Study of the clinical pharmacist role in preparation and application of radiopharmaceuticals

Abstract

Introduction: The use of a specific type of radioactive medicinal products and medical devices is a unique opportunity of Nuclear medicine for visualization the morphology of organs, their functions and dysfunctions as well for staging and treatment of diseases. Very important role in this process has the clinical pharmacist through monitoring and control of a potential drug related risks and assistance for ensuring optimal application of this specific kind pharmaceuticals. Objective: To explore a various opportunities for optimize the preparation and application processes of radiopharmaceuticals in clinical setting in Bulgaria through the participation of a clinical pharmacist in the multidisciplinary team of healthcare specialists in the Nuclear medicine departments. Materials and methodology: The systematic review of literature data is based on key words: radiopharmaceutical, clinical pharmacist, nuclear medicine, good practices, national standard of nuclear medicine in the following bibliographic databases: Scopus, Medline, Springer, Embase, and others. The analysis is performed grounded on the current legislation of the Republic of Bulgaria, which regulates activities pertaining to radioactive pharmaceutical products, radiopharmaceutical, radionuclide generators, kits, radionuclide precursors, as well as the educational regulations for all experts participating in such activities. Results and discussions: All radiopharmaceutical medicinal products (RPMP) hide potential risk of drug interactions (DI) and adverse drug reactions (ADR). The expertise of a clinical pharmacist plays an important role in the therapeutic and diagnostic processes and is applicable to avoiding potential risks, consulting the patient regarding their behavior in the event such risks cannot be avoided or have already taken place. Potential DI with RPMP present changes in the biological distribution of the radiopharmaceuticals in the physiological compartments, changed absorption, accelerated elimination, pharmacological, pharmaceutical and/or toxic interactions. Some RPMP can extend or reduce their accumulation in the targeted organs and influence the diagnostic and therapeutical results. Conclusion: The participation of a clinical pharmacist in the preparation and application of radioactive medicinal products, radionuclide generators, kits, and radionuclide precursors as a part of the healthcare team can present a real opportunity for the optimization of such processes, as well as the improvement of the diagnostic and therapeutic outcomes of the patients in a clinical setting.