Nuclear medicine is a branch of medical imaging that uses small amounts of radioactive material to diagnose and determine the severity of or treat a variety of diseases,
One nuclear medicine procedure, called a PET (positron emission tomography) scan, precisely localizes many types of diseases in the body just by determining how the disease uses sugar. No other imaging method has the ability to use our body’sown functions to determine disease status.The main difference between nuclear imaging and other imaging systems is that, in nuclear imaging, the source of the emitted radiation is within the body. Nuclear imaging shows the position and concentration of the radioisotope. If very little of the radioisotope has been taken up a ‘cold spot’ will show on the screen indicating, perhaps, that blood is not getting through. A ‘hot spot’ on the other hand may indicate excess radioactivity uptake in the tissue or organ that may be due to a diseased state, such as an infection or cancer. Both bone and soft tissue can be imaged successfully with this system.
a radioactive isotope that can be injected safely into the body, and a carrier molecule which delivers the isotope to the area to be treated or examined.
Widely available mode of treatmentThey can be given by injection, inhalation or orally.)
The Gamma Counter LG-4 is designed for radioimmunoassay (RIA) and immunoradiometric assay (IRMA) in medium size laboratories employing isotope 125I. The counter is an easy to operate instrument with no moving mechanical components enlarging his operation reliability.
DEFINITIONCOMPOSITION USESADVANTAGES &DISADVANTAGES Is a radioactive PROCUREMENT pharmaceutical agent that is used forCOMPOUNDING QUALITY ASSURANCE diagnostic or therapy in DISPENSING & DISTRIBUTIONHEALTH & SAFETY a tracer quantity.AVAILABILITY INTHE PHILIPPINES MONITORINGPATIENT OUTCOME
How is nuclear medicine different from an x-ray,a CT scan, an ultrasound, or an MRI? DEFINITIONCOMPOSITION Nuclear medicine can detect USES the radiation coming from inside aADVANTAGES & patient’s body. All of these otherDISADVANTAGES procedures expose the patient to PROCUREMENT radiation from outside the body usingCOMPOUNDING machines that send radiation through QUALITY the body. As a result, nuclear ASSURANCE medicine determines the cause of a DISPENSING & medical problem based on organ DISTRIBUTIONHEALTH & SAFETY function in contrast to the other diagnostic tests, that determine theAVAILABILITY IN presence of disease based onTHE PHILIPPINES anatomy or structural appearance. MONITORINGPATIENT OUTCOME
DEFINITIONCOMPOSITION • A version of a chemical USESADVANTAGES & element that has anDISADVANTAGES unstable nucleus and emits PROCUREMENTCOMPOUNDING radiation during its decay QUALITY to a stable form. ASSURANCE DISPENSING & DISTRIBUTIONHEALTH & SAFETY • All isotopes are notAVAILABILITY INTHE PHILIPPINES radioisotopes. MONITORINGPATIENT OUTCOME
THERAPEUTIC DEFINITION Designed to deliver therapeuticCOMPOSITION dose of ionizing radiation to USES specific disease site, such asADVANTAGES &DISADVANTAGES cancerous tumors, with high PROCUREMENT specificity in the body.COMPOUNDING QUALITY ASSURANCE Historically, used to treat Thyroid DISPENSING & cancer, Graves’ DISTRIBUTION disease, hyperthyroidism, andHEALTH & SAFETY bone pain pallitation associatedAVAILABILITY IN with skeletal metastasis.THE PHILIPPINES MONITORINGPATIENT OUTCOME
DIAGNOSING DEFINITIONCOMPOSITION used to derive detailed description of the USESADVANTAGES &DISADVANTAGES PROCUREMENT morphology andCOMPOUNDING dynamic functioning of QUALITY ASSURANCE the various internal DISPENSING & DISTRIBUTION organs of the body.HEALTH & SAFETYAVAILABILITY INTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION • It can be used as diagnosis andCOMPOSITION treatment of patients USESADVANTAGES & • It is common cure to cancersDISADVANTAGES PROCUREMENTCOMPOUNDING • Can treat multiple disease sites. QUALITY ASSURANCE • Widely available mode of treatment DISPENSING & DISTRIBUTION • Directly treats tumor, especiallyHEALTH & SAFETY useful for bone metastasisAVAILABILITY INTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION • Can provide fast onset of pain reliefCOMPOSITION USES • Single dose is effective for someADVANTAGES & patientsDISADVANTAGES PROCUREMENT • Nuclear medicine tests can beCOMPOUNDING performed on children QUALITY ASSURANCE • Nuclear medicine procedures are DISPENSING & cost effective and painless DISTRIBUTIONHEALTH & SAFETY • Nuclear medicine procedures haveAVAILABILITY INTHE PHILIPPINES no side effects and are completely MONITORING safePATIENT OUTCOME
