Tomorrow's Pharmacist
2007:18-20
January 2007
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A career as a specialist radiopharmacist |
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Radiopharmacists provide a clinical and technical pharmacy service within nuclear medicine. Zoë Gross outlines the work involved and the career path followed by some of the pharmacists working in this field |
Radiopharmacy is the branch of the profession that involves the manufacture and supply of safe and effective radiopharmaceuticals (radioactive products) for the diagnosis and therapeutic treatment of patients with cancer. It also involves providing advice and support on the use of radiopharmaceuticals. A radiopharmacy service in a hospital is provided either as a stand-alone service by a radiopharmacy department or by a radiopharmacy section of a nuclear medicine department. Radiopharmacies generally produce from 2,000 to over 10,000 doses every
year. However, the range and complexity of the radiopharmacy (or nuclear
medicine) service provided does not necessarily depend on the size of
the hospital in which it is based.1 Role of the radiopharmacist The radiopharmacist’s main responsibility is the procurement, preparation, quality control and supply of radiopharmaceuticals, ensuring the safety and efficacy of such products. Daily activities may include managing the production of radio-pharmaceuticals. Radiopharmacists also have a clinical role to play, eg, providing advice on the use of radiopharmaceuticals and having input to patient care in the nuclear medicine department. In addition, they may provide education and training to their own staff as well as other health care professionals. There is scope to get involved in the research and development of new radio-pharmaceuticals, including clinical trials and in the development of new dispensing techniques. Other examples of activities carried out by radiopharmacists and areas of expertise are summarised in the first panel.
Day-to-day practice So what do radiopharmacists and their teams do in practice? Beverley Ellis, is head of radiopharmacy services at Central Manchester and Manchester Children’s University Hospitals NHS Trust. The radiopharmacy unit at this trust is based in the trust’s clinical nuclear medicine department and prepares approximately 12,000 doses a year. It provides a clinical radiopharmacy service to the trust as well as to other hospitals requesting a radiopharmacy service. Dr Ellis works as part of a multidisciplinary team, comprising nuclear medicine physicians, medical physicists, nuclear medicine technologists and nuclear medicine nurses. Dr Ellis said: “I provide advice on potential and actual drug interactions with radiopharmaceuticals, possible causes of abnormal biodistributions seen on nuclear medicine scans, the choice and suitability of using drugs to enhance nuclear medicine studies, and the stability and formulation of radiopharmaceuticals, as well as monitoring and reporting adverse reactions.” However, the routine preparation and quality control testing of both radiopharmaceuticals and radiolabelling of blood components (for reintroduction into a patient for diagnostic purposes, eg, for infection and inflammation imaging) is mainly undertaken by nuclear medicine technologists who rotate through the radiopharmacy unit.
Mrs Croasdale also conducts in-house research projects with a view to publishing or presenting the results, plays an active role in training new staff and participates in the dispensing and manufacturing process to help keep staff radiation dose exposure down and to “keep her hand in”. In addition, she is involved in a clinic for hyperthyroid patients, which is currently run by the radiopharmacy team at City Hospital two afternoons a week. Outside the City Hospital, she acts as regional expert, which requires her to support other radiopharmacies in the region. “I visit them every quarter, sending a report to their chief pharmacist afterwards, and I audit them once a year,” she said. Conclusions Radiopharmacy provides pharmacists with the opportunity to be a key part of a multidisciplinary nuclear medicine team. According to Mrs Croasdale: “It is a job where you can use the science background that is part of your pharmacy degree, as well as giving you contact with patients, managerial experience and practical work.” For those pharmacists thinking about a career in radiopharmacy, think carefully about the type of career you wish to pursue. As a pharmacist within a small specialty, you might find limits to promotional progression. On the other hand, if you wish to follow a career that is intellectually and scientifically challenging, with opportunity to interact with a wide range of scientists, clinicians and technologists, then radiopharmacy may be the one. 1. Connolly M, Frier M, Lazarus CR, Maltby P, Thom J. Guidelines for
the provision of radiopharmacy support to nuclear medicine. Nuclear Medicine
Communications 2003;24:429–33 |
Consultant radiopharmacist Jilly Croasdale is based at City Hospital,
Birmingham, and fulfils both a managerial role at the hospital and a
regional role with West Midlands Regional Health Authority. She manages
the hospital’s centralised radiopharmacy department, working alongside
three radiopharmacy technicians — two pharmacy trained and one
trained in nuclear medicine — to provide both an advice and supply
service to City Hospital and five other hospitals. The team manufactures
technetium radiopharmaceuticals for diagnostic nuclear medicine and radio-labels
blood cells for clinical studies for all purchasers of the service. Her
managerial role involves considering ways of developing the radiopharmacy
service and possibilities for expanding the business, writing business
cases and service level agreements, managing the department’s budget
and ensuring customers’ needs are met.