A patient arrives at a hospital with a hard-to-diagnose illness. X-rays
shed no light on what the cause might be.
In days gone by, that would have been the end of the story. But in the
age of nuclear medicine, things are just warming up.
The patient takes a radiopharmaceutical -- a drug containing small amounts
of radioactive material known as "tracers." They reveal detailed information
about the trouble spot to a special camera. Now, the illness can be named,
studied and ultimately beaten.
Nuclear pharmacists, also known as radiopharmacists, specialize in the
procurement, compounding, dispensing and use of radiopharmaceuticals. Their
work is a recognized specialty within pharmacy.
"It is unique in that the drugs are radioactive or combined with radioactive
isotopes," explains John Yuen. He is a nuclear pharmacist in Los Angeles.
Common procedures involving radiopharmaceuticals include bone scans, heart
scans, breast scans, liver and gallbladder scans, ovarian and colorectal cancer
imaging, prostate cancer imaging, brain imaging and renal (kidney) imaging.
The drugs can also be used to treat thyroid conditions and some forms of
Nuclear pharmacists work alongside other specialists in nuclear medicine
-- a branch of health care that harnesses radioactivity to diagnose and treat
the ill. Its very concept comes as a surprise to most people, who tend to
associate radiation with sickness, rather than health.
"I don't glow in the dark!" says nuclear pharmacist Tim Younkin. He works
for a commercial radiopharmacy in Virginia. "Everybody seems to ask me that."
Contrary to popular belief, radiation in small doses has few harmful effects.
Patients given a prescribed radiopharmaceutical -- which is usually injected,
but can sometimes be inhaled or swallowed -- receive roughly the same exposure
to radiation as they would during a standard X-ray examination.
"The majority of nuclear pharmacists are employed by large industry firms,
providing bulk and unit dosed radiopharmaceuticals," says Yuen. Others work
for universities, government organizations and medical institutions.
"Many of the premier and university-based hospitals offer on-site nuclear
pharmacy services," he notes.
Wherever they work, nuclear pharmacists must know how to handle radioactive
materials -- and the responsibility that goes along with it.
"Personnel authorized to handle radioactive materials need special training
and certification. [They must] wear protective garments and shielding from
the radiation, and must follow strict guidelines on the receipt, handling,
disposition, disposal and transfer of radioactive materials," Yuen says.
To avoid exposure to radiation, nuclear pharmacists do most of their hands-on
work in contained workstations with lead glass screens and gloved ports.
"Monitoring badges are worn on the body and the hand of nuclear pharmacists
to measure personal exposure on a weekly, monthly, quarterly, annual and lifetime
basis," Yuen says.
Younkin spends most of his workdays drawing up and packaging doses to fill
orders. He believes he stands a greater chance of injury in a car accident
than on the job. "Our radiation levels are monitored and are very low compared
to what we are allowed to receive by law," he says.
Besides brains, nuclear pharmacists need brawn. When sending and receiving
shipments, they sometimes have to move packages weighing as much as 50 pounds.
Some nuclear pharmacists work only slightly longer than the norm. Ingrid
Koslowsky, who works for a public hospital, estimates that she works 40 to
50 hours per week.
In the private sector, hours can be more unpredictable. "My first job opened
at midnight till 4:30 p.m.," says Younkin. "My present job opens at 2 a.m.
till 5 p.m. If the pharmacy lab does a lot of doses, it will probably open
up very early and possibly close later."
The good news is that most nuclear pharmacists work on a rotating schedule.
"That way, a pharmacist won't always have to come in so early every week,"