principles of production
IN-VITRO ANALYSIS:
Radio assay
Micro analytical technique (RIA)
Hiring of nuclear pharmacist is not yet legal in
Pakistan.
19. It is a board established for supervision and
control of hospital isotope program.
The committee may include:
Medical physicist
Clinical radiologist
Hematologist
Surgeon
It is also suggested that a representative from
administration, pharmacy and nursing service
should also be included in the committee.
20. Pharmacist assist in purchasing, receiving and
storage of isotopes.
The administrator contribute to the
development of entire program the nurses
became familiar with the type of work carried
out, the associated dangers and means of
protection.
21. Radio isotope committee has following
responsibilities:
Review and approval of use of isotopes
Special prescribing conditions like training of
personnel, disposal method etc
Receive reports from radiation protection
officer
Review of records
Recommend remedial actions
Keep record of actions taken in approving the
use of isotopes
22. Carried out under supervision of qualified
person and approved by ATOMIC ENERGY
COMMISSION and must follow laws and
regulations.
Documentation of inventory and disposition is
to be labelled with:
Standard radiation symbol
Name of radionuclide
Chemical forms
Amount of radioactive material in Curies or
Baqural
23. The environmental requirements are more critical
in radio pharmacy practice because short lived
radio pharmaceuticals have to be administered
without conducting qc tests.
Non terminally-sterilized radio pharmaceuticals
must be critically controlled to retain sterility till
administration
Special purpose-build unidirectional air flow
cabinets provide aseptic conditions for
preparation and handling of radio
pharmaceuticals
Ultra violet light fitted in cabinets offers
decontamination
24. ISOLATORS: cabinets used fitted with lead
lined gloves that isolates material under
processing from the worker and external
environment
Preparations is carried out in a fume
cupboards with proper shielding
Adequate ventilation temperature at 22
degree and humidity less than 80%
Storage of radioactive materials should far
away to keep background activity at low level.
25. He is responsible for ordering, receiving, storage
and keeping the record of all the isotopes in
current use
All radio isotopes stored in lead vault and a date
and time of receipt, purchase order number,
name of isotopes and quantity of isotopes
received is recorded by radio pharmacist. The
radioactivity of vault is also recorded.
Disposal of waste products
Perform quality control tests
Implementation of GRP
Radiation monitoring of radio pharmacy
26. Implementation of radiation protection and
safety policy in radio pharmacy.
Support research and active participation in
research
Training to the technologists on the
pharmaceutical aspects of nuclear medicine,
radiation biology and protection.