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Nuclear Pharmacy Challenges, Rewards Technician

Kate Traynor

Lea Boyles, CPhT, says the benefits of her job far outweigh the inconvenience of arising at 2:00 a.m. each day.

Boyles works for Central Pharmacy Services Inc., in Orange, Texas, a nuclear pharmacy that prepares and delivers radiopharmaceuticals to health care facilities in the southeast part of the state. The pharmacy meets its customers’ production and delivery needs by operating "from three in the morning to about four or five in the afternoon," she said.

The nuclear pharmacy is a busy place to work, Boyles said. "We have two full-time pharmacists, one part-time pharmacist. There’s me, I’m a certified technician, but also the office manager and back-up technician. I have one full-time tech, one part-time tech, and about seven drivers."

Although some material prepared by the pharmacy is used to treat cancer, primarily bone cancer, most of the products prepared in the pharmacy are used in diagnostic scans.

"We get the labels ready, the doses ready—prescriptions, so to speak," Boyles said. "The prescription needs to have the doctor’s name, the patient’s name, what the dose is, in what organ it’s specified for, and what time it’s calibrated for and what time it expires."

"The doses that we send out are organ specific," Boyles said. "There’s gallium, that is for tumors and infections. And something we call "mag-three" [from TechneScan MAG3, Mallinckrodt Medical Inc.'s kit for preparing technetium Tc 99m mercaptoacetyltriglycine]—that’s used for kidney scans and if there’s an infection in the kidney or if there’s high blood pressure....And we do brain scans—that’s for [ascertaining] activity in the brain such as brain death or advanced Alzheimer’s."

Lead-encased "generators" containing radioactive parent material are shipped overnight to the pharmacy twice each week. On mornings when the generators arrive, pharmacy staff members carefully unpack the generators and "wipe" them to document their level of radioactivity. Staff members then use the liquid eluted from the generators and the contents of nonradioactive kits to prepare patient-specific doses of radiopharmaceuticals.

The shelf life of a radioactive product presents a major logistical issue for the pharmacy, since the isotope in the product decays quickly at a rate that cannot be changed. "The generator is only good for two or three days," Boyle noted.

In addition to preparing radioactive pharmaceuticals, Boyle said her work tasks "run the gamut from answering the phone to performing quality control calibrating equipment and everything in-between."

Boyles said the pharmacy "struggled through" the days following the Sept. 11 attacks on the World Trade Center in New York City and the Pentagon in Arlington, Va.—days during which air transport virtually ground to a halt in the United States.

"We weren’t able to get our generators last week with the horrible attack on the country," Boyles said a week after the disasters. This meant that, for a few days, patients could not undergo diagnostic scans that required radiopharmaceuticals from the pharmacy.

But things were "back to normal" a week after the temporary disruption caused by the attacks, she said.

Boyles, who has also worked in military, hospital, and community pharmacies, did not set out to become a nuclear pharmacy technician.

"I went to work for a retail pharmacist, and he was opening up a nuclear medicine department in the back and asked me, would I be interested in doing that," she said.

Boyles accepted the offer. "I learned everything...[about nuclear pharmacy] from him and the pharmacists that I’m currently working with," she said.

"Minimal exposure, minimal risk," said Boyles, is a basic tenet of nuclear pharmacy. "We are as absolutely sterile [in our procedures] and as clean as we possibly can be," she added.

Boyles said she made the right career choice: "I love my job and would recommend the nuclear field to anyone."