Rubidium Rb 82 (Intravenous)

Rubidium Rb 82 is a radioactive pharmaceutical product that is administered as part of a PET scan in order to assist the physician when diagnosing the heart's blood flow rate.

Overview

Rubidium Rb 82 is a radioactive substance that is used in an intravenous form only, sold under the brand name CardioGen-82. This product is not used to treat any diseases or conditions but is instead used during the administration of a positron emission tomography (PET) scan when the doctor wants to obtain images of the blood making its way through the heart and the heart valves.

Normally, a PET scan with rubidium Rb 82 involves two phases of testing. In the first part of the test, the patient will have images taken while the heart is at rest. In the second portion of the test, the patient will be given an additional drug that will increase the speed of the heart. A second scan will then be performed. The presence of rubidium Rb 82 within the bloodstream allows the PET scanner to image the blood making its way through the circulatory system.

The PET scan allows the doctor to see if there are any blockages in the heart's vessels. If blockages do exist, the PET scan will let the doctor know the extent and the severity of the blockage. Depending on the severity, a angioplasty or a coronary bypass surgery may be required. Also, if a patient has had a heart attack, the rubidium Rb 82 in the bloodstream will allow the scanner to detect which part of the heart tissue is damaged or destroyed and which part of the tissue is still vital and undamaged.

This drug is radioactive. It is only to be used in a medical setting where precautions have been taken for radioactive containment, such as a unit where x-rays are performed. Appropriate measures will be taken to ensure that no patient is overexposed to any source of radiation.

As with most drugs, rubidium Rb 82 has a number of side effects that will need to be monitored while the PET scan is being performed. The patient will also need to follow the physician's instructions for clearing the drug from their system after the PET scanning is completed.

Conditions Treated

  • Diagnosis of atherosclerosis
  • Diagnosis of myocardial infarction
  • Diagnosis of diseased heart tissue
  • Diagnosis of impaired blood flow

Type of Medicine

  • Radioactive pharmaceutical

Side Effects

Many of the side effects that have been reported with the use of rubidium Rb 82 are centered around the injection site where the drug is administered. Patients have reported pain in this area, especially when the drug is first being introduced into the bloodstream. Other patients have reported a hot sensation as the drug is being introduced into the bloodstream.

For a few days after the drug has been administered, patients have reported redness at the injection site. Some patients experience itching in the injection area, and some have even reported that the area around the injection site has ulcerated.

There have been reports of more systemic side effects with the use of rubidium Rb 82. Some patients have had an allergic-type reaction to the drug. This can manifest as a generalized rash, or as hives over portions of the body. Generalized itching and eczema have been reported.

After the drug has been administered, some patients may experience shortness of breath. Others have experienced a tightness in the chest, accompanied with the shortness of breath.

One of the most common systemic side effects of Rubidium Rb 82 is a feeling of heat going through the body as the drug makes its way through the bloodstream.

Most side effects of Rubidium Rb 82 are minor and do not require any corrective action. While the drug is being administered, the patient will be in a medical setting where any possible side effects will be measured and addressed as necessary.

Any possible side effects that occur after the patient has returned home from the procedure should be promptly reported to a physician or qualified medical professional.

Dosage

Physicians are urged by the manufactures of this drug to use the lowest possible amount that is necessary to achieve satisfactory cardiac visualization.

The recommended dose of rubidium Rb 82 is 1480 MBq, though the dosage range for the drug is 1110 to 2220 MBq. No more the 2220 MBq of the drug should be administered.

The drug is administered by injection through a peripheral vein catheter. Rubidium Rb 82 should be administered at a rate of 50 ml per minute until all of the drug is in the system. The drug should not be administered at a rate greater than 100 ml per minute.

After administration, the PET scan of the heart may begin when 60 to 90 seconds have elapsed. The doctor will then scan the heart for approximately five minutes.

Sometimes, the heart will also be imaged while it is in a state of stress. When this is done, a stress inducing drug is administered to the patient 10 minutes after the resting scan is completed. The physician will then wait for three minutes and once again infuse the patient with a dose of rubidium Rb 82. After an additional 60 to 90 seconds, the heart may be scanned again for the stress portion of the test.

Interactions

No extensive testing has been performed to determine if there are any drug interactions with rubidium Rb 82. As far as is known, there are no drug interactions. However, it is always important that patients inform their doctor regarding all prescription and non-prescription medications that they are taking so their doctor can consider any possible interactions that may occur.

Warnings

Rubidium Rb 82 is a radioactive component. Patients should be informed of this before the drug is administered. The half-life of rubidium Rb 82 is brief, so there should be no major concerns regarding radiation exposure. With that said, radiation exposure does cause a cumulative effect over a person's lifetime and overexposure to radiation is a known cause of several forms of cancer. Any patient who has concerns regarding radiation exposure should ask their doctor for further information about the procedure.

Patients with congestive heart failure need to be monitored closely when this drug is administered as they may experience a volume overload on the heart, especially when the stress portion of the PET scan is conducted. This may also occur in elderly patients who receive this drug and undergo the stress portion of the PET scan.

This drug is rated with a pregnancy category of C. Researchers are unsure if this drug will cause harm to a fetus. However, since it is a radioactive substance, there is potential for it harm to the fetus. Also, nursing mothers are advised not to breastfeed for at least one hour after the infusion of rubidium Rb 82 as this drug may be excreted in breast milk.

There has been no testing performed to see how children will respond to rubidium Rb 82. Caution should be exercised when using this drug on pediatric patients.

In order to eliminate the drug from the system, patients will be asked to urinate immediately after the PET scan is complete. Patients will then be asked to urinate as often as possible for one hour after the test is administered.

Storage

This drug is stored in a generator unit that is lead lined, making it radiation safe. The generator must be stored between 68 and 77 degrees Fahrenheit. This drug is only to be stored in a medical facility where proper hazardous material protocols are in place.

Summary

Rubidium Rb 82 is a radioactive pharmaceutical product that is marketed under the name of CardioGen-82. This drug is used to allow doctors to image the heart and the heart vessels while a PET scan is being performed. Rubidium Rb 82 is not used to treat any conditions by itself. It is solely used as a diagnostic aid to help doctors detect heart blockages and determine the extent of damage to the heart after a heart attack.

Most of the side effects with this drug are mild and transitory. The main systemic side effect is a feeling of warmth throughout the body while the drug makes its way through the bloodstream. Most of the additional side effects of the drug relate to the injection site. These side effects include pain, itching and redness.

People who are pregnant or nursing infants should be cautious when using this drug. It should only be used if it is absolutely necessary. Additionally, patients who have congestive heart failure and patients who are elderly should be closely monitored when using rubidium Rb 82, as the drug may increase the volume load on the heart during the stress portion of the PET scanning.

 

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Last Reviewed:
January 28, 2018
Last Updated:
February 10, 2018
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