A radiopharmaceutical is a specialized pharmaceutical compound that contains a radioactive isotope as an integral part of its structure. These compounds are designed for use in nuclear medicine procedures, where they emit radiation that can be detected externally by imaging devices such as gamma cameras or positron emission tomography (PET) scanners. Radiopharmaceuticals are utilized for diagnostic imaging, as well as for targeted therapy in some cases, to visualize or treat specific tissues or organs within the body.
Here is a comprehensive list of radiopharmaceutical drugs, including their active ingredients, mode of action, indications, contraindications, and side effects:
1. Technetium 99m (Tc 99m) Sestamibi
Active Ingredient: Technetium 99m
Mode of Action: Tc 99m Sestamibi is used in cardiac imaging to assess myocardial perfusion. It accumulates in cardiac muscle cells based on blood flow.
Indications: Diagnosis of coronary artery disease, assessment of myocardial perfusion, and detection of viable myocardial tissue.
Contraindications: Hypersensitivity to the drug, pregnancy (unless absolutely necessary), and breastfeeding.
Side Effects: Rare, but may include allergic reactions, injection site pain, or transient alterations in blood pressure or heart rate.
2. Fluorine 18 (F 18) Fluorodeoxyglucose (FDG)
Active Ingredient: Fluorine 18
Mode of Action: F 18 FDG is used in PET imaging to assess glucose metabolism. It accumulates in cells with high metabolic activity.
Indications: Detection and staging of various cancers, assessment of brain function, and evaluation of cardiac viability.
Contraindications: Pregnancy and breastfeeding, severe hyperglycemia, and known hypersensitivity to FDG.
Side Effects: Generally well tolerated, but rare side effects may include allergic reactions, transient nausea, or headache.
3. Iodine 131 (I 131) Sodium Iodide
Active Ingredient: Iodine 131
Mode of Action: I 131 Sodium Iodide is used for thyroid imaging and therapy. It is taken up by the thyroid gland.
Indications: Thyroid cancer diagnosis and treatment, as well as hyperthyroidism management.
Contraindications: Pregnancy, breastfeeding, and severe thyroid eye disease.
Side Effects: Radiation induced thyroiditis, transient neck pain or swelling, and rare allergic reactions.
4. Gallium 68 (Ga 68) Dotatate
Active Ingredient: Gallium 68
Mode of Action: Ga 68 Dotatate is used in PET imaging to detect neuroendocrine tumors. It binds to somatostatin receptors on tumor cells.
Indications: Diagnosis and staging of neuroendocrine tumors.
Contraindications: Hypersensitivity to the drug.
Side Effects: Generally well tolerated, with rare instances of mild injection site pain or allergic reactions.
5. Radium 223 (Ra 223) Chloride
Active Ingredient: Radium 223
Mode of Action: Ra 223 is used in targeted alpha particle therapy for metastatic prostate cancer. It selectively targets bone metastases.
Indications: Treatment of bone metastases in advanced prostate cancer.
Contraindications: Hypersensitivity to the drug, pregnancy, and breastfeeding.
Side Effects: Potential bone marrow suppression, nausea, diarrhea, or vomiting.
6. Indium 111 (In 111) Pentetreotide
Active Ingredient: Indium 111
Mode of Action: In 111 Pentetreotide is used in scintigraphy to detect somatostatin receptor positive neuroendocrine tumors.
Indications: Imaging and staging of neuroendocrine tumors.
Contraindications: Hypersensitivity to the drug.
Side Effects: Generally well tolerated, but may rarely cause transient discomfort at the injection site.
7. Thallium 201 (Tl 201) Chloride
Active Ingredient: Thallium 201
Mode of Action: Tl 201 Chloride is used in myocardial perfusion imaging to assess blood flow to the heart.
Indications: Diagnosis of coronary artery disease.
Contraindications: Hypersensitivity to the drug, pregnancy, and breastfeeding.
Side Effects: Rare, but may include allergic reactions and transient alterations in blood pressure or heart rate.
8. Sodium Iodide I 131 (I 131)
Active Ingredient: Iodine 131
Mode of Action: I 131 Sodium Iodide is used for thyroid imaging and therapy, similar to I 131 Sodium Iodide.
Indications: Thyroid cancer diagnosis and treatment, as well as hyperthyroidism management.
Contraindications: Pregnancy, breastfeeding, and severe thyroid eye disease.
Side Effects: Radiation induced thyroiditis, transient neck pain or swelling, and rare allergic reactions.
9. Iodine-123 (I-123) Sodium Iodide
Active Ingredient: Iodine-123
Mode of Action: I-123 Sodium Iodide is used for thyroid imaging. It is taken up by the thyroid gland.
Indications: Evaluation of thyroid function, thyroid nodules, and goiter.
Contraindications: Hypersensitivity to the drug, pregnancy, and breastfeeding.
Side Effects: Rare, but may include allergic reactions and transient alterations in blood pressure.
10. Technetium-99m (Tc-99m) Mertiatide (MAG3)
Active Ingredient: Technetium-99m
Mode of Action: Tc-99m Mertiatide is used in renal scintigraphy to assess kidney function and drainage.
Indications: Evaluation of renal function, detection of renal obstruction, and assessment of blood flow to the kidneys.
Contraindications: Hypersensitivity to the drug.
Side Effects: Generally well-tolerated, with rare instances of mild injection site pain or allergic reactions.
11. Strontium-89 (Sr-89) Chloride
Active Ingredient: Strontium-89
Mode of Action: Sr-89 Chloride is used in targeted therapy for the palliation of pain in bone metastases.
Indications: Pain relief in patients with bone metastases.
Contraindications: Hypersensitivity to the drug, pregnancy, and breastfeeding.
Side Effects: Potential bone marrow suppression, transient bone pain, and rare gastrointestinal symptoms.
12. Yttrium-90 (Y-90) Microspheres
Active Ingredient: Yttrium-90
Mode of Action: Y-90 Microspheres are used in targeted radio embolization therapy for liver cancer.
Indications: Treatment of liver tumors, including hepatocellular carcinoma and metastatic liver lesions.
Contraindications: Hypersensitivity to the drug, pregnancy, and breastfeeding.
Side Effects: Potential liver toxicity, fatigue, abdominal pain, and mild flu-like symptoms.
13. Samarium-153 (Sm-153) Lexidronam
Active Ingredient: Samarium-153
Mode of Action: Sm-153 Lexidronam is used for pain palliation in patients with bone metastases.
Indications: Relief of pain associated with bone metastases.
Contraindications: Hypersensitivity to the drug, pregnancy, and breastfeeding.
Side Effects: Potential bone marrow suppression, transient bone pain, and rare gastrointestinal symptoms.
These radiopharmaceuticals play crucial roles in the field of nuclear medicine, aiding in both the diagnosis and treatment of various medical conditions. However, their use should always be carefully considered and administered by qualified healthcare professionals, taking into account individual patient factors and specific clinical indications.
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