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Role of the clinical radiopharmacist in patient safety during myocardial perfusion imaging with vasodilator stress agents.
Salgado-Garcia, C; Moreno-Ballesteros, A; Guardia-Jimena, P; Sanchez-de-Mora, E; Rebollo-Aguirre, A C; Ramirez-Navarro, A; Santos-Bueno, A; Jimenez-Heffernan, A.
Afiliación
  • Salgado-Garcia C; Radiopharmacy Unit (Department of Nuclear Medicine), Hospital Juan Ramon Jimenez, Huelva, Spain. Electronic address: carlos.salgado.garcia@gmail.com.
  • Moreno-Ballesteros A; Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain.
  • Guardia-Jimena P; Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain.
  • Sanchez-de-Mora E; Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain.
  • Rebollo-Aguirre AC; Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain.
  • Ramirez-Navarro A; Radiopharmacy Unit (Department of Nuclear Medicine), Hospital Virgen de las Nieves, Granada, Spain.
  • Santos-Bueno A; Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain.
  • Jimenez-Heffernan A; Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain.
Article en En | MEDLINE | ID: mdl-38184070
ABSTRACT

AIM:

To assess the radiopharmacist's role in a multidisciplinary team focused on the contraindications of regadenoson in order to ensure the safe use of pharmacologic vasodilator stress agents in patients undergoing SPECT-MPI.

METHODS:

We ambispectively studied its safe use in 1905 patients (54.1% female, mean age 66.6±11.7 years, range 20-95 years). Sex, age, medical history, medications, drug allergies, and contraindications for stress testing were registered together with recommendations for the nuclear physician in charge.

RESULTS:

Detected contraindications and corresponding recommendations were as follows risk factors for QTc interval prolongation 7.5% - measurement of QTc interval previously to test and monitor ECG; prior stroke or TIA 4.2% - consider carotid stenosis assessment; salicylates/sulfonamides allergy 3.1% - use 99mTc-sestamibi; epilepsy or risk factors for seizures 2.4% - use of adenosine or reconsider test indication; systemic corticosteroid therapy for severe COPD 1.3% - reassessment of patient's condition; acute exacerbation of COPD 0.8% - defer test until acute episode is over; severe asthma 0.4% - do not perform test; methylxanthine ingestion 0.3% - avoid consumption previously; other 6.1% - evaluation of other contraindications. No contraindications were detected in 73.6% of patients. The test was canceled due to absolute contraindications in 2.9% of the requests.

CONCLUSIONS:

Working in a systematic way, the radiopharmacist was able to detect a high number of issues related to regadenoson, with one out of four patients presenting some clinical contraindication. The recommendations given by the radiopharmacist were well accepted by the nuclear physicians who changed their approach contributing to increase the safety of patients referred for MPI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Pulmonar Obstructiva Crónica / Imagen de Perfusión Miocárdica Tipo de estudio: Guideline / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Rev Esp Med Nucl Imagen Mol (Engl Ed) Año: 2024 Tipo del documento: Article Pais de publicación: España

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad Pulmonar Obstructiva Crónica / Imagen de Perfusión Miocárdica Tipo de estudio: Guideline / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Rev Esp Med Nucl Imagen Mol (Engl Ed) Año: 2024 Tipo del documento: Article Pais de publicación: España