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Radiopharmacy PHAR 1013
Interventional Pharmaceutical Assignment


For each of the following drugs, list their form, purpose, and dosages in relation to clinical Nuclear Medicine



Ugie : Dipyridamole - Liquid form/ intravenous
0.56mg/kg for 4minutes
It prevents the adenosine from degradation, thereby increasing and
prolonging vasodilation 3-5times normal blood flow, mimicking true
exercise
Coronary vasodilator
Maximum of 50 mg


Adenosine Liquid Form/intravenous
140µg/kg over 6min
Achieves maximal coronary vasodilation
Vasodilator

Dobutamine - Liquid form/ intravenous
5µg/kg/min for 3mins followed by stepped increase to 10, 20, 30 and
40µg/kg/min for each successive 3 min
It causes increase in heart rate, myocardial contractility and systolic blood
pressure which increases myocardial oxygen demand mimicking exercise.

Beta 1 Antagonist

Aminophylline - intravenous/liquid form
100 – 200mg
Reversal of the adverse effects of dipyridamole

Bronchodilator

Captropril - Solid (tablet) – crushed and administered with glass of water
25 – 50mg
Detection of renal artery stenosis – prevent the production of
angiostensin II
ACE inhibitor

Enalaprilat - Liquid form/Intravenous
0.04mg/kg up to a maximum of 2.5mg, over 3-5mins
As an alternative to captopril in patients with uncertain gastrointestinal
absorption of oral medication

ACE Inhibitor



Furosemide
Purpose: Furosemide or Lasix is a loop-acting diuretic that stimulates
tubular function and causes the kidneys to increase the flow of urine, ​
which reduces the amount of water in the body and lowers blood pressure.
Form: Furosemide is in liquid form and administered intravenously
after the administration of MAG3.
Dose: 1 mg/kg in infants, 0.5 mg/kg in children 1-16 years old, 40 mg
in adults

Insulin
Purpose: Insulin is a hormone used for the treatment of diabetes,
metabolism of glucose, maintenance of blood glucose levels, storage of
glycogen in the liver and muscle tissue, and prevents the breakdown of
proteins>
Form: Insulin is administered intravenously in Nuclear Medicine,
therefore, its in liquid form.
Dose: 7--120 mg/dl (pre-meal)
[http://www.fpnotebook.com/Endo/Pharm/InslnDsng.htm]

Subcutaneous injection


Acetazolamide
Purpose: Acetazolamide is a carbonic-anhydrase inhibitor (diuretic)
that causes an increase in urine volume and change to the alkaline
(base) pH.
Form: Acetazolamide is in liquid form, administered intravenously.
Dose: 1gm

Used to cause cerebral vasodilation during rCBF studies

Also known as Diamox


Sincalide/ CCK
Purpose: Sincalide (analog of CCK) / CCK is a hormone released from
intestinal mucosa due to the presence of fats and proteins and is used
to contract the gallbladder in order to determine the GBEF. CCK also
causes the pancreas to release digestive enzymes and relaxes the
Sphincter of Oddi so that bile and enzymes can enter the duodenum.
Form: Sincalide/ CCK is in liquid form and administered intravenously.
Dose: 0.02 ug/kg

0.01-0.02 ug/kg


Morphine
Purpose: Morphine is an opiod used if the gallbladded hasn't be
visualized by 60 mins, but the bowel has and to constrict the
Sphincter of Oddi in order to differentiate between acute and chronic
cholecystitis.
Form: Morphine is in liquid form and administered intravenously.
Dose: 0.04 mg/kg in 10 mL of saline
0.04 – 0.1 mg/kg

Lisa:
Cimetidine/ranitidine/famotidine
In nuclear medicine: cimetidine may be used for Meckels diverticulum studies.
Purpose: Histamine H2 blocker
-Lowers the amount of gastric acid secretion
-Gives higher retention of the radiopharmaceutical in the gastric mucosa
Form: Tablet or liquid
Dose: IV; 300mg in 100ml of D5W infused over 20 minutes
Oral; 300mg four times a day for two days(adults)
20mg/kg/day for two days(children)
10-20mg/kg/day prior to starting(neonates)

