Question

1. Describe briefly the "essential" personnel for operating a nuclear pharmacy and what each person does. 2. What are the basic "steps" or "stages" in the practice of Nuclear Pharmacy that must be established and properly managed and why is the significance or importance of each? 3. What sort of records are required to be created and maintained on file at a nuclear pharmacy and why are they required?

Answer 1

1. Nuclear pharmacy or radio-pharmacy, includes preparation of radioactive materials to administer for patient, that will be utilized for diagnostic and therapeutic purpose in particular ailments in nuclear medicine.

The essential member of a nuclear pharmacy is a pharmacy technician. He is the integral part of nuclear pharmacy with various roles to perform. Other members in nuclear pharmacy includes :

1. Radiation safety officer
2. Manager
3. Sales executive

In majority of nuclear pharmacy setting the pharmacy technician himself takes up the various above mentioned roles.

The role of each person in a nuclear pharmacy are as follows:

SERIAL NO:	PERSONNEL	JOB RESPONSIBILITIES
1	Pharmacy technician	He is the one who is responsible for preparing radioactive drugs from radioisotopes in combination with reagent kits and compounding drugs that are unavailable commercially. He has to check the functioning of instruments, equipments and devices , and determine the quality and purity of radiopharmaceuticals. He is responsible for filling the prescription orders. He has to look into the packaging , labeling and transporting radioactive drugs . He should do the testing of new drugs , compounding procedures , and quality control techniques and taking part in clinical trials.
2	Radiation safety officer	He is responsible to handle biological specimens and hazardous chemicals properly. Also he has to communicate radiopharmaceutical related information to others. He should ensure that proper preparation is administered to patients before radiopharmaceutical administration. He should be able to trouble shoot the outcomes that are unanticipated.
3	Manager	He is responsible for managing the department , medication dispensing and an overall handling of pharmacy.
4	Sales executive	He is responsible to order, receive , store and control inventory of radioactive drugs and other drugs used in the nuclear pharmacy and the related supplies. He also deals with all the procurement and sales of drugs and other supplies.

1. There are mainly 5 stages or steps in the practice of nuclear pharmacy which are noted below.

1. Procurement , storage and handling
2. Preparation , compounding and dispensing
3. Quality assurance
4. Health and safety
5. Drug information and professional consultation.

Procurement , storage and handling

This is the stage to identify the products needed for nuclear pharmacy practice. The pharmacy technician has to identify the needed drugs and other supplies and procurement of those materials to be done in this step. Also the purchased material has to be stored safely as per requirement . According to the need arise , the drugs and other agents , components and supplies should be handled properly.

Preparation , compounding and dispensing

This is one of the important stage of nuclear pharmacy practice where the technician has to review the orders of radiopharmaceuticals, devices and adjunct agents for appropriateness. Also he has to see the indication, dosage, and route of administration of the drug. In this stage he will select the products, components, supplies and equipments required to prepare the compound prescription orders. He should look for the quality, purity and safety of the drug by maintaining appropriate aseptic and hazard control techniques. He has to determine the proper dosage according to patient history, age, weight and other factors. This is the step where the pharmacists handles the situations requires clinical pharmacological interventions.

Quality assurance

In this stage , the quality assurance procedures are performed based on the standards and regulations regarding the use, possession and quality control and testing of instruments & devices. He should ensure the proper sterility of aseptic preparations and maintain records to identify the trends and document compliance.

Health and safety

In health and safety , the technician has to ensure the compliance with regulations concerning with radioactive materials, license requirements for radioactive drugs, handling, labeling , packaging and transporting of radiopharmaceuticals and biomedical waste management. He should apply the policies and procedures for safe working environment, standards and medical events , security of the facility , radioactive materials , drugs and supplies.

Drug information and professional consultation.

This is the last stage where the evaluation of radiopharmaceuticals and its outcome on patients. In this stage, consultation with practitioners for the optimal utilization of radioactive drugs and other agents in providing patient care. Also to assess the progress of patient and provide information regarding any adverse drug effects or clinical issues associated with the usage of drugs. It is the final step which provides information about the health physics and radiation safety where it reveals the effect of medicine procedures and therapy application by assessing the condition of patient during post radionuclide administration.

1. The records that has to be created and maintained in the nuclear pharmacy are as follows:

1. Records of acquisition
2. Records of inventory
3. Records of distribution
4. Records of disposal

Records of acquisition

The records of acquisition includes the whole process of acquiring the materials from any sources by transfer , donation, or purchase . All the details of procurement of drugs or other agents or supplies should be documented accurately and regularly. This record explains the materials available and acquired.

Records of inventory

Inventory record is to be maintained in the department to identify the materials available in its type, quantity, date range , format, volume , location and item-wise information.. The record of inventory helps to locate any radioactive agent or other supplies with their complete information.

Records of distribution

Nuclear pharmacies shall maintain records of distribution, which includes all the details of distribution of drugs and other supplies. The materials or agents will be distributed according to the requirements of preparing the compound and each time distribution happens it needs to be documented carefully.

Records of disposal

Records of disposal include the condemnation of any material from the storage. For the purpose of quality assurance the unused or decayed materials has to be disposed regularly. The technician has to keep a check on the manufacturing dates of the drugs and maintain the health and safety by following the proper management and disposal which need to be documented accurately.