DEFINITIONCOMPOSITION • Can produce some allergic reactions USESADVANTAGES & • It has a radiation riskDISADVANTAGES PROCUREMENT • Myelosuppression mayCOMPOUNDING occur, especially with prior QUALITY chemotherapy ASSURANCE DISPENSING & • When multiple fractions are given, it DISTRIBUTION may produce prolongedHEALTH & SAFETY inconvenience and discomfort forAVAILABILITY INTHE PHILIPPINES patients MONITORINGPATIENT OUTCOME
DEFINITIONCOMPOSITION • Nuclear medicine tests are not USES recommended for pregnant womenADVANTAGES & because unborn babies have aDISADVANTAGES PROCUREMENT greater sensitivity to radiation thanCOMPOUNDING children or adults QUALITY ASSURANCE • Filling in patients teeth, dental DISPENSING & braces and permanent bridges may DISTRIBUTIONHEALTH & SAFETY cause some distortion around theAVAILABILITY IN mouth areaTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION Purchasing radiopharmaceutical involvesCOMPOSITION determining product specifications, initiating USES purchase orders, receiving shipments, maintaining inventory and storing materials under properADVANTAGES & conditions.DISADVANTAGES PROCUREMENT Since, some radiopharmaceutical poses aCOMPOUNDING short half-life. Typically, the nuclear pharmacist QUALITY would order the drug directly from the ASSURANCE manufacturer primarily by overnight delivery DISPENSING & DISTRIBUTION Storage of radioactive materials mustHEALTH & SAFETY incorporate appropriate radiation shielding inAVAILABILITY IN addition to traditional requirements forTHE PHILIPPINES light, temperature, and humidity. MONITORINGPATIENT OUTCOME
DEFINITION Compounding of radiopharmceuticalsCOMPOSITION requires receipt (or anticipation) of: USES • a valid prescription/drug orderADVANTAGES &DISADVANTAGES • appropriate components, supplies, and equipment PROCUREMENT • a suitable environment, especially for sterile dosageCOMPOUNDING forms QUALITY • appropriate recordkeeping, including witten ASSURANCE procedures and lot-specific in formation to ensure DISPENSING & traceability; DISTRIBUTION • Validation/verification of the compoundingHEALTH & SAFETY procedure, storage conditions, and expirationAVAILABILITY INTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION Involves reconstituting reagent kits, radiolabelling, and strict aseptic technique must be followedCOMPOSITION during compounding. USESADVANTAGES & A kit involves pre-packed set of sterile ingredients.DISADVANTAGES PROCUREMENT The freeze-dried kit is reconstituted by asepticallyCOMPOUNDING transferring the necessary activity of sodium pertechnetate using a sterile syringe and needle. QUALITY ASSURANCE DISPENSING & The reconstituted kit is aseptically subdivided to provide each patient dose with a sufficient activity DISTRIBUTION after administration.HEALTH & SAFETYAVAILABILITY IN A diluent may be added to the final dose to giveTHE PHILIPPINES the desired radioactive concentration. MONITORINGPATIENT OUTCOME
DEFINITION DEFINITION Radiopharmaceuticals are generallyCOMPOSITIONCOMPOSITION expected to conform to specifications USES USES under the following heading:ADVANTAGES & ADVANTAGES &DISADVANTAGESDISADVANTAGES a. Radionuclide f. Absence of foreign PROCUREMENT PROCUREMENT concentration particulate matterCOMPOUNDINGCOMPOUNDING b. Radiochemical g. Particle size (if QUALITY QUALITY purity appropriate) ASSURANCE ASSURANCE DISPENSING & DISPENSING & c. Chemical h. pH DISTRIBUTION DISTRIBUTION purity i. BiologicalHEALTH & SAFETYHEALTH & SAFETY d. Sterility distributionAVAILABILITY INAVAILABILITY INTHE PHILIPPINESTHE PHILIPPINES e. Apyrogenicity MONITORING MONITORINGPATIENT OUTCOMEPATIENT OUTCOME
