A newly developed software called Datinrad has combed through extensive literature and compiled more than two hundred radiopharmaceutical interactions and adverse effects is now accessible through a single PC portal, according to an article published July 15 in the Journal of Nuclear Medicine Technology.
Jesus Luis Gomez Perales, a radiopharmaceutical specialist from the Nuclear Medicine Service at Puerta del Mar University Hospital in Cadiz, Spain, and colleagues have developed a portable computer application that provides access to 275 drug interactions and 44 adverse reactions from the literature for use by nuclear medicine clinicians to improve safety and awareness of the risks.
“The biodistribution or pharmacokinetics of radiopharmaceuticals may be altered by a variety of drugs, disease states, and surgical procedures, which can have a significant clinical impact on safety, scan interpretation, and diagnostic imaging accuracy,” wrote Perales et al. “In their most extreme manifestations, unanticipated imaging results may even compromise the utility or accuracy of nuclear medicine studies.”
Datinrad is a Microsoft Access-based reference tool that uses a dual module that provides both a portal to the library of records gleaned from six comprehensive reviews and 281 studies complete with bibliographic references culled from sources including MEDLINE, PubMed, EMBASE, SCOPUS and Google scholar, as well as a means to update records with new evidence of either drug interactions with radiopharmaceuticals of adverse reactions to them.
“Information on drug interactions with radiopharmaceuticals is becoming increasingly abundant—so much so that the nuclear medicine staff can feel overwhelmed,” wrote the authors. “The challenge, therefore, is to keep all this information organized and accessible. Although the occurrence of adverse events in nuclear medicine has been rare, they may be seen more frequently in the future because of the administration of contrast agents in hybrid imaging and the increasing use of therapeutic radionuclides that have a significant risk of subacute and chronic toxicity. The consequent greater diligence required in reporting adverse events will be aided by having more easily accessible reporting systems.”
The database includes interactions for both diagnostic and therapeutic radiopharmaceuticals. Interactions and adverse effects are relatively few, but range from issues with biodistribution of radiopharmaceuticals related to preparation and formulation, administration and protocol, alterations in pathophysiology and complications due to previous treatment such as with radiation therapy, surgery or dialysis. An instance of a radiolabeled agent having adverse effects for mechanical reasons is the potential misdistribution of radiolabeled particles such as Tc-99m macroaggregated albumin and its potential for nonuniform spatial distribution in the lungs, which in patients with severe pulmonary hypertension can lead to an embolic effect.
“Drug interactions with radiopharmaceuticals and adverse reactions to radiopharmaceuticals should be better documented and reported,” the researchers wrote. “Collecting these data and providing all nuclear medicine staff with access to them may help decrease the incidence of adverse reactions to radiopharmaceuticals and prevent misdiagnoses. To this end, the database software application Datinrad might play an important role and would be particularly welcomed as a quick guide for routine daily use by nuclear medicine staff in hospitals.”
The open-access app is free in both English and Spanish and available at www.radiopharmacy.net.