Radiopharmaceuticals and Radio Opaque Contrast Media:
Practice, Prospects and Potentials.
Dibyajyoti Saha1*, Milan Hait2, Mayukh Jana3, Suprodip
Mandal3 and Utpal Jana4
1School of Pharmacy, Chouksey Engineering College, Lal
Khadan, Masturi Road, Bilaspur- 495004,
C.G.
2Dept. of Chemistry, Dr.C.V. Raman University, Kargi
Road, Kota, Bilaspur, C.G.
3Dept. of Pharmacy, Bharat
Technology, Uluberia-711316, W.B.
4Dept. of Pharmacy, Annamalai University, Annamalai
Nagar.
*Corresponding Author E-mail: saha.dibyajyoti@gmail.com
ABSTRACT:
The compounds or substance which emit radiation and
which are used in medicine area called radiopharmaceuticals. Radio opaque
substances are those compounds (both inorganic and organic) that have the
property of casting a shadow on x-ray films. Radiopharmaceuticals preparations
are the preparations containing one or more radionuclides.
Radionuclides are radioactive and transform
spontaneously into other nuclides. The unstable nuclei undergo spontaneous
nuclear changes in order to achieve stability by emitting radiation are called
radioisotopes or radionuclides. The radioactive
substances disintegrates or decays with the emission of certain particles or
certain quantities of energy which is always characteristics of the isotope.The present article gives various ideas about
radiations, radioactivity, radioisotopes, radio opaque and contrast media,
radioactive pollution as well as quality control and also pharmaceutical
applications of radioisotopes.
KEYWORDS: Radiopharmaceuticals,
Radio opaque, Contrast media, Radioisotopes.
INTRODUCTION:
Many heavy elements like uranium, thorium, radium and
their compounds emit radiations spontaneously. These radiations can penetrate
through solid material, can ionize gases, produce a glow on zinc sulphate paint or affect the photographic plates. The
substance which emits such radiation is called as radioactivity. For
therapeutic and diagniostic purposes they are
referred as ‘Radiopharmaceuticals’. The radioactive isotopes continue to decay
for a particular period of time. Half life is defined as the time in which the
amount of radio nuclides decays to half of its initial value1.The X-rays contrast media
are the chemical compounds which have the ability to absorb x-rays and block
the passages of X-rays. Thus, they are opaque to X-rays examination. All radio opaque are not radiopharmaceutical
unless they contain a radio isotope in their structure or formula2.
RADIOACTIVITY
AND ITS UNITS:
Henry
Beequerel (1896) first noted that elements like
uranium, thorium etc. affected photographic plates,
when placed nearby these elements.
This phenomenon was considered
as a new form of activity and called radioactivity .The element like uranium,
radium, cobalt phosphorous , iodine etc. are called radioactive elements. The
activity of any radioactive material decreases with time. This is called as
radioactive decays. Radiation dosimetry in simple
terms means measurement of dose of radiation or radioactivity an object is
exposed to or absorbs3.
v Properties
of Radioactivity or Radioactive decay particles3,4:
I. ALPHA Particles:
1. They
affect photographic plates.
2. They
produce fluorescence.
3. They have
maximum ionizing power.
4. They have
maximum penetrating power.
5. They have equivalent to nuclei of helium
atoms.
6. They are
heavy and positively charged.
7. They are
affected by strong magnetic field.
8. They
possess discrete energies.
9. Their penetration power is few cms in air and a fraction of millimeter in body tissues.
10. Their
velocities are 3*107m/s.
11. They have max kinetic energy.
12.
When emitted atomic mass decreases by
4 and atomic no by 2.
13.
They are not used in the
pharmaceutical preparations.
II.
BETA Particles:
1. They affect photographic plates.
2. They produce fluorescence.
3. They have moderate ionising
power.
4. They have moderate penetrating power.
5. They may be negatively and positively charged.
6. It has the same mass as an electron.
7. Their penetration power is few meters in air and about
few cms in body tissues.
