Radiopharmacology

Short description: Pharmacologic study of radiated medical compounds

Radiopharmacology

Lead container for iodine-123 capsule

Other names| Medicinal radiochemistry
Specialty| oncology

[edit on Wikidata]

Radiopharmacology is radiochemistry applied to medicine and thus the pharmacology of radiopharmaceuticals (medicinal radiocompounds, that is, pharmaceutical drugs that are radioactive). Radiopharmaceuticals are used in the field of nuclear medicine as radioactive tracers in medical imaging and in therapy for many diseases (for example, brachytherapy). Many radiopharmaceuticals use technetium-99m (Tc-99m) which has many useful properties as a gamma-emitting tracer nuclide. In the book Technetium a total of 31 different radiopharmaceuticals based on Tc-99m are listed for imaging and functional studies of the brain, myocardium, thyroid, lungs, liver, gallbladder, kidneys, skeleton, blood and tumors.[1]

The term radioisotope, which in its general sense refers to any radioactive isotope (radionuclide), has historically been used to refer to all radiopharmaceuticals, and this usage remains common. Technically, however, many radiopharmaceuticals incorporate a radioactive tracer atom into a larger pharmaceutically-active molecule, which is localized in the body, after which the radionuclide tracer atom allows it to be easily detected with a gamma camera or similar gamma imaging device. An example is fludeoxyglucose in which fluorine-18 is incorporated into deoxyglucose. Some radioisotopes (for example gallium-67, gallium-68, and radioiodine) are used directly as soluble ionic salts, without further modification. This use relies on the chemical and biological properties of the radioisotope itself, to localize it within the body.

## Contents

* 1 History
* 2 Production
* 3 Practical use
* 4 Drug nomenclature for radiopharmaceuticals
* 5 See also
* 6 References
* 7 Further reading
* 8 External links

## History

See nuclear medicine.

## Production

Production of a radiopharmaceutical involves two processes:

* The production of the radionuclide on which the pharmaceutical is based.
* The preparation and packaging of the complete radiopharmaceutical.

Radionuclides used in radiopharmaceuticals are mostly radioactive isotopes of elements with atomic numbers less than that of bismuth, that is, they are radioactive isotopes of elements that also have one or more stable isotopes. These may be roughly divided into two classes:

* Those with more neutrons in the nucleus than those required for stability are known as proton-deficient, and tend to be most easily produced in a nuclear reactor. The majority of radiopharmaceuticals are based on proton deficient isotopes, with technetium-99m being the most commonly used medical isotope, and therefore nuclear reactors are the prime source of medical radioisotopes.[2]
* Those with fewer neutrons in the nucleus than those required for stability are known as neutron-deficient, and tend to be most easily produced using a proton accelerator such as a medical cyclotron.[3]

## Practical use

Because radiopharmeuticals require special licenses and handling techniques, they are often kept in local centers for medical radioisotope storage, often known as radiopharmacies. A radiopharmacist may dispense them from there, to local centers where they are handled at the practical medicine facility.

## Drug nomenclature for radiopharmaceuticals

As with other pharmaceutical drugs, there is standardization of the drug nomenclature for radiopharmaceuticals, although various standards coexist. The International Nonproprietary Name (INN) gives the base drug name, followed by the radioisotope (as mass number, no space, element symbol) in parentheses with no superscript, followed by the ligand (if any). It is common to see square brackets and superscript superimposed onto the INN name, because chemical nomenclature (such as IUPAC nomenclature) uses those. The United States Pharmacopeia (USP) name gives the base drug name, followed by the radioisotope (as element symbol, space, mass number) with no parentheses, no hyphen, and no superscript, followed by the ligand (if any). The USP style is not the INN style, despite their being described as one and the same in some publications (e.g., AMA,[4] whose style for radiopharmaceuticals matches the USP style). The United States Pharmacopeial Convention is a sponsor organization of the USAN Council, and the USAN for a given drug is often the same as the USP name.

