The following ancillary pharmaceuticals are used as an adjunct to a radiopharmaceutical during a Nuclear Cardiac stress test/Myocardial Perfusion, Renal scan, and Neurologic Vascular scan.
Dipyridamole, Aminophylline, Acetazolamide, and Furosemide are the pharmaceuticals that will be described in detail, as the brand name, indications, contraindications, the study where the pharmaceutical is utilized in, dosages, side effects, and the correct administration time frame during the Nuclear Medicine study.
Dipyridamole is also known as Persantine which is the brand name, is a bronchodilator, vasodilator, and blood thiner, as it can prevent embolus in some heart surgeries, Myocardial Infractions, and Cerebro Vascular Accidents (CVA). During a cardiac stress test Dipyridamole helps expand healthy vessels in the coronary arteries, Dipyridamole will not be useful with diseased vessels. A cardiac stress test is done in order to know if the heart is receiving enough blood. This pharmaceutical is given intravenously (IV) to dilate the vessels, and it will appear in the areas of the heart supplied by normal arteries and the ones with diseases, such a blocked artery.
Dosage for Persantine is 0.56mg per kilogram (patient weight) intravenously, with a rate of 0.142mg/kg/minutes, with a half life of thirty to forty-five minutes, The radiopharmaceutical is then injected two to five minutes after the Persantine is given, monitoring the patient for fifteen minutes in case of any adverse reactions. Patients with hypotension, tachycardia, asthma or lung diseases, are not good candidates for this drug as it decreases blood pressure, elevates pulse, and is a vasodilator and bronchodilator, these are the contraindications for Persantine. Dizziness, difficulty breathing, headaches, nausea, vomiting, upset stomach, diarrhea, muscle/joint pain, mild skin rash, and/or tingly feeling under the skin are some side effects of this drug. An antagonist for Persantine is the administration of Aminophylline or Theophylline with a dose of 50-250mg intravenously.
Aminophylline has three different brand names Truphylline, Phyllocintin, and Norphyl, is a bronchodilator, and is used to treat conditions such apnea, acute asthma, and other lung diseases. Aminophylline is given intravenously to reverse the effects of Dipyridamole during a cardiac stress test, Adenosine, and Regadenoson, as it blocks the receptors of these four drugs. It should not be given if medications such Cognex, Tagamet, Mintezol, Erythromycin, Enoxacine, are in patient system as these drugs cause to drop the metabolism and resulting in an increase levels of Aminophylline. Other drugs to avoid are, Tergetol this medication is used to treat bipolar disorders, nerve pain, and seizures, also Luminal which is used to treat certain types of epilepsy. Tergetol and Luminal increase the Aminophylline metabolism resulting in low levels of the same.
Dosage of this medication is based on the patient BMI (Body Mass Index) but when used to reverse effects of Theophylline a recommended dose goes from 50 to 250mg intravenously. Contraindications for Theophylline are for patients with porphyria which is a rare disorder in red blood cell proteins, and the administration of Aminophylline (Theophylline) should be injected with a slow push of the syringe to prevent Central Nervous System (CNS) damage and Cardiovascular problems due to the direct stimulation of Theophylline, also patients with peptic ulcers because when is given intravenously has a notable increase of gastric acid and as well with patients with history of seizure disorders as Theophylline induce seizures.
Aminophylline has a wide list of side effects such, Central Nervous System excitement, headaches, restlessness, irritability, seizures, insomnia, diarrhea, vomiting, tremors, nausea, increased urination, palpitations, scaly skin, tachycardia, and respiratory distress are some of the most common side effects of Aminophylline. The correct time to administer this drug is if the technologist wants to interfere with the Persantine effects, if the patient is having a side effect to Persantine an antagonist medication should be administrated, in this case is Aminophylline, and the technologist must wait at least sixty seconds after the injection of the radiopharmaceutical.