Galbraith Wendy, Chen Xinlian, Talley Katie, Grantham Vesper
University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma
University of Oklahoma College of Pharmacy, Oklahoma City, Oklahoma.
J Nucl Med Technol. 2015 Mar;43(1):61-3. doi: 10.2967/jnmt.114.147983. Epub 2014 Dec 23.
It has been widely reported that (99m)Tc-succimer adsorbs to plastic syringes significantly (up to 50%), often resulting in a lower administered dose than intended or inaccurate dosing. This adsorption rate is especially problematic in the pediatric population. To improve (99m)Tc-succimer dosing, we compared the adsorption of (99m)Tc-succimer with 2 types of syringes: silicone-coated syringes with nonlatex rubber on the plunger and inert nonreactive syringes with no silicone coating and no rubber on the plunger.
(99m)Tc-succimer kits were compounded according to the manufacturer's instructions. (99m)Tc-succimer doses (37-185 MBq) were drawn into 3-mL (silicone-coated or inert nonreactive) syringes in a 1-mL volume. Thirty min, 1 h, 2 h, and 4 h later, the syringes were assayed in a dose calibrator and assayed again after being emptied and rinsed with saline. In addition, we examined the data collected from 129 (99m)Tc-succimer doses administered in a pediatric department, in which 52 were dispensed in silicone-coated syringes and 77 were dispensed in inert nonreactive syringes. The doses were assayed immediately before and after injection. The syringes were flushed with normal saline.
The labeling efficiency of the (99m)Tc-succimer kits was more than 95%. Residual activity left in the inert nonreactive syringes was 0.73% (SD, ±0.18%), which was significantly lower than the activity left in the silicone-coated syringes, 20.