International Nonproprietary Name (INN) | United States Pharmacopeia (USP) | Comments

|
|

technetium (99mTc) sestamibi | technetium Tc 99m sestamibi |
fludeoxyglucose (18F) | fludeoxyglucose F 18 |
sodium iodide (125I) | sodium iodide I 125 |
indium (111In) altumomab pentetate | indium In 111 altumomab pentetate |

## See also

* Radioactive tracer
* Nuclear medicine

## References

1. ↑ Schwochau, Klaus. Technetium. Wiley-VCH (2000). ISBN 3-527-29496-1
2. ↑ "Canada's Chalk River Reactor coming back online will not solve long-term isotope shortage in hospitals, researchers say". https://www.sciencedaily.com/releases/2010/07/100708111326.htm.
3. ↑ "Archived copy". http://www.ansto.gov.au/__data/assets/pdf_file/0019/32941/Nuclear_Medicine_Brochure_May08.pdf.
4. ↑ Iverson, Cheryl, et al. (eds) (2007), "15.9.2 Radiopharmaceuticals", AMA Manual of Style (10th ed.), Oxford, Oxfordshire: Oxford University Press, ISBN 978-0-19-517633-9, http://www.amamanualofstyle.com/.

## Further reading

* Notes for guidance on the clinical administration of radiopharmaceuticals and use of sealed radioactive sources. Administration of radioactive substances advisory committee. March 2006. Produced by the Health Protection Agency.
* Malabsorption. In: The Merck Manual of Geriatrics, chapter 111.
* Leukoscan summary of product characteristics (Tc99m-Sulesomab).
* Schwochau, Klaus. Technetium. Wiley-VCH (2000). ISBN 3-527-29496-1

## External links

* National Isotope Development Center U.S. Government resources for isotopes - production, distribution, and information
* Isotope Development & Production for Research and Applications (IDPRA) U.S. Department of Energy program sponsoring isotope production and production research and development

* v
* t
* e

Diagnostic radiopharmaceuticals (ATC: V09)

Central nervous system|

* 99mTc (Exametazime)
* 123I (Ioflupane
* Iofetamine
* Iomazenil)
* 18F (Florbetapir, Flutemetamol)

Skeletal system|

* 99mTc (Medronic acid)

Renal|

* 123I (Sodium iodohippurate)
* 64Cu (Cu-ETS2)

Gastrointestinal/Hepatic|

* 75Se (SeHCAT)

Respiratory system|

* 133Xe
* 81mKr
* 99mTc (99mTc-MAA)

Cardiovascular system|

* 99mTc (Sestamibi
* Tetrofosmin)
* 111In (Imciromab)
* 82Rb (Rubidium chloride)

Inflammation/infection|

* 99mTc (Exametazime
* Sulesomab
* Tilmanocept)
* 111In
* 67Ga

Tumor|

* 99mTc (Arcitumomab
* Votumumab
* Hynic-octreotide)
* 111In (Capromab pendetide
* Satumomab pendetide)
* 125I (Minretumomab)
* 123I / 131I (Iobenguane)
* 18F (Fluciclovine
* Fludeoxyglucose
* Fluoroethyltyrosine
* Sodium fluoride)

Adrenal cortex|

* 123I
* 125I / 131I (Iodocholesterol)

Radionuclides
(including tracers)|

| positron (PET list)|

* 11C ([11C]ME@HAPTHI
* 25B-NBOMe (Cimbi-36)
* Acetate
* Choline
* Carfentanil
* DASB
* DTBZ
* Flumazenil
* Methionine
* N-Methylspiperone
* Pittsburgh compound B
* Raclopride
* Verapamil)
* 13N (Ammonia)
* 15O (Water)
* 18F (Altanserin
* Desmethoxyfallypride
* FMISO
* Fallypride
* Florbetaben
* Florbetapir
* Flubatine
* Fluciclovine
* Fludeoxyglucose (18F) (FDG)-glucose analogue
* Flumazenil
* Fluorocholine
* Fluorodeoxysorbitol (FDS)
* Fluorodopa
* Fluorothymidine F-18
* Fluspidine
* Flutemetamol
* MPPF
* Mefway
* Nifene
* N-Methylspiperone
* FET
* Setoperone)
* 64Cu
* 68Ga
* 82Rb (Rubidium chloride)

|

gamma ray/photon (SPECT/scintigraphy)|

* 51Cr
* 57Co
* 67Ga
* 75Se
* 81mKr
* 99mTc
* 111In
* 123I
* 125I
* 131I
* 133Xe
* 153Sm
* 201Tl

