There are certain precautions that must be taken into account when handling radiopharmaceutical materials on a daily basis. Nuclear pharmacists receive extensive training on the various radiopharmaceuticals that they use. They are trained in radiation safety and other aspects specific to the compounding and preparation of radioactive materials. Many things are required to become pharmacists, but to become a nuclear pharmacist one must go through the following training: 1. 200 hours of classroom training in basic radioisotope handling techniques specifically applicable to the use of unsealed sources is required. The training should consist of lectures and laboratory sessions in the following areas: Radiation physics and instrumentation Radiation protection Mathematics of radioactivity Radiation biology Radiopharmaceutical chemistry 2. 500 hours in handling unsealed radioactive material under a qualified instructor is also required. This experience should cover the type and quantities of by-product material requested in the application and includes the following: Ordering, receiving, surveying, and unpackaging radioactive materials safely. Calibration of dose calibrators, scintillation detectors, and survey meters Calculation, preparation, and calibration of patient doses including the proper use of syringe shield.

There are essentially two different kinds of nuclear pharmacy services called Institutional Nuclear Pharmacy and Commercial Centralized Nuclear Pharmacies: Institutional Nuclear Pharmacy is most likely operated through large medical centers or hospitals. 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.

The concept of nuclear pharmacy was first described in 1960 by Captain William H. Briner while at the National Institutes of Health (NIH) in Bethesda, Maryland. Along with Mr. Briner, John E. Christian, who was a professor in the School of Pharmacy at Purdue University, had written articles and contributed in other ways to set the stage of nuclear pharmacy. William Briner started the NIH Radiopharmacy in 1958. John Christian and William Briner were both active on key national committees responsible for the development, regulation and utilization of radiopharmaceuticals.A Technitium-99 (a radionuclide) generator was commercially availability which was followed by the availability of a no. of Tc-99m based radiopharmaceuticals……… Though training in the field was initially restricted to military personnel, it was eventually expanded to include the private sector. The first civilian and first female instructed in the practice of Nuclear Pharmacy was Lori Schneider, trained at Letterman Army Medical Center, San Francisco in 1984.

Tc-99m Sestamibi Breast Tumor Scan In this study, the injected radiotracer shows high affinity for areas of high metabolism, as is commonly seen with tumor cells.  In this example, the tracer is taken up in areas of increased metabolism in the breast and surrounding lymphatic areas.  This is indicative of primary breast cancer, as well as the metastatic spread to the surrounding lymph nodes.  

Tc-99m Exametazime Brain Imaging Highly lipophilic molecules (such as exametazime) will penetrate the protective blood brain barrier and be taken up in the brain tissues.  Since uptake will be proportional to regional blood flow, the amount of tracer deposited will be indicative of how much blood flow reaches a particular area.  In this example, an overactive seizure focus shows a greater amount of tracer uptake due to the increased metabolic and blood flow demand.

Nuclear pharmacy is a specialty area of pharmacy practice dedicated to the compounding and dispensing of radioactive materials for use in nuclear medicine procedures.  A specialty area of pharmacy practice is one that requires a concentration of knowledge in a once specific area.  The development of nuclear pharmacy as a specialty area followed the development of nuclear medicine as a recognized specialty by the American Medical Association in the early 1970’s. Prior to discussing the field of nuclear pharmacy, it is important to understand some background regarding radioactivity and how it is used in patients.  Most people hear the word radiation, and immediately have an image of danger or injury.  However, most people do not realize that there is radiation in everyone’s lives in many different forms.  Electromagnetic radiation is emitted from the sun, from signals sent from radio and TV stations, from radar used to track airplanes, and even visible light.  In this particular field, we are interested in a type of radiation termed radionuclides.  A radionuclide is an atom that has an unstable nucleus.  Recalling chemistry, the nucleus of an atom consists of protons and neutrons.  If a nucleus, for whatever reason, has an excess of either one…