Nuclear Pharmacist: Specialty area of Pharmacy Profession

Nuclear pharmacy is a specialty area of pharmacy practice dedicated to the compounding and dispensing of radioactive materials for use in nuclear medicine procedures.  A specialty area of pharmacy practice is one that requires a concentration of knowledge in a once specific area.  The development of nuclear pharmacy as a specialty area followed the development of nuclear medicine as a recognized specialty by the American Medical Association in the early 1970's.

As nuclear medicine procedures became more widely used, the need for someone to prepare the labeled products for administration to the patients became more evident.   As a result, in the early 1970's, the concept of centralized nuclear pharmacies was born. 
When developed, the centralized nuclear pharmacy served as the "drugstore" for the nuclear medicine department.  When a particular radioactive material was needed, a trained nuclear pharmacist was available to prepare the product and dispense it to the end user.  
When you look at a nuclear pharmacy, its operation is not much different than that of a traditional pharmacy - a "prescription" for a particular product is presented, and the nuclear pharmacist must prepare and dispense that "prescription".  

Where a traditional pharmacist will dispense doses in milligram weight units, a nuclear pharmacist will dispense in millicurie activity units.  Where a traditional pharmacist dispenses tablets and capsules, a nuclear pharmacist dispenses the radioactive material in liquid or capsule form.  Where a traditional pharmacist will generally dispense the prescription to the patient, the nuclear pharmacist will dispense to a hospital or clinic nuclear medicine department where the dose will be administered to the patient.  In general however, the 2 branches of pharmacy are strikingly similar.

In addition to preparing and dispensing the radioactive products, nuclear pharmacists are available to provide drug information to other health professionals, to aid the nuclear medicine staff in the selection of products, and to assist in the interpretation of unusual studies.  Nuclear pharmacists receive extensive training on the various radiopharmaceuticals that are used, as well as training on the safe handling of radioactive materials and the procedures that will minimize radiation exposure to themselves and to others.  There are very few schools of pharmacy that have any courses in nuclear pharmacy - Purdue University is unique in that it has several undergraduate courses available to students enrolled in the school of pharmacy, as well as a continuing education certificate program which allows licensed pharmacists who have had no exposure to nuclear pharmacy the opportunity to receive the necessary training to become a nuclear pharmacist.

LICENSING REQUIREMENTS: In most cases nuclear pharmacists do not hold a special license to practice. After meeting the training and experience requirements, a pharmacist must be listed as an "authorized user" of radioactive materials on the pharmacy or hospital's radioactive materials license. This license is issued by either the Nuclear Regulatory Commission or a state's radiological health division. Currently there is one state which is an exception. The state of Florida licenses nuclear pharmacists through the Board of Pharmacy. Pharmacists hold a radiopharmacist license in addition to their traditional license (additional CE in the field of nuclear medicine is required also). The Florida Board of Pharmacy uses the same training and experience guidelines set by the Nuclear Regulatory Commission; the requirements are described below. MINIMUM TRAINING AND EXPERIENCE REQUIREMENTS 1. Classroom training in basic radioisotope handling techniques specifically applicable to the use of unsealed sources is required (~200 hours). The training should consist of lectures and laboratory sessions in the following areas: A. Radiation physics and instrumentation B. Radiation protection C. Mathematics of radioactivity  D. Radiation biology  E. Radiopharmaceutical chemistry 2. Supervised experience in handling unsealed radioactive material under a qualified instructor is also required (~500 hours). This experience should cover the type and quantities of by-product material requested in the application and includes the following: A. Ordering, receiving, surveying, and unpackaging radioactive materials safely. B. Calibration of dose calibrators, scintillation detectors, and survey meters C. Calculation, preparation, and calibration of patient doses including the proper use of syringe shield. NUCLEAR PHARMACY TRAINING PROGRAMS There are several ways a pharmacist can receive nuclear training. Completion of nuclear training is not a prerequisite for hiring; most nuclear pharmacy companies will pay for the training programs. Some program providers are listed below: Certificate Programs: Nuclear Education Online (UAMS & UNM) Purdue University Ohio State University Nuclear Medicine Associates U.S. Army (residency program)