Nuclear pharmacy involves the preparation of radioactive materials that will be used to diagnose specific diseases. These materials are generally injected into a patient’s bloodstream or are swallowed, after which, gamma cameras scan the organs looking for the minute amounts of radioactive material. These scans provide the physician with a dynamic view of organ function. Other modalities, such as CT, MRI or X-ray, provide only structural information. It’s a growing field, with more than 1000 nuclear pharmacists in the World wide.
In addition to preparing radiopharmaceutical agents, a nuclear pharmacist is responsible for quality control of these chemicals. Radiopharmaceuticals must meet certain IP or USP compendium standards for purity, particle size and pH. While this generally is the responsibility of the drug manufacturers, it is up to the nuclear pharmacist to make sure the standards are upheld. Because of the radioactive nature of the materials, disposing of waste materials properly is an important responsibility within the pharmacist’s realm. Uniform standards for this purpose have been set by the government and must be strictly adhered to in all institutions provided.
Profiling the job
Meticulous record keeping matters, too. Nuclear pharmacists are responsible for reviewing patient charts prior to any testing. This procedure allows them to determine whether there are any other scheduled diagnostic tests for that time period which might use an incompatible agent. Sometimes medical conditions are present that might contraindicate the use of a radioactive drug, although, fewer than one in 300,000 patients develops an allergic reaction to radiopharmaceuticals.
The radiopharmaceuticals used in diagnostic imaging for 85 percent of the hospitals and clinics in Worldwide. Most of the drugs are bound with the radioactive isotope technetium 99 M. But the other ingredients are determined by the organ function the physicians are monitoring. Some drugs offer high-resolution bone scans to help doctors look for fractures; others provide the best imaging for heart blockages.
Nuclear pharmacists earn about the same as those in all other specialties of pharmacy and the job market is wide open. There are perhaps 4,000 nuclear pharmacists in every country and job openings for many more. That demand intensified the need of training program for the pharmacy graduates studying for four to 6 years in handling, dispensing and compounding of radioactive materials.
From my words nuclear pharmacist’s terrain is considerably more relaxed than that of a retail or hospital pharmacist. Although the general routine and intense focus required is the same every day, no day is ever the same. Calls from hospital and lab staff keep the day busy and varied. The variants in compounds keep him constantly doing tabulations in his head. Although many of the prescriptions are standing orders, each day a nuclear medicine technologist from each hospital calls to amend the order for the next day.
TYPES OF NUCLEAR PHARMACY
There are essentially two different kinds of nuclear pharmacy services called Institutional Nuclear Pharmacy and Commercial Centralized Nuclear Pharmacies:
1) Institutional Nuclear Pharmacy is most likely operated through large medical centers or hospitals.
2) Commercial Centralized Nuclear Pharmacies provide their services to subscriber hospitals. They prepare and dispense radiopharmaceuticals as unit doses that are then delivered to the subscriber hospital by nuclear pharmacy personnel.
PRACTICE OF NUCLEAR PHARMACY
The practice of nuclear pharmacy is composed of several domains related to the provision of nuclear pharmacy services. These domains, determined by formal task analyses, serve as the basic structure for the Nuclear Pharmacy Practice Guidelines. The nine general domains involved in nuclear pharmacy practice are
- Procurement
- Compounding
- Quality assurance
- Dispensing
- Distribution
- Health and safety
- Provision of information and consultation
- Monitoring patient outcome
- Research and development
ROLE OF NUCLEAR PHARMACIST PHARMACY PRACTICE
When a particular radioactive material was needed, a trained nuclear pharmacist was available to prepare the product and dispense it to the end user. When you look at a nuclear pharmacy, its operation is not much different than that of a traditional pharmacy a "prescription" for a particular product is presented, and the nuclear pharmacist must prepare and dispense that "prescription". Where a traditional pharmacist will dispense doses in milligram weight units, a nuclear pharmacist will dispense in mill curie activity units.Where a traditional pharmacist dispenses tablets and capsules, a nuclear pharmacist dispenses the radioactive material in liquid or capsule form. Where a traditional pharmacist will generally dispense the prescription to the patient, the nuclear pharmacist will dispense to a hospital or clinic nuclear medicine department where the dose will be administered to the patient.
Nuclear pharmacists are available to provide drug information to other health professionals, to aid thenuclear medicine staff in the selection of products, and to assist in the interpretation of unusual studies. Nuclear pharmacists receive extensive training on the various radiopharmaceuticals that are used, as well as training on the safe handling of radioactive materials and the procedures that will minimize radiation exposure to themselves and to others.
Nuclear pharmacists serve as vital links in the provision of nuclear medicine services. By working closely with the nuclear medicine staff, nuclear pharmacists can contribute a tremendous amount to the provision of care for the patients who are undergoing nuclear medicine procedures. While similar to traditional pharmacy, nuclear pharmacy is also in many ways unique, and can be a challenging and rewarding carrier choice for pharmacists.
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by
Akshaya Srikanth
Pharm.D Internee
Hyderabad, India
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