Nuclear Pharmacy Quick Reference

Dao Le

doi:10.2967/jnumed.112.116194

C.N. Cole, S.M. Shaw, and R.J. Kowalsky

Washington, DC: American Pharmacists Association, 2012, 150 pages, $30.95

Nuclear Pharmacy Quick Reference is a practical and informative text on radiopharmaceuticals. This book is authored by experienced and well-respected individuals in the nuclear pharmacy community. The intent of the authors was to deliver a book that could be a source of readily accessible information, and that goal was realized. The book offers essential and pertinent information on radiopharmaceuticals, organized in a concise fashion, and thus proves to be a practical, rapidly accessible reference source for the health-care provider.

The book is compact and lightweight, containing 8 chapters in a total of 150 pages. The information either is presented in well-organized tables or is summarized by bullet points. The text begins with a chapter that includes a reference table on radiopharmaceuticals, highlighting dosage forms, use, typical dose, and route of administration. A second table follows, providing an encompassing list of radionuclides and their nuclear properties. This table offers adequate information on the physical properties of radionuclides that may be used in nuclear imaging. The second chapter, “Radiopharmaceuticals and Procedures,” compares different radiopharmaceuticals used in specific imaging procedures. For example, Table 2-3, “Biologic Properties of Renal Imaging Radiopharmaceuticals,” lists 5 radiopharmaceuticals commonly used for renal imaging and their properties. From the table, it can easily be concluded that ^99mTc-mercaptoacetyltriglycine undergoes renal excretion via tubular secretion, versus ^99mTc-diethylenetriaminepentaacetic acid, which relies on glomerular filtration for excretion. Thus, a decision can quickly be made that ^99mTc-mercaptoacetyltriglycine is the better agent for visualizing the renal collecting system. It should be noted that although Table 2-4, “Comparison of ⁶⁷Ga-Citrate vs. ^99mTc- vs. ¹¹¹In-WBCs for Infection Labeling,” is an invaluable tool, the same table appears in both Chapter 2 and Chapter 3.

Chapter 4, “Quality Control,” follows the same summarizing-table format as the previous chapters. The authors successfully extract pertinent information from the package inserts of the radiopharmaceuticals and organize the information in a straightforward manner. With the addition of the “Special Instructions” column, the authors include comprehensive, vital information on different radiopharmaceuticals. The user can reference pearls of practice by locating the corresponding letter notations at the bottom of the table. The following chapter, “Radiation Dose Information,” focuses on the average effective dose for different radiologic procedures. The table in this chapter provides a good reference to address radiation exposure or safety inquiries. Furthermore, this chapter also includes guidelines on special instructions or documentation needed for breast-feeding patients who are receiving radiopharmaceuticals.

The next chapter highlights information on the regulation of radiopharmaceuticals and on regulatory agencies significant to the practice of nuclear pharmacy. The remaining chapters cover drug interactions in nuclear medicine procedures and the clinical applications of radiopharmaceuticals. Although the authors recognize that the presented list of drug interactions is not comprehensive, the information serves as a great foundation to begin an investigation on the causes for altered biodistribution in a radiopharmaceutical. The chapter on clinical applications delivers a good overview of commonly used radiopharmaceuticals, organized by organ system. A review of the anatomy and physiology of each organ system is followed by essential information on the radiotracer and its clinical application.

Nuclear Pharmacy Quick Reference was intended to be a rapidly accessible reference of useful information, and its content and organization proves to have satisfied the authors’ goal. It is a valuable tool for individuals working in the nuclear medicine department or the nuclear pharmacy.