Detection of Drug Interactions Involving Radiopharmaceuticals: A Professional Responsibility of the Clinical Pharmacist

Abstract

Radiopharmaceuticals are radioactive drugs used in nuclear medicine for diagnosis and, to some degree, for the treatment of disease. Considerable evidence exists in regard to the potential for altered biorouting of radiopharmaceuticals resulting from the coadministration of therapeutic drugs, as well as from certain disease states, nutritional conditions, and other factors. Altered biorouting may reduce the usefulness of the diagnostic test or provide misleading information. While retrospective identification of an altered biodistribution problem can be helpful, prospective detection is more desirable and can be achieved by a hospital-based pharmacist. Although most drug-radiopharmaceutical interactions are not beneficial, some nuclear medicine procedures are conducted using drug intervention to enhance the diagnostic efficacy of the test. Also, nuclear medicine procedures may be used to monitor the outcome of a therapeutic regimen or to aid in determining the pharmacologic effect of an investigation drug. While not covering the full scope of the area, the material in this chapter is intended to provide an introduction to the problems and opportunities associated with drug-radiopharmaceutical interactions and to stimulate pharmacists to provide clinical pharmacy services to nuclear medicine.