Ioflupane I 123 (Intravenous)

Ioflupane I 123 is a radiopharmaceutical drug used in conjunction with other diagnostic tests like SPECT, which aids neuroscientists in detecting Parkinsonian syndromes.

Overview

Ioflupane I 123 is a type of radioactive agent, which offers targeted therapy for various diseases. It is also beneficial for assisting doctors in finding and evaluating localized ailments.

To optimize brain scanning for Parkinsonian syndromes, for example, a procedure known as SPECT, which is short for single photon emission computed tomography is performed. Prior to the scan, Ioflupane I 123 is injected into the patient's vein.

The types of Parkinsonian syndromes that can be identified from this procedure include:

Though Ioflupane is beneficial for recognizing Parkinsonian syndromes, it should be noted that it does not differentiate the type of syndrome present.

Ioflupane I 123 injections are sold under the brand name DaTscan and it is only intended for use in adult patients. A nuclear medicine specialist must supervise the procedure, which is exclusively performed in a clinical setting.

Conditions Treated?

  • Parkinsonian syndrome diagnosis

Type Of Medicine?

  • Radiopharmaceutical, Neuro-Imaging Radiopharmaceutical Drug

Side Effects

Patients who receive Ioflupane 123 may experience adverse reactions. Most subside with time and the most common include side effects correlate to the site of the injection:

  • Skin that blisters easily
  • A cold or burning sensation
  • Bleeding
  • Skin rashes
  • Puffiness
  • A tingling sensation
  • Pain and lumps
  • Discoloration

Rare side effects of Ioflupane I 123

Some of the rare side effects reported after using this medicine are:

  • Feeling dizzy or faint
  • Dry mouth
  • A sensation of constant spinning or movement
  • A headache
  • An allergic reaction

Dosage

Ioflupane I 123 is usually supplied in a vial containing 185 MBq in 2.5 mL of sterile solution. However, a nuclear medicine specialist will measure the correct dose amount based on patient analysis and a physician's order.

A becquerel is considered to be a minute amount of radioactivity. When dosing patients with Ioflupane I 123, a radioactivity calibration device is utilized to verify measurement. In most cases, adult patients are given between 111 to 185 MBq or megabecquerel. Safety has not been established in pediatric patients.

Best practices for use 'for medical professionals

  • Sterile processes ' To reduce the transmission of infectious diseases, medical workers should practice aseptic methods prior to administering the injection. For example, sterile and disposable gloves must be worn and all used needles must be disposed of in a biohazard waste container.
  • Inspect for quality ' After preparing the solution, be sure to check for quality. Look for any discolorations or particulates in the vial. If these are observed, a new vial should be used instead.
  • Limit radiation exposure ' Since DaTscan releases radiation, practice safe measures when handling this drug to reduce exposure levels to patients and other staff. For example, radiation shielding devices should be utilized during the preparation of the drug and while administering the injection.
  • Use a thyroid blocking agent ' To protect the thyroid glands, follow safe protocols and administer a thyroid blocking agent at least 60 minutes before the procedure.
  • Wait and see ' monitor patients for an allergic reaction or any other adverse side effect. The standard practice is to wait for 3-6 hours after administering the injection with Ioflupane I 123 to commence the SPECT scan.
  • Radioactivity elimination ' When handling bodily waste, care should be taken to wear protective gear to prevent contamination from radioactivity.

How to administer Ioflupane I 123

Medical specialists recommend injecting Ioflupane I 123 into a vein located in the arm region. The medicine should be injected slowly for no less than 15 seconds.

Specific instructions are available for performing SPECT procedures as well as how to read the images. Consult the insert label for more guidelines.

Doses must be administered by an approved medical specialist

For best results and to protect patients and other on-duty healthcare workers, this radioactive agent should only be handled by a healthcare professional who has received detailed training and hands-on practice working with radionuclides. The provider must also be approved by the Nuclear Regulatory Commission, which regulates the use of radiopharmaceuticals.

