Temple nuclear pharmacists practice
a ‘hot’ new specialty
|Fourth-year students Abebech Abebe (center) and Yuen Tsang (right) use equipment in lead shields to work with radiopharmaceuticals in the nuclear pharmacy lab, while Elaine Mackowiak observes.
As nuclear medicine has perfected its ability to “see” inside the body, nuclear pharmacy, which supplies the ingredients that make nuclear imaging possible, has taken off.
Consequently, said Elaine Mackowiak, professor of pharmacy practice and director of the nuclear pharmacy elective track at the School of Pharmacy, the demand for certified nuclear pharmacists has heated up.
In nuclear medicine, radioactive materials — radiopharmaceuticals — are used to create images of the body that reveal both structure and function.
Temple’s School of Pharmacy is one of only eight schools in the country and the only one in Philadelphia to offer nuclear pharmacy as a track of study. This is supported by Temple’s nuclear pharmacy lab, where students can learn how to create radiopharmaceuticals. Nuclear pharmacists prepare radiopharmaceuticals primarily for diagnostic studies (such as PET scans and stress tests) that are performed daily in nuclear medicine departments of hospitals throughout the country.
“We used to prepare all radiopharmaceuticals at our in-hospital ‘hot’ lab,” explained Alan Maurer, chief of nuclear medicine at the School of Medicine and Temple University Hospital.
“But about a decade ago, as hospitals looked for ways to cut costs, centralized nuclear pharmacy labs began cropping up and the nuclear pharmacy business has since exploded.”
Centralized nuclear pharmacies, four of which are located in the Philadelphia area, make and distribute radioactive drugs to hospitals. Because the drugs have such a short shelf life, they need to be made from scratch on a daily basis, making nuclear pharmacy a round-the-clock business. One of the most common radioactive ingredients, technetium 99m, has a half-life of six hours, at which point its activity is reduced by half.
Patients undergoing certain medical scans, such as PET, need to take radioactive drugs that will travel to and illuminate a specific organ or area of the body, for instance an organ with cancer growth or bones with evidence of metastatic disease. Because nuclear imaging uncovers function and physiology — rather than just anatomical structure as traditional X-rays do — it often picks up problems, such as metastases or infection, before an X-ray would. Nuclear images are also used to stage cancer and predict a tumor’s response to chemotherapy.
To be an authorized nuclear pharmacist, the individual must be a licensed pharmacist in the state where he or she works, and must obtain a license from the Nuclear Regulatory Commission. Students using the School of Pharmacy’s nuclear pharmacy lab employ lead shields that allow for safe handling of radioactive drugs and instrumentation. Students also complete a five-week clerkship in a nuclear pharmacy and work closely with Maurer at the hospital to see how radiopharmaceuticals work in actual patients.
At every step of the process, lead provides a barrier between the pharmacist and the radioactive ingredients. Drug vials and containers are placed in lead shields and narrow lead shields cover the syringes that are used to move the radioactive drugs.
As for the risk to patients, Mackowiak explains, “The body metabolizes most radiopharmaceuticals. Patients receive a very low dose of radiation from nuclear imaging, often less than that from traditional X-rays.”
- By Eryn Jelesiewicz