Administration of Radiopharmaceuticals Radiopharmaceuticals Radiopharmaceuticals are agents used

Administration of Radiopharmaceuticals

Radiopharmaceuticals � Radiopharmaceuticals are agents used to diagnose certain medical problems or treat certain diseases. They may be given to the patient in several different ways. For example, they may be given by mouth, given by injection, or placed into the eye or into the bladder.

� Radiopharmaceuticals are radioactive agents. However, when small amounts are used, the radiation your body receives from them is very low and is considered safe. When larger amounts of these agents are given to treat disease, there may be different effects on the body

� When radiopharmaceuticals are used to help diagnose medical problems, only small amounts are given to the patient. The radiopharmaceutical then passes through, or is taken up by, an organ of the body (which organ depends on what radiopharmaceutical is used and how it has been given). Then the radioactivity is detected, and pictures are produced, by special imaging equipment. These pictures allow the nuclear medicine doctor to study how the organ is working and to detect abnormalities.

� Some radiopharmaceuticals are used in larger amounts to treat certain kinds of cancer and other diseases. In those cases, the radioactive agent is taken up in the cancerous area and destroys the affected tissue

Before administration � Check for allergies � In care of pediatrics or geriatrics, before administration, consult with the physician for the dosage � Radiopharmaceuticals usually are not recommended for use during pregnancy. This is to avoid exposing the fetus to radiation. � Drug interactions: Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, the doctor may want to change the dose, or other precautions may be necessary. Enquire if the patient is taking any other prescription or nonprescription (over-thecounter [OTC]) medicine

� Wear laboratory coats or other protective clothing at all times in areas where radioactive materials are used. � Wear disposable gloves at all times while handling radioactive materials. � Either after each procedure or before leaving the area, monitor hands and feet for contamination in a lowbackground area using an appropriate survey instrument.

� Wear personnel monitoring devices, if required, at all times while in areas where radioactive materials are used or stored. These devices shall be worn as prescribed by the Radiation Safety Officer. � Wear extremity dosimeters, if required, when handling radioactive material.

� Do not eat, store food, drink, smoke, or apply cosmetics in any area where licensed material is stored or used. � Do not bring anything you intend to eat, drink, smoke or apply as a cosmetic into an area where licensed material is stored or used.

� Never pipette by mouth. � Wipe-test unsealed byproduct material storage, preparation, and administration areas weekly for contamination. If necessary, decontaminate the area. � Survey with a radiation detection survey meter all areas of licensed material use, including the generator storage, kit preparation, and injection areas, daily for contamination. If necessary, decontaminate the area. Areas used to prepare and administer therapy quantities of radiopharmaceuticals must be surveyed daily (except when administering therapy dosages in patients’ rooms when patients are confined).

• Store radioactive solutions in shielded containers. • Radiopharmaceutical multi-dose diagnostic and therapy vials must be properly labeled. • Syringes and unit dosages must be labeled. Mark the label with the radionuclide, the activity, the date for which the activity is estimated, and the kind of materials (i. e. , radiopharmaceutical). To avoid mistaking patient dosages, label the syringe with the type of study and the patient’s name. • For prepared dosages, assay each patient dosage in the dose calibrator (or instrument) before administering it.

dose calibrator � An ionization chamber used in nuclear medicine to measure the amount of radioactivity of a radionuclide before injection into a patient.

� Use syringe shields for reconstitution of radiopharmaceutical kits and administration of radiopharmaceuticals to patients, except when their use is contraindicated (e. g. , recessed veins). In these and other exceptional cases, use other protective methods, such as remote delivery of the dose (e. g. , use a butterfly needle).

� Dispose of radioactive waste only in designated, labeled, and properly shielded receptacles. � Do not use a dosage if it does not fall within the prescribed dosage range or if it varies more than ± 10% from the prescribed dosage, except as approved by an Authorized User. � When measuring the dosage, you need not consider the radioactivity that adheres to the syringe wall or remains in the needle.

� Check the patient’s name and identification number and the prescribed radionuclide, chemical form, and dosage before administering. If the prescribed dosage requires a Written Directive, the patient’s identity must be verified and the administration must be in accordance with the Written Directive Policy. � Check that the physician ordering administration of the radiopharmaceutical is an authorized user � Always keep flood sources, syringes, waste, and other radioactive material in shielded containers. � Secure all licensed material when not under the constant surveillance and immediate control

� Confirm the patient identity as per the patient identification policy (i. e. , two forms of identification). � Confirm that the patient is not pregnant or breastfeeding as per the policy. � Provide informed consent and have patient sign form for stress test procedures. � Verify the identity, dose and route of administration of the radiopharmaceutical with the prescribed dose from the protocol or standing orders in the procedure manual. � In the case of a pediatric patient, the physicist and radiopharmacist will verify appropriate dose based on weight.

� All administrations will be performed in designated areas. � All injections are performed using radiation safety precautions (i. e. , appropriate syringe shields, etc. ) All injections are performed using universal precautions (i. e. , gloves and lab coats) and aseptic technique. � The exact dose amount assayed in the dose calibrator will be recorded along with the patient name, identity of radiopharmaceutical, route of administration, time and date injection, site of administration and initials of the person administering. This information will be kept in the binder labeled drug log

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