Interactions

Some contraindications have been found when Ioflupane I 123 is used concomitantly with other medicines or when there is an underlying ailment to factor in:

Drug interactions

Using certain medicines may interrupt the functionality of Ioflupane I 123 'and possibly distort test results. Some examples include:

  • Phentermine
  • Methylphenidate
  • Bupropion
  • Phenylpropanolamine
  • Sertraline
  • Norephedrine
  • Paroxetine
  • Selegiline
  • Cocaine
  • Methamphetamine
  • Amphetamine
  • Benztropine
  • Buspirone
  • Mazindol
  • Amoxapine
  • Citalopram

If these drugs are currently being taken, your doctor may recommend stopping the treatment temporarily until after the SPECT scan is performed. However, you should never discontinue your prescription medications without first consulting with your healthcare provider.

Pre-existing conditions

If you have kidney disease, extra precautions must be taken while using this medicine as the waste removal process may be delayed, resulting in kidney problems or a worsening condition.

Warnings

Some of the main precautions of using Ioflupane I 123 are:

Frequent urination

After receiving an injection with Ioflupane I 123, you may feel the sudden urge to urinate. The urinary frequency may continue for up to two days following the injection. Go to the bathroom as often as possible to pass the urine and aid with waste removal. Additionally, to help you pass more urine, your doctor may recommend drinking copious amounts of water before and after the injection.

This precaution is also listed to reduce radiation exposure to the bladder.

Allergies

Patients who receive Ioflupane I 123 injections may be susceptible to an allergic reaction, particularly if there is a history of hypersensitivities to other medications.

Before taking this medicine, inform your doctor of any past allergies to drugs, foods, dyes, preservatives, or any other substance. After taking this medicine, watch out for the signs of an allergic reaction and tell your medical provider if you experience:

  • A fever
  • Difficulty swallowing
  • Hives or welts
  • Lethargy
  • Muscles that feel limp
  • Queasiness
  • Skin irritations
  • Swelling or puffiness
  • Trouble breathing

Pregnancy

Limited studies exist for how Ioflupane I 123 affects fetal development. However, medical researchers know that radioactive agents may cause harm to an unborn baby. The medicine may also cross the placental barrier and can irreversibly damage the thyroid glands of developing fetuses.

The manufacturers, therefore, warn against administering this medicine in pregnant women unless it is necessary.

Breastfeeding

Ioflupane I 123 may excrete in human milk and may cause harm to infants. Most medical professionals recommend the pump and dump method for up to one week after the procedure to reduce the chance of infants being affected by an adverse reaction.

Thyroid gland

One of the main concerns when prescribing Ioflupane I 123 is patients developing thyroid neoplasia due to radiation exposure.

To shield the thyroid gland from exposure to radiation, your doctor will prescribe potassium iodide before you get Ioflupane I 123. Currently, there are three versions currently used by healthcare providers, including:

  • Potassium Iodide Oral Solution
  • Lugol's Solution 'Equal to 100 Mg Iodide
  • Potassium Perchlorate 400 Mg

Tell your doctor if you have had an allergic reaction to these medicines or other products containing iodine since allergies can occur.

Storage

Ioflupane I 123 is supplied in a lead container to help protect handlers from radiation. Keep the solution in the original container until the time of treatment.

The vials should be stored at a controlled room temperature of 20° to 25°C (68° to 77°F).

Confirm the expiration date before use and discard of any outdated medicines appropriately.

Summary

Ioflupane I 123 is a type of neuroimaging radiopharmaceutical that highlights if the shakiness experienced by patients is the result of Parkinson's disease. It is otherwise known as DaTscan and is typically given before a SPECT scan'an abbreviation for the single photon emission computed tomography procedure.

The drug is effective for providing an optimized visualization of the inner workings of the brain. Subsequently, a more accurate diagnosis can be made.

The injection is given by a healthcare provider who is trained and proficient in handling radionuclides. For best results, a radioactivity calibration instrument is used to meter the dose.

To further protect patients, additional precautions are taken including administering a thyroid blocking agent such as potassium iodide at least one hour before the neuroimaging procedure. This lowers the risk of thyroid neoplasia.

Additionally, to limit the radiation dose to the bladder and prevent kidney problems, patients are advised to urinate often and drink a lot of water for up to 48 hours following the procedure.

Patients are generally monitored for between 3-6 hours after receiving an injection with Ioflupane I 123 for any allergic reactions and any other side effects.

To reduce contraindications, patients are advised to disclose their full medical history, particularly any hypersensitivities to iodine products. Also, tell your doctor if you are taking any medicines, as certain drugs may affect how this treatment works.