Radioactive Pharmaceutical Handling

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Handling of Radiopharmaceuticals in Hospital

• Presented By- Deepa Kumari Karn
• M pharm (C.P), First Semester

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Contents

• Introduction
• Uses
• Properties
• Advantages and Disadvantages
• Important Radiopharmaceuticals
• Procurement
• Compounding and Dispensing
• Handling and storage
• Discard of Radiopharmaceuticals
• References

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Introduction

• Pharmaceutical formulations consisting of
  radioactive substances (radioisotopes and
  molecules labeled with radioisotopes)
• Essential component
• of the nuclear medicine
• practice

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• Composed of the radioactive isotope and a carrier
  molecule
• Radiopharmacy practice combines the expertise of
  pharmaceutical preparation and the skills needed
  to handle radioactive substances
• Due to the short half and rapid decay, they must
  be prepare shortly before their clinical use and
  comprehensive quality control of the final
  product cant be performed

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Uses

• Diagnosis
• The radiopharmaceuticals are injected to the
  vein, emits the gamma radiations as it decay and
  the gamma camera scan the radiation and create
  the image and the functional information of the
  target organ

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• Treatment
• ß-ray energy from the radioisotope is delivered
  to the target tissue partially or completely
  destroy the diseased tissue

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Properties of ideal Radiopharmaceuticals

• Short physical half life time
• Eliminated from the body with an effective half
  life time approximately equaling the examination
  time to prevent subsequent exposure to the body
• Pure gamma emitter by isometric transition
• Gamma rays emitted should be mono-energetic and
  highly specific activity

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• Localize largely and quickly at the target site
  and decay into a more stable daughter nucleus
• Easily and effectively attached to the chemical
  compound at room temperature and cheap per
  patient dose

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Advantages and Disadvantages

• Advantages
• Used for both diagnostic as well as treatment
  purpose
• Used for the treatment of the cancer as well as
  bone metastasis
• Provide the fast onset and single dose may be
  sufficient for the treatment
• No side effect and completely safe

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• Disadvantage
• Not recommended to the pregnant women
• Have risk of radiation
• Produce some allergic response and long term use
  cause discomfort to the patient

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Important Radiopharmaceuticals
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Procurement
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Compounding and Dispensing

• There should be special area dedicated to the
  compounding and dispensing radiopharmaceuticals
  for use in nuclear medicine procedures
• Production of ready to use kits or cold kits
  which provide individual/ multiple dose and can
  be reconstituted by the addition
• Minimize the risk of cross contamination and
  mix-up

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• All surfaces (walls, floor, tables and furniture)
  must be made out of materials that are easy to
  clean and disinfect and to decontaminate in the
  event of a radioactive spill and sinks used
  should be outside the production area

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Handling and storage

• Should not touch the radioactive substance with
  hand but can be handled by using forceps
• Sufficient protective clothing have to be used
• Smoking, drinking and eating activity should be
  avoided in laboratory and area where the
  radioactive substance are stored and are
  compounded

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• Radioactive material should be stored in suitable
  labeled container and shielded by lead bricks
• Personnel should correctly apply special aseptic
  technique throughout the preparation of equate
  and the radio labelling of kits
• Storage area should be monitored properly
• Disposal should be carried out with great care

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• The storage and handling of any kind of
  biological material should be avoided in the same
  place
• Radioactive liquid preparation should be carried
  out in trays having absorbent tissue paper so
  that any spillage will get absorbed
• Waste radioactive materials have to be stored
  till the activity becomes low before its disposal

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Discard of Radiopharmaceuticals

• The LAF-cabinet for the preparation of
  radiopharmaceuticals is normally provided with a
  small shielded bin for radioactive waste
• Bin or container can be emptied into a bigger
  container during the cleaning up procedure 
• Radiopharmaceuticals wastes should be separated
  into the different categories on the basis of the
  half life, safety concern and safety property

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Fig Flow chart for managing radioactive waste
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References

1. Operational Guidance on the Hospital
   Radiopharmacy (2008) International Atomic Energy
   Agency, 1-70.
2. Management of Radioactive waste from the use of
   Rradionuclides in medicine (2000) International
   Atomic Energy Agency, 9-80.
3. Radiopharmaceuticals (2008) World Health
   Organization, 1-16.
4. Precaution in the Handling of the
   Radiopharmaceuticals for Injection (2012)
   Pharmaceutical and Medial Devices Agency
5. URL https//humanhealth.iaea.org/HHW/Radiopharmacy
   /VirRad/Radioactive_Waste_Management/index.htm
   (Assessed on April 8 2017)

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THANK YOU FOR KIND ATTENTION!!!!