8. Their velocities are 1.2 to 2.7*108 m/s.
9. They have max kinetic energy.
10. When emitted atomic no increases by 1.
11. Ionization power is less than alpha particles.
12. They have high penetration power.
13. They are affected by strong magnetic field.
14. They are used as pharmaceuticals preparations.
15. Its max energy is 1.5 Mev
and the mean energy is 0.6 Mev.
III.GAMMA
Particles:
1. They affect photographic plates.
2. They produce fluorescence.
3. They have maximum ionizing power.
4. They have maximum penetrating power.
5. They have and neutral charged.
6. They have electromagnetic waves.
7. Their velocities are 3*108m/s.
8. They have max kinetic energy.
9. No change in atomic mass or atomic no.
10. It travels with the speed of light.
11. Photons type behavior are
present.
12. Not affected by electronic or magnetic field.
13. A very thick lead sheet is required to protect from
these radiation.
v Half life of
Radioactive compounds:
Radioactive isotopes continue to decay for
a particular period of time. Half life is defined in which the amount of radio
nuclides decays to half of its initial value.
For e.g. Polonium-212: Half life 3-10
seconds.
Iodine-131; Half
life 8 days.
Uranium-238: Half life 4.5-10 year.
Zinc-65: Half life 150 days.
Sodium-22: Half life 2-6 years.
v Units:
·
Curie(c).
·
Millicurie(mc)
·
Microcurie(μc)
·
Roentgen(R)
·
Relative
Biological Effectiveness(RBE)
·
Radiation Absorbed
Dose(RAD)
·
Roentgen
Equivalent Man(REM)
·
Exposure Rate
Constant.
Pharmaceuticals dosage forms may be
described in terms of RAD units5.
PREPARATION
OF RADIO ISOTOPES IN LABORATORY:
The preparation of radio isotopes in a laboratory
should include following special rooms6:
·
Dispensary
·
Counting Room
·
Hot Laboratory
·
Store
·
Annexe.
The various types of equipments are required to prepare
radio isotopes. They are in the following6:
·
Beakers
·
Pipettes
·
Surgical Rubber
Gloves
·
Trays
·
Long Forceps
·
Tissue Papers
·
Carriers ( for
containers)
·
Waste Bin
·
Aseptic Screen.
MEASUREMENTS
OF RADIOACTIVITY:
The measurement of radioactivity of a substances
consist in the determination of the rate of emission of α,β, γ rays by it. These radiations are also
known as ionizing radiation because they are capable of causing ionization,
either directly or indirectly. The following instruments are used for
measurement of radioactivity7, 8:
·
The Geiger-Muller
Counter
·
Scintillation
Counter
·
Ionization chamber
·
Proportional
chamber
·
Auto radiography
·
Semiconductor
detector
·
Photographic plate
method
·
Bubble Chamber
·
Wilsons Cloud
Chamber
·
Nuclear Emulsion
·
Film Badges
·
Electroscope
·
Cerenkov Detectors
·
Thermo-Luminescence
Dosimeters
·
Track Etch
Detectors.
BIOLOGICAL
EFFECTS OF RADIATION:
Ionization and excitation of molecules in the body
cause abnormal chemical reaction. The effect of abnormal chemical reactions
depends on number of factors such as3, 9:
1.
The energy of the
radiation.
2.
Dose rate of the
radiation.
3.
The particular
tissue and surface area exposed.
4.
The ability of the
radiation to penetrate tissue.
5.
Time of the
exposure.
The various biological effects are in the following:
1.
Skin Damages: Erythema, Brittleness, Dryness, Burns.
2.
Somatic Effects:
Anemia, Leukemia, Cancer, Cataract.
3.
Genetic Effects:
Chromosomes damage and increase the chance of gene manipulation.
4.
Direct radiation
effects.
5.
Indirect radiation
effects.
6.
Effect on Rate of
cell divisions.
7.
Effect on human
body:
·
Short term
effects.
·
Long term effects.
STORAGE,
HANDLING AND PRECAUIONS OF RADIOACTIVE MATERIALS:
A care should be taken to protect people and personnel
from harmful radiation during handling and storage of radioactive materials
emits. The following precautions are taken while working with radio detectors,
radio assays, traces experiments, manufacturing or handling of radioactive
materials1, 8:
1. These
materials should be handled with forceps or suitable instruments and direct
contact should be avoided.
2. Any
substances which is taken internally (food, drinks,
smokes etc.) should not be carried in laboratory where radioactive materials
are used.
3. Sufficient
protective clothing or shielding must be used while handling the materials.
4. Radioactive
materials should be kept is suitable labeled containers, shield by lead bricks
and preferably in remote corner.
5. Areas where
radioactive materials are used or stored should be monitored constantly (tested
regularly for radioactivity).
6. The final
disposed of radioactive material should be done with great care to animals and
environment.
QUALITY CONTROL OF RADIOPHARMACEUTICALS:
The numbers of chemicals are use in preparations of
radiopharmaceuticals. A series of tests are carried out on these materials to
ensure their quality so that dosage forms prepared should be of the safety and
desired efficiency. The various important aspects are1, 4:
1.
Identification of
radio nuclides.
2.
Radioactive
content.
3.
Radio nuclidic purity.
4.
Radio chemical
purity.
5.
Specific activity.
The various factors are in the following:
1.
Sterility.
2.
Pyrogenicity.
3.
Isotonicity.
4.
PH.
5.
Storage.
PHARMACEUTICALS
APPLICATIONS OF RADIOISOTOPES:
The various pharmaceutical applications of
radioisotopes are in the following2, 4,5,10:
I.
PATHWAYS :
1.
Therapeutic
applications of isotopes:-
Ø External sources as used in therapy:
a)
Teletherapy.
b)
Surface sources.
c)
Extracorporeal
irradiation.
Ø Internal Sources as used in therapy:
a)
Infusion.
b)
Interstitial
implant.
c)
Selectively
absorbed or concentrated,
d)
Locally injected
radiopharmaceuticals.
e)
Intravenously or
orally administered radiopharmaceuticals.
2.
Diagnostic application of radioisotopes:-
Ø In vitro quantitative analysis:
a)
Radiometric
analysis.
b)
Competitive radio
assay or saturation analysis.
c)
Receptor assays.
d)
Activation
analysis.
e)
Functional radio
assay.
Ø In vivo quantitative studies:
a)
Thyroid studies.
b)
Red blood cell
volume and plasma volume.
c)
Red blood cell
survival time.
d)
Shilling test.
Ø Scanning techniques:
a)
Cardiovascular
studies.
b)
Bone imaging.
c)
Renal studies.
d)
Lung imaging.
e)
Thyroid and Para
thyroid imaging.
f)
Brain imaging.
g)
Liver, spleen and
bone marrow imaging.
h)
Tumor
localization.
3.
Radiation Sterilization:
It can be brought about either by electromagnetic
radiations or by particulate radiations.
Table1. Some inorganic commonly used
Radiopharmaceuticals are in the following:
|
Products |
Applications |
|
Ammonium
Bromide (Br-82), Injection |
Extra
cellular water measurement |
|
Calcium
chloride (Ca45/Ca47), Solution |
Study
of calcium metabolism disorders, bone cancer and other bone lesions |
|
Chlormerodrin (Hg-197/Hg-203), Injection |
Scintillation
scans of kidneys, brain etc. |
|
(Radio)-Cromated Serum Albumin (Cr-51), Injection |
Plasma
volume determinations, placental localization procedures |
|
Chromic
chloride (Cr-51), Injection |
Study
of protein loss from GIT and absorption |
|
Colloidal
Gold (Au-198), Injection |
Scintillation
scan of liver, study of reticuloendothelial systems
(RES); treatment of disorder secondary to neoplastic
(cancer) situations, especially in pleural and peritoneal cavities, etc. |
|
Cyanocobalmin (Co-57, Co-58, Co-60), Capsules and Solutions |
Co-57/58:
Diagnosis of pernicious anemia Co-60:
Treatment of advanced stages of cancer involving cervix, vagina, uterus,
bladder, mouth, tongue and lips etc. |
|
Ferric
Chloride/Citrate (Fe-59), Ferrous Citrate (Fe-59) solution and Injections |
Study
of iron metabolism and RBC formation |
|
Indium
Chloride in Chelate Form (In-113m), Injection |
Brain
and renal scans; and plasma volume measurement |
|
Iodinated
(I-125) Serum Albumin, Injection; Iodinated
(I-133) Serum Albumin, Injection |
Determination
of plasma volume, total blood volume, Circulation
time and cardiac output; localization of neoplasm of the brain |
|
Potassium
Chloride (K-42) Injection |
Study
of potassium ion (K+) exchange |
|
Rubidium
Chloride (Rb-86) Injection |
Myocardial
blood flow determination |
|
Selenomethionine (Se-75) |
Pancreas
and parathyroid gland scans |
|
Sodium
Chloride (Na-24) Injection |
Study
of Na+ exchange |
|
Sodium
Fluoride (F-18) |
Bone
scanning and study of bone metabolism |
|
Sodium
Iodide (I-125), Solution Sodium Iodide (I-131), Capsules and Solutions |
Thyroid
scanning and study of thyroid uptake |
|
Sodium
Iodohippurate (I-131), Injection |
Renal
scanning and study of renal function |
|
Sodium
Phosphate (P-32) solution |
Treatment
of polycythemia vera
(over production of RBC) |
|
Sodium
Rose Bengal (I-131) Injection |
Liver
scan, liver function test |
|
Sodium
Sulphate (S-35) Solution |
Extracellular
fluid volume determination |
|
Sodium
Pertechnetate (Tc-99m), Injection |
Brain
scanning, thyroid function tests |
|
Technetium
Sulphate (Tc-99m) Collodial
Solution |
Liver
and spleen scans |
|
Yb-169-DTPA
(Diethylenetriaminopentacetate) |
Brain
scanning and determination of glomerlar filtration
of glomerular filtration rate in kidneys. |
RADIOACTIVE
POLLUTION11:
Radioactive substances and nuclear radiations (i.e. α,
β and γ- particles) produced during nuclear reactions affect our
environment adversely and thus radioactive pollution is created.
Ø Sources:
1.
Low level
radioactive liquid wastes, radioactive gaseons
wastes, dusts are released during during nuclear
explosions.
2.
The radioactive
substances produce energy which is so strong that the living cells are damaged
or destroyed.
3.
People working
with radioactive elements develop tumors.
4.
Radioactive
elements affect our soil and through this human beings and animals are also
affected.
5.
Nuclear explosions
which are operated in sea make sea water polluted. This affects the aquatic
life.
6.
The γ-radiation
may be pass freely in human body, where they loss energy. Lastly, produces
disease like leakaemania and cancer.
7.
U-235 is used as a
nuclear fuel which may damage the health of human beings and animals.
Ø Control:
Most of the nuclear wastes are being stored in strong
leak proof containers. These will be disposed off whenever a safe method of
their disposal is found out.
RADIO OPAQUE
CONTRAST MEDIA:
Radio opaque contrast media are chemical compounds of
elements of high atomic number. They hinder the passage of X- rays and used as
diagnostic aid in radiology emits X-rays which can pass soft tissues of the
body but are observed at hard tissues (bone). The ray produces a black spot on
photographic plate by forming complex with silver bromide. Wherever these rays
does not form a bright spot of the similar shape, as that of X-ray observing
object is formed. Certain inorganic agents like iodine or barium salts can act
as radio contrast media, by absorbing at soft tissues and these tissues becomes
capable of absorbing X-rays. The barium sulphate salt
is given to identify of ulcer in G.I.T. whenever ulcer is formed, broken mucosa
retains barium sulphate and this spot (ulcer) is
identified with the help of X-ray film. X-rays are electromagnetic radiations
of short wavelength and have high penetrating power. The electrons of high
atomic number element can interact with X-rays8, 9.
The relative difference between the light and dark
areas on a radiographic image reflects is called radiographic contrast. Any agent
or compound administrated to a patient to improve the visualization of an organ
or tissue is called a contrast agent. They can be classified as negative or
positive. An ideal contrast agent should have the following properties:
1.
Ready availability
and low cost.
2.
Excellent X-ray
absorption characteristics at the X-ray energies
used in diagnostic radiology.
3.
Minimum toxicity
and ready patient acceptance.
4.
Chemical
stability.
5.
High water
solubility with low viscosity and no significant
osmotic effects.
6.
The ability to be
administered for selective tissue uptake and excretion.
Barium sulphate is ideal
contrast agent for oral and rectal studies of the GI tract. Contrast media are
used in very large quantities and are usually administered over a short time.
The majority of contrast agents used to opacity blood vessels and increase
contrast in solid organs such as the liver are water soluble organic iodides12.
The various types of common contrast agents are in the
following11:
1.
High-osmolality (1,400-2,938 mosm/kg)
(“ionic”) agents;
Conray 60 (60% meglumine
iothalamate), Hypaque 50
(50% sodium diatrizoate), Reno-M-60 (60%meglumine diatrizoate) etc.
2.
Low-osmolality (“nonionie”) agents
(290 to 862mosm/kg);
Amipaque (metrizamide), Isoune (iopamidol) – Bracco Diagnostics, Xenetrix (iobitridol) etc.
3.
Miscellaneous
infrequently used biliary contrast agents;
Teletrast, Telepaque
(iopanoic acid); Cholebrine,
Cholimil (iocetamic acid)
etc.
4.
Oily and fat
soluble contrast agents (water-Insoluble agents);
Dionosil (propyliodone),
Lipiodol (iodinated poppy seed oil) etc.
5.
Gadolinium-based
magnetic resonance imaging (MRI) agents;
Dotarem (gadoterate
meglumine); Eouist (godoxeic acid); Gadouist (gadobutrol) etc.
The radiology procedures are in the following11:
1.
Plain film
radiology:- Routine chest, abdomen, skeletal studies.
2.
Contrast Studies:-
·
Barium studies : Esophagram, Ugi examination, SBFT, BE and other specialized GI tract
examinations.
·
Water insoluble
contrast studies : Lymphangiography, bronehography, myelography.
·
Gallbladder studies : Abdominal ultrasound, oral cholecystography,
intravenous cholagiography.
3.
Studies using
water soluble contrast agents :-
Exeretory urography
(IVP), Venography, Arteriography,
Contrast-enhance CT and MRI, arthrography, myelography, hysterosalpingography.
4.
Cross section
imaging studies.
5.
Ultrasound
examinations.
6.
CT studies.
7.
MRI studies.
CONCLUSION:
Lastly, radiopharmaceuticals are more or less like
pharmaceutical preparations (solutions, injections etc.) with all the usual
controls for such preparations5. In radio opaque contrast media,
barium sulphate and some bismuth compunds
are useful for diagnostic purpose.
The field of radiopharmaceuticals is a rather new one
for this country. The educational institutes should initiate various activities
in the field so that more and more of the pharmacy students may take interest
in this field. Competent persons who are solely devoted to this field should be
engage for the teaching purposes10.
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Received on 16.02.2011 Accepted on 25.03.2011
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Asian J. Res. Pharm. Sci.
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