RNI Pharmaceutical

Question 1

what is a radionuclide?

Answer 1

• nuclei of some atoms are unstable and they fly apart - emitting radiation and fast moving particles
• they undergo spontaneous changes in their nuclei to form stable elements or another radionuclide

Question 2

types of decay

Answer 2

Alpha particle emission
Beta particle emission
Gamma particle emission

Question 3

unit of radioactivity

Answer 3

• SI

Question 4

1 Bq =

Answer 4

one transformation per second

Question 5

what are a radionulcides ideal properties for diagnostic imaging with a gamma camera

Answer 5

• relatively short physical half-life
• relatively short effective half-life - short, but remains active enough for efficient uptake
• relatively short biological half-life can be excreted from the body
• non-toxic
• can be administered to the patient
• can be easily labelled to pharmaceutical products e.g. MAG3, DMSA
• inert in the body - does interfere with the patient’s physiological processes

Question 6

Radionuclides used in PET/CT

Answer 6

• fluorine-18 (F18)
• Carbon-11 (C11)
• Oxygen 15 ( O15)

Question 7

radionuclides used in Radiotherapy

Answer 7

strontium-89 (Sr89)
Phosphor-32 (P32)
Iodine-131 (I131)

Question 8

what is a radiopharmaceutical

Answer 8

where a radionuclide and a pharmaceutical are combined.

A drug that contains a radioactive substance and is used to diagnose or treat disease

Question 9

pharmaceutical kit

Answer 9

A pre-packed set of sterile ingredients designed for the preparation of a specific radiopharmaceutical.
- solution is freeze-dried, sterilised and evacuated then filled with sterile nitrogen gas

Question 10

what are the ideal properties for a radiopharmaceutical

Answer 10

• non-toxic
• the radionuclide and pharmaceutical combine properly
• short reaction time
• single target organ- improves sensitivity
• stable in vivo - maximum target organ placement without altering physiology
• stable in vitro
• pathology see as increased activity
• multiple patients per vial

Question 11

what are the ideal properties for a radiopharmaceutical

Answer 11

• non-toxic
• the radionuclide and pharmaceutical combine properly
• short reaction time
• single target organ- improves sensitivity
• stable in vivo - maximum target organ placement without altering physiology
• stable in vitro
• pathology see as increased activity
• multiple patients per vial

Question 12

radiopharmaceutical MDP is used for

Answer 12

bone scans - 500-700MBq

Question 13

radiopharmaceutical ECD is used for

Answer 13

brain scans - 750MBq

Question 14

radiopharmaceutical Sestamibi is used for

Answer 14

cardiac scans - 800MBq

Question 15

radiopharmaceuticals MAG3 and DMSA are used for

Answer 15

• renal scans
• MAG3 - 100MBq - function
• DMSA - 80MBq - cortical

Question 16

radiopharmaceutical MAA is used for

Answer 16

• lung perfusion scans
• 100MBq
• low does for pregnant patients - 40 MBq

Question 17

radiopharmaceutical TC 99m sodium perechnetate is used for

Answer 17

• thyroid scans

- 80MBq

Question 18

patient considerations and administration

Answer 18

• 3 forms of patient ID
• calculating the dose on weight and height for paediatrics
• Draw up the sterile injection in the radiopharmacy from the correct vial
• explain the procedure to the patient and gain consent
• safety considerations- avoiding contact with children and pregnant women
• delays between injection and scan time, eating and drinking
• urinating in specific toilet and flushing twice
• measuring residual dose

Question 19

why is it important to measure residual dose

Answer 19

• checking that you are administering the correct amount to the patient
• record the amount drawn
• can observe the uptake amount from the body e.g. kidneys
• re-sheath the needle to avoid contamination
• the residual dose is subtracted from the original drawn dose to give absolute dose - this is entered into the computer to calculate uptake