DEFINITION DispensingCOMPOSITION USESADVANTAGES & Recommends dosage levels basedDISADVANTAGES on patient history, age, weight, PROCUREMENT surface area, and/or other factorsCOMPOUNDING QUALITY ASSURANCE Dispenses prescriptions in DISPENSING & conjunction with applicable DISTRIBUTIONHEALTH & SAFETY pharmacy law and keepsAVAILABILITY IN appropriate recordsTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION DispensingCOMPOSITION USES Develops policies and procedures toADVANTAGES & ensure that the correct drug in the correctDISADVANTAGES dosage and dosage form is received by PROCUREMENT the correct patient at the correct time viaCOMPOUNDING the correct route of administration QUALITY ASSURANCE DISPENSING & Develops policies and procedures, DISTRIBUTION supervises, and reviews the activities ofHEALTH & SAFETY non-pharmacist personnel under theAVAILABILITY IN pharmacists supervisionTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION DistributionCOMPOSITION USES Complies with all applicable regulationsADVANTAGES & concerning packaging, labeling, andDISADVANTAGES transportation of radioactive and other PROCUREMENT materials (e.g., biohazards),COMPOUNDING demonstrating knowledge of: QUALITY ASSURANCE DOT regulations concerning packaging, DISPENSING & labeling, and transportation of DISTRIBUTION radioactive and other materials.HEALTH & SAFETYAVAILABILITY IN Proper procedures and use ofTHE PHILIPPINES equipment necessary to verify that MONITORING package meet DOT requirements.PATIENT OUTCOME
DEFINITION DEFINITION AllergiesCOMPOSITIONCOMPOSITION USES USES If you will be receiving albumin in theADVANTAGES & ADVANTAGES & form of radioiodinated albumin, technetiumDISADVANTAGESDISADVANTAGES Tc 99m albumin aggregated, technetium Tc PROCUREMENT PROCUREMENT 99m albumin colloid, or technetium Tc 99mCOMPOUNDINGCOMPOUNDING albumin for your test, tell your doctor if you QUALITY QUALITY have ever had any unusual or allergic ASSURANCE ASSURANCE reaction to products containing DISPENSING & DISPENSING & DISTRIBUTION DISTRIBUTION human serum albumin.HEALTH & SAFETYHEALTH & SAFETYAVAILABILITY INAVAILABILITY INTHE PHILIPPINESTHE PHILIPPINES MONITORING MONITORINGPATIENT OUTCOMEPATIENT OUTCOME
DEFINITION PregnancyCOMPOSITION Radiopharmaceuticals usually are not USES recommended for use during pregnancy. ThisADVANTAGES & is to avoid exposing the fetus to radiation.DISADVANTAGES PROCUREMENTCOMPOUNDING This is especially important with QUALITY radiopharmaceuticals that contain ASSURANCE radioactive iodine, which can go to the DISPENSING & babys thyroid gland and, in high enough DISTRIBUTION amounts, may cause thyroid damage.HEALTH & SAFETYAVAILABILITY INTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION DEFINITION Breast-feedingCOMPOSITIONCOMPOSITION USES USES Some radiopharmaceuticals passADVANTAGES & ADVANTAGES &DISADVANTAGESDISADVANTAGES into the breast milk and may expose PROCUREMENT PROCUREMENT the baby to radiation. If you mustCOMPOUNDINGCOMPOUNDING receive a radiopharmaceutical, it may QUALITY QUALITY be necessary for you to stop breast- ASSURANCE ASSURANCE feeding for some time after receiving it. DISPENSING & DISPENSING & DISTRIBUTION DISTRIBUTIONHEALTH & SAFETYHEALTH & SAFETYAVAILABILITY INAVAILABILITY INTHE PHILIPPINESTHE PHILIPPINES MONITORING MONITORINGPATIENT OUTCOMEPATIENT OUTCOME
DEFINITION DEFINITION ChildrenCOMPOSITIONCOMPOSITION USES USESADVANTAGES & ADVANTAGES & For most radiopharmaceuticals,DISADVANTAGESDISADVANTAGES the amount of radiation used for a PROCUREMENT PROCUREMENT diagnostic test is very low andCOMPOUNDINGCOMPOUNDING considered safe. QUALITY QUALITY ASSURANCE ASSURANCE DISPENSING & DISPENSING & DISTRIBUTION DISTRIBUTIONHEALTH & SAFETYHEALTH & SAFETYAVAILABILITY INAVAILABILITY INTHE PHILIPPINESTHE PHILIPPINES MONITORING MONITORINGPATIENT OUTCOMEPATIENT OUTCOME