Glucagon
In Nuclear medicine: glucagon (hyperglycemic agent) can be used for meckels diverticulum study
Purpose: Limits GI movement by relaxing the smooth muscle.
-Increases the retention of the radiopharmaceutical in the stomach and the GI tract.
Form: Liquid (IV injection)
Dose: 50ug/kg ten minutes after the admin of the radiopharmaceutical (note:Thrall says ten minutes before)

Pentagastrin (PeptavlonR) In Nuclear medicine: may be used for Meckels diverticulum study.
Purpose: Increases the retention of the radiopharmaceutical in the gastric mucosa
-Increases gastric secretions (higher chance for finding Meckels)
-Increase GI movement (lower chance for finding Meckels

Form: Liquid (SC injection)

Dose: 6ug/kg 15-20 minutes before the admin of radiopharmaceutical


Synthetic polypeptide

ACD solution
In Nuclear medicine: Used when labeling RBC`s (in-vitro)
Purpose: Anticoagulant
Form: Liquid (IV injection)
Dose: Maximum of 0.15ml

ONLY USED WHEN LABELING WITH 51Cr for Blood volume studies

Heparin In Nuclear Medicine: An anticoagulant in blood collection syringes. Purpose: stops blood from clotting. Form: Liquid (IV injection) Dose: 1-5ml of heparin (10-15 units per ml of blood)


Ascorbic acid (AKA: Vitamin C)t is a reducing agent that is used when labeling red blood cells with Cr-51 (RBC Volume & RBC Survival)
Form: Liquid

Dose: 100mg
Hetastarch
A settling agent used in labeling WBC. (Makes RBCs settle to bottom of the syringe)
Form: liquid
Dose: 10 mL (6% solution)

Colloidal starch

Intrinsic factor
Is used in a Shillings test to differentiate between a diagnosis of pernicious anemia or malabsorption of B12.
Form: solid (orally in a capsule)
Dose: 60 mg

A protein

Vitamin B12
Is used in a Shillings test as a flushing dose (fills up all of the B12 storage areas tanscobalamin I so that the radioactive B12 is excreted in the urine.
Form: liquid (IM)
Dose: 1000ug

Cyanocobalamin


Lugol’s solution/SSKI (Saturated Solution Potassium Iodide)
Is a blocking agent that is administered either before or after administration of radioactive iodine to protect the thyroid from the effects of the radiation. It may also be used after accidental exposure.
Form:liquid (orally)
Dose: is based on weight and predicited thyroid exposure
SSKI - 1g KI per mL
Lugol's Solution - 130mg KI per 0.8mL


Potassium perchlorate: Potassium perchlorate is given to make sure that the injected pertechnetate does not gather in the choroid plexus. It is given in a 200mg dose orally in a capsule

TSH:rhTSH is also known as Thyrogen, it is a synthetic thyroid stimulating hormone that allows the patients o continue their medications before a WB 131I scan. Its given as an IM injection.


· Patient receives an IM injection of 1 ml of Thyrogen (containing 0.9 mg of thyrotropin alfa) in the gluteal muscle.

· 24 hours later patient receives another IM injection of 1 ml of Thyrogen (containing 0.9 mg of thyrotropin alfa) in the gluteal muscle.



EDTA: is chelating agent that is used as an anti coagulant in the tubes used to store blood as it is collected. It comes in a solid form and there is no dose as it comes in the collection tubes.

Lidocaine:
an anesthetic in a liquid form given as an injection before a mammolymphoscintigraphy is performed. It can also be useful in the treatment of arrhythmias given as an IV injection. The dose is 40 mg/mL.
http://www.drugs.com/pro/lidocaine-injection.html

Lidocaine (EMLA) cream: An anesthetic that is applied topically (in the form of a cream). It can be used before a procedure that may be painful (before an injection). The dose is up to the physicians discretion.

Atropine:
blocks acetylcholine receptors, it is used to counteract the dobutamine when a patient has had a pharmalogical induced stress test. It can be given orally, IV, IM or topically. The dose for injection is about 0.1 mg/mI for an adult or0.05 mg/mL for a pediatric patient.
http://www.rxlist.com/atropine-drug.htm