RADIO PHARMACY AN INTRODUCTION TO ITS CLINICAL APPLICATIONS By Jamie Al-Nasir, School of Pharmacy, Kingston university. Presented on 15/04/2008

Overview What is Radiopharmacy? The answer to this question requires us to briefly understand the role of Nuclear medicine as the two are inter-related disciplines. Nuclear Medicine – A branch of science dedicated to the application of radiation in medicine. This can be in the form of diagnostics, treatment (both in the curative and palliative sense), research and clinical trials. Radiopharmacy – According Prof Malcolm Frier a medical physicist, Radiopharmacy is The Preparation of high quality, radioactive, medicinal products for use in diagnosis and therapy. It's work carried out in accordance with Specials licensure and within an aseptic environment.

Introducing Applications What are the applications of Radiopharmacy? Diagnostic Barium swallow – examination of upper GI tract Non-imaging diagnostics Radioactive Isotope labelling for tracing i.e. More specific tests for thyroid function, renal function and vitamin adsorption. Research Pharmacological Drug delivery – i.e. brain perfusions and examining whether or not drugs cross blood brain barrier. Curative & Palliative Radiotherapy Brachytherapy – The introduction of a Radionuclide into a localised area of tissue, i.e. a tumour. The radiation destroys cells within the vicinity. Iodine-131 – A radioactive isotope used to treat Hyperthyroidism. Once injected the isotope concentrates within certain tissues. Has the advantage of not requiring invasive surgery or anaesthesia. – Who makes the drug? Palliative treatment - refers to the management of symptoms when the underlying disease is untreatable or terminal. Radiotherapy may aid in prolonging the life of dying patients.

Radiopharmacy & responsibilities Radiopharmacy - the preparation of radioactive medicinal products In the previous examples, the radioactive substances used for diagnostics, treatment pharmacological studies and clinical trials require careful, precise preparation. This is the main function of Radiopharmacy. Many radiotherapeutic substances are administered via intravenous injection and require the use of aseptic technique as well as protection of those preparing the drug! In addition there are a number of other important responsibilities and duties: - Specialist knowledge - Radiopharmacy normally allied to medical physics due to the specialist knowledge involved. Health and safety of those working with the substances Quality control – ensuring the correct formulation and efficacy – often involves analytical tests Storage – Half-life determine storage, and other considerations Correct usage – liaise with other professions to advise on correct usage of the substances. Radiopharmacy is therefore critical to the implementation of areas of nuclear medicine that require very specialist radioactive substances.

Summary Radiopharmacy Allied to Nuclear medicine and medical physics. Fundamentally the preparation of radioactive substances for therapeutic, diagnostic and research uses. Crucial to the above-mentioned applications - no other professional is qualified to prepare such substances. If you were a patient who else would you choose to prepare your radiotherapeutic medicine! – Doctors or nurses?? A specialist discipline, requires Specials licensure Highly regulated! Role encapsulates various critical responsibilities: Highly specialised technical preparation, Health and safety, Quality control, and storage. Important in the research, development and testing of non-radiotherapeutic drugs such as those that act within the brain. An exiting area given the specialist knowledge and skills required!

References Thank you for your time! Medical physics department, Nottingham University hospital On the web: (under medical physics section) British Nuclear Medicine Society On the web: Chemistry and the Living Organism, 3 rd edition, p160