* v
* t
* e

Therapeutic radiopharmaceuticals (ATC: V10)

Pain palliation|

* 153Sm
* Lexidronam
* 89Sr (Strontium chloride)

Adrenergic tumors|

* 131I
* Iobenguane

CD20 antibodies|

* 90Y
* Ibritumomab tiuxetan
* 131I
* Tositumomab

Radionuclides|

| alpha emitters|

* 223Ra (Radium chloride)

|

beta emitters|

* 32P
* 89Sr
* 90Y
* 131I
* 153Sm
* 165Dy
* 169Er
* 177Lu (Oxodotreotide)
* 186Re
* 198Au

* v
* t
* e

Radiation oncology

* (ICD-9-CM V3 92.2-92.3
* ICD-10-PCS D)

Specific
therapies

| Teletherapy1|

| by photon|

* Superficial X-rays
* Orthovoltage X-rays
* Megavoltage X-rays
* Radiosurgery / Stereotactic radiation therapy
* Cyberknife
* Gamma Knife
* Cobalt therapy

|

by electron|

* Electron therapy

by hadron|

* Particle therapy
* fast neutron
* neutron-capture
* proton

Brachytherapy2|

* Prostate
* 125I
* 103Pd
* Plaque radiotherapy (125I)
* Selective internal radiation therapy / SIR-Spheres / TheraSphere (90Y)

Unsealed source
radiotherapy3

* Iobenguane (131I)
* 90Y
* Lexidronam (153Sm)
* 89Sr
* Radioimmunotherapy
* ibritumomab tiuxetan

Other|

* Intraoperative radiation therapy
* electron
* TARGIT
* Tomotherapy

Conditions|

* Radiation burn
* Radiation proctitis
* Radiation-induced lung injury

Features and
equipment

* BEAMnrc
* Bolus
* Bragg peak
* D50
* Dose profile
* Dose verification system
* Dose-volume histogram
* Dosimetry
* Isocenter
* Mobetron
* Monitor unit
* Multileaf collimator
* Nanoimpellers
* Neutron generator
* Oxygen enhancement ratio
* Pencil
* Pencil-beam scanning
* Percentage depth dose curve
* Radiation oncologist
* Radiation Therapist
* Radiation treatment planning
* Radiopharmacology
* Tissue to Air Ratio (TAR)

* 1 Also known as external-beam radiotherapy.
* 2 Also known as sealed-source radiation therapy.
* 3 Also known as systemic radioisotope therapy.

* v
* t
* e

Nuclear technology

| Science|

* Chemistry
* Engineering
* Physics
* Atomic nucleus
* Fission
* Fusion
* Radiation
* ionizing
* braking

|

Fuel|

* Tritium
* Deuterium
* Helium-3
* Fertile material
* Fissile material
* Isotope separation
* Nuclear material
* Uranium
* enriched
* depleted
* Plutonium
* Thorium

Neutron|

* Activation
* Capture
* Poison
* Cross section
* Generator
* Radiation
* Reflector
* Temperature
* Thermal
* Fast
* Fusion

Power|

* by country
* Power plant
* Economics
* Multi-Mission Radioisotope Thermoelectric Generator
* Accidents and incidents
* Policy
* Fusion
* Radioisotope thermoelectric (RTG)
* Propulsion
* rocket
* Safety and security

Medicine|

| Imaging|

* RadBall
* Scintigraphy
* Single-photon emission (SPECT)
* Positron-emission tomography (PET)

|

Therapy|

* Fast-neutron
* Neutron capture therapy of cancer
* Targeted alpha-particle
* Proton-beam
* Tomotherapy
* Brachytherapy
* Radiation therapy
* Radiosurgery
* Radiopharmacology

