Pharmacology, Part 4: Nuclear Cardiology

Currie, Geoffrey

doi:10.2967/jnmt.118.219675

Cited by 7 publications

(10 citation statements)

References 13 publications

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“…CT and MRI contrast agents are unique interventions that demand an expanded skill set and understanding of basic and applied pharmacology (1)(2)(3)(4)(5). Having insight into the complexities of both iodinated and gadolinium contrast agents enhances practice and patient safety.…”

Section: Resultsmentioning

confidence: 99%

“…Free gadolinium (Gd 31 ) is highly toxic, as relates, in part, to cellular inhibition of calcium (Ca 21 ) at calcium channels (27,30,35). As outlined in a previous article in this series (5), alteration of calcium influx interferes with muscle contraction (e.g., cardiac force of contraction), vascular smooth muscle vasoconstriction, and bronchial smooth muscle bronchoconstriction. Free gadolinium can also depress the reticuloendothelial system, including inhibition of phagocytosis (27,30).…”

Section: Adverse Reactionsmentioning

confidence: 99%

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Pharmacology, Part 5: CT and MRI Contrast Media

Currie

2019

J. Nucl. Med. Technol.

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CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than September 2022. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test. Pharmacology principles provide key understanding that underpins the clinical and research roles of nuclear medicine practitioners. The scope of practice of the nuclear medicine technologist demands knowledge and understanding of indications, contraindications, warnings, precautions, proper use, drug interactions, and adverse reactions for each medication to be used. This article is part of a series that aims to enhance understanding of pharmacologic principles relevant to nuclear medicine. This article will build on the introductory concepts, terminology, and principles of pharmacology explored in the first 2 articles in the series. Specifically, this article will focus on the pharmacologic principles and adverse reactions associated with iodinated and gadolinium contrast media used in CT and MRI, respectively.

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Section: Resultsmentioning

confidence: 99%

Section: Adverse Reactionsmentioning

confidence: 99%

Pharmacology, Part 5: CT and MRI Contrast Media

Currie

2019

J. Nucl. Med. Technol.

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“…It is generally recommended that other medications that affect coronary blood flow be held for 5 half-lives before conducting MPI. 4 Following the same guidance for nicotine and NRT may present a reasonable approach to ensure accurate imaging results. Based on the discussed literature, patients should be instructed to refrain from cigarette smoking for at least 5 to 10 hours prior to MPI, given nicotine' s half-life of about 1 to 2 hours.…”

Section: Discussionmentioning

confidence: 99%

“…3 In some cases, other medications that can affect coronary blood flow, such as long-acting nitrates, β-blockers, and calcium channel blockers, are recommended to be avoided for 12 to 48 hours in order to obtain the most accurate depiction of underlying coronary disease. 4 Because nicotine and nicotine replacement therapy (NRT) may have substantial effects on coronary circulation, a current area of controversy is whether these should be stopped prior to the use of a stress-inducing medication during MPI. To date, no formal drug interaction studies have been conducted between nicotine and regadenoson.…”

mentioning

confidence: 99%

Nicotine and Nicotine Replacement Therapy Use During Myocardial Perfusion Imaging

Longueira

Khazan²,

Burke

2022

Federal Practitioner

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Background: Myocardial perfusion imaging (MPI) is commonly used to assess the presence and severity of coronary artery disease (CAD). A radiopharmaceutical is used before and after patients undergo either exercise-induced stress via a treadmill or medication-induced stress. While certain therapies that are known to influence the accuracy of results are avoided prior to conducting MPI, it is currently unknown whether nicotine and nicotine replacement therapy (NRT) should be avoided, even though they may have significant effects on coronary circulation. Observations: Nicotine has been demonstrated to have both vasoconstrictive and vasodilatory properties. However, in patients with underlying CAD, vasoconstrictive properties ap-pear to predominate and can allow the disease to appear more severe than it is during MPI. Similarly, NRT products may cause vasoconstriction but to a lesser degree given the lower concentration of nicotine present. Due to the lack of robust studies, the clinical impact of these findings on clinician diagnosis and patient management remains unclear. Conclusions: Based on the available data, nicotine and NRT should ideally be avoided prior to MPI. The specific time frame in which they would be stopped before conducting MPI differs based on the pharmacokinetics of each product. More studies are needed to analyze the impact of nicotine and NRT on the accuracy of MPI using medication.

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“…The general principles of pharmacology, pharmacodynamics and pharmacokinetics have been previously outlined 1 , 2 and form a foundation for understanding the medications of the crash cart. Deep insights into cardiac pharmacology, 3 and the pharmacology of both CT contrast and MRI contrast 4 have also been previously detailed.…”

Section: Introductionmentioning

confidence: 99%

Emergency pharmacology for the CT technologist

Currie

2022

J of Medical Radiation Sci

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The scope of practice of the medical radiation practitioner demands knowledge and understanding of the indications, contraindications, warnings, precautions, proper use, drug interactions and adverse reactions of a variety of medications. The risk of patient deterioration or acute emergent event, particularly following contrast administration, makes the command of crash cart medications particularly important. This article explores the pharmacological principles of medications most likely to be required in a medical emergency in the medical radiation department and in particular by the computed tomography (CT) technologist. The article also outlines early warning signs to assist in identifying the emergent or deteriorating patient. The learning outlined is designed to equip medical radiation practitioners with the capacity to identify and respond to a medical emergency typical of the medical radiation department, and to respond to that situation with the appropriate use of emergency medications where appropriate. The ability of medical radiation practitioners to recognise and respond to (including the use of medicines) the deteriorating patient or circumstances of a medically urgent nature are key capabilities required to meet minimum standards for Medical Radiation Practice Board of Australia registration and National Safety and Quality Health Service standards.

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Pharmacology, Part 4: Nuclear Cardiology

Cited by 7 publications

References 13 publications

Pharmacology, Part 5: CT and MRI Contrast Media

Pharmacology, Part 5: CT and MRI Contrast Media

Nicotine and Nicotine Replacement Therapy Use During Myocardial Perfusion Imaging

Emergency pharmacology for the CT technologist

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