DEFINITION Side effectsCOMPOSITION USESADVANTAGES & When radiopharmaceuticals areDISADVANTAGES used in very small doses to study an PROCUREMENT organ of the body, side effects are rareCOMPOUNDING and usually involve an allergic QUALITY reaction. These effects may occur ASSURANCE DISPENSING & almost immediately or a few minutes DISTRIBUTION after the radiopharmaceutical is given.HEALTH & SAFETYAVAILABILITY INTHE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION Are radiopharmaceuticals safe?COMPOSITION USES Absolutely. Like any medicine, withADVANTAGES & great care. Before they or tested carefully.DISADVANTAGES PROCUREMENT The quantity of the pharmaceuticalCOMPOUNDING part of the radiopharmaceutical is very small, generally 1/10th of a millionth of QUALITY ASSURANCE an ounce. The risk of a reaction is 2-3 DISPENSING & incidents per 100,000 injections, over 50% DISTRIBUTION of which are rashes, as compared toHEALTH &SAFETY HEALTH SAFETY 2000-3000 per 100,000 injections of x-rayAVAIILABILITY INAVAILABILITY IN contrast media.THE PHILIPPINES MONITORINGPATIENT OUTCOME
DEFINITION DEFINITIONCOMPOSITIONCOMPOSITION Is the radioactivity harmful? USES USESADVANTAGES & ADVANTAGES & Although exposure to radioactivity inDISADVANTAGESDISADVANTAGES very large doses can be harmful, the PROCUREMENT PROCUREMENT radioactivity in radiopharmaceuticalsCOMPOUNDINGCOMPOUNDING is carefully selected by the nuclear QUALITY QUALITY medicine physician to be safe . ASSURANCE ASSURANCE DISPENSING & DISPENSING & DISTRIBUTION DISTRIBUTIONHEALTH SAFETYHEALTH & SAFETYAVAIILABILITY INAVAILABILITYTHE PHILIPPINES THE PHILIPPINES MONITORING MONITORINGPATIENT OUTCOMEPATIENT OUTCOME
DEFINITION Urea Breath TestCOMPOSITION UBT is currently considered to be the gold USES standard for non-invasive diagnosis of H.pylori. It isADVANTAGES & highly reliable- 95% sensitivity and 100% specificity,DISADVANTAGES for pre- and post- PROCUREMENT treatment follow up of infection.COMPOUNDING Clinical Applications: Cardiology QUALITY ASSURANCE Endocrinology DISPENSING & Gastroenterology DISTRIBUTION InfectionHEALTH &SAFETY HEALTH SAFETY NephrologyAVAILABILITY IN OncologyTHE PHILIPPINES Pulmonary MONITORINGPATIENT OUTCOME
DEFINITION DEFINITION Develop institutional standards for the rational and appropriate use of radiopharmaceuticals.COMPOSITIONCOMPOSITION USES USES Prospectively screens and review patients data to assure appropriate use of radiopharmaceuticals and ancillary ADVANTAGES &ADVANTAGES & medicines used to enhanced their effect.DISADVANTAGESDISADVANTAGES PROCUREMENT Ensure the patients are selected appropriately for PROCUREMENT radionuclied therapy and monitored after therapy to preventCOMPOUNDINGCOMPOUNDING compilation and/or intervene with necessary therapy. QUALITY QUALITY Evaluate the safety and effectiveness of ASSURANCE ASSURANCE radiopharmaceuticals and ancillary medications. DISPENSING & DISPENSING & DISTRIBUTION DISTRIBUTION Ensure proper preparation of patients prior to the administration of radiopharmaceuticals and ancillaryHEALTH & SAFETYHEALTH SAFETY medication.AVAIILABILITY INAVAILABILITY THE PHILIPPINESTHE PHILIPPINES Prevent minimize and or rectify clinical problems associated MONITORING MONITORING with the use of radiopharmaceuticals or interventionalPATIENT OUTCOMEPATIENT OUTCOME medications.
Do I need to do anything special after I havea nuclear medicine procedure? DEFINITION DEFINITIONCOMPOSITIONCOMPOSITION After most nuclear medicine USES USES procedures it is generally best to drink ADVANTAGES &ADVANTAGES &DISADVANTAGESDISADVANTAGES a lot of fluids and urinate as frequently PROCUREMENT PROCUREMENT as you can. This helps to flush theCOMPOUNDINGCOMPOUNDING remaining radioactivity out of your QUALITY QUALITY body. The length of time you need to ASSURANCE ASSURANCE DISPENSING & do this will depend on the kind of study DISPENSING & DISTRIBUTION DISTRIBUTION you had and the type ofHEALTH & SAFETYHEALTH SAFETY radiopharmaceutical that was used.AVAIILABILITY INAVAILABILITY THE PHILIPPINESTHE PHILIPPINES MONITORING MONITORINGPATIENT OUTCOMEPATIENT OUTCOME
Group 3 Bautista, Christine Hazel A. Carait, Marielle jean R. BSP 2L 2011-2012 Esmaeli, Fereshteh Gaviola, 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. Mr. Bryan de Padua Instructor