Weapons|

| Topics|

* Arms race
* Delivery
* Design
* Disarmament
* Ethics
* Explosion
* effects
* History
* Proliferation
* Testing
* high-altitude
* underground
* Warfare
* Yield
* TNTe

|

Lists|

* Estimated death tolls from attacks
* States with nuclear weapons
* Historical stockpiles and tests
* Tests
* Tests in the United States
* WMD treaties
* Weapon-free zones
* Weapons

Waste|

| Products|

* Actinide
* Reprocessed uranium
* Reactor-grade plutonium
* Minor actinide
* Activation
* Fission
* LLFP
* Actinide chemistry

|

Disposal|

* Fuel cycle
* High-level (HLW)
* Low-level (LLW)
* Repository
* Reprocessing
* Spent fuel
* pool
* cask
* Transmutation

Debate|

* Nuclear power
* Nuclear weapons
* Blue Ribbon Commission on America's Nuclear Future
* Anti-nuclear movement
* Uranium mining
* Nuclear power phase-out

Nuclear reactors

Fission

Moderator

Light water|

* Aqueous homogeneous
* Boiling
* BWR
* ABWR
* ESBWR
* Kerena
* Pressurized
* AP1000
* APR-1400
* APR+
* APWR
* ATMEA1
* CAP1400
* CPR-1000
* EPR
* HPR-1000
* ACPR1000
* ACP1000
* VVER
* many others
* Supercritical (SCWR)
* Natural fission

Heavy water|

| D2O|

* Pressurized
* CANDU
* CANDU 6
* CANDU 9
* EC6
* AFCR
* ACR-1000
* AHWR
* CVTR
* IPHWR-X
* PHWR KWU
* MZFR
* R3
* R4 Marviken

|

H2O|

* HWLWR
* ATR
* HW BLWR 250
* Steam-generating (SGHWR)

Organic|

* WR-1

CO2|

* HWGCR
* EL-4
* KKN
* KS 150
* Lucens

Graphite
by coolant

| Water|

| H2O|

* AM-1
* AMB-X
* EGP-6
* RBMK

|

Gas|

| CO2|

* Uranium Naturel Graphite Gaz (UNGG)
* Magnox
* Advanced gas-cooled (AGR)

|

He|

* GTMHR
* MHR-T
* UHTREX
* VHTR (HTGR)
* PBR (PBMR)
* AVR
* HTR-10
* HTR-PM
* THTR-300
* PMR

Molten-salt|

| Fluorides|

* Fuji MSR
* Liquid-fluoride thorium reactor (LFTR)
* Molten-Salt Reactor Experiment (MSRE)
* Integral Molten Salt Reactor (IMSR)
* ThorCon

|

None
(fast-neutron)

* Breeder (FBR)
* Integral (IFR)
* Liquid-metal-cooled (LMFR)
* Small sealed transportable autonomous (SSTAR)
* Traveling-wave (TWR)
* Energy Multiplier Module (EM2)
* Reduced-moderation (RMWR)
* Fast Breeder Test Reactor (FBTR)
* Dual fluid reactor (DFR)

Generation IV|

* Sodium (SFR)
* BN-350
* BN-600
* BN-800
* BN-1200
* CFR-600
* Phénix
* Superphénix
* PFBR
* CEFR
* PFR
* PRISM
* Lead
* Helium gas (GFR)

Others|

* Organic nuclear reactor
* Arbus
* Piqua
* Aircraft Reactor Experiment

Fusion

by confinement

Magnetic|

* Field-reversed configuration
* Levitated dipole
* Reversed field pinch
* Spheromak
* Stellarator
* Tokamak

Inertial|

* Bubble (acoustic)
* Fusor
* electrostatic
* Laser-driven
* Magnetized-target
* Z-pinch

Other|

* Dense plasma focus
* Migma
* Muon-catalyzed
* Polywell
* Pyroelectric

* Category
* Commons
* Portal

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