What Is Nuclear Pharmacy?

April 6, 2018
By Richard Van Sant, PharmD

Nuclear pharmacy is a specialty area of pharmacy practice. The nuclear pharmacist compounds radiopharmaceuticals for nuclear medicine departments and outpatient diagnostic clinics for the diagnosis and staging of cancer or metabolic function of target organs. Nuclear pharmacy was the first specialty recognized in 1978 by the BPS (Board of Pharmaceutical Specialties).

How do you become a nuclear pharmacist?

In order to become a nuclear pharmacist, one must first be a licensed pharmacist. After which the NRC requirements to become an authorized nuclear pharmacist (ANP) is 200 didactic hours in basic areas of radiation physics and instrumentation, radiation protection, radiation biology, math related to radioactivity decay and radiopharmaceutical chemistry. In addition to the didactic training, 500 hours of practical training in a nuclear pharmacy under the direct supervision of an ANP is required. After which you may be placed on a RAM (Radioactive Materials License).

What are the types of nuclear pharmacy?

Nuclear pharmacy can be divided into two types:

  1. Low energy traditional SPECT (Single Photon Emission Computed Tomography) is considered the practice of pharmacy where the nuclear pharmacist will compound a kit (drug) with a radioactive isotope. When the isotope is added to the kit, a chemical reaction takes place binding the isotope to the drug in the vial. When the tagging is complete the final product is ready for quality control verification and unit dose dispensing. This is performed in a ISO 7 environment under a ISO 5 hood. These isotopes can generally speaking be handled with your hands.
  2. High Energy PET (Positron Emission Tomography) is considered drug manufacturing and is regulated as such by the FDA. High energy radiopharmaceuticals typically have very short half-lives (seconds to minutes) and as the name imply have a high energy, 511KeV vs 140 KeV of low energy isotopes. These isotopes are cyclotron produced and are primary carbon, oxygen, nitrogen and fluorine. With radiopharmaceuticals of these elements it is possible to create an endless variety of labeled radiotracers, substrates, drugs, and ligands. Some examples of a PET radiopharmaceutical are FDG (measure of metabolic activity), NaF (high quality bone imaging), F-Dopa (neuro endocrine tumors, movement disorders and brain tumor).

The production of a PET radiopharmaceutical is a multi-step process that includes:

  • Isotope production (Cyclotron)
  • Radiochemical synthesis (Making the drug)
  • Quality control testing
  • Preparing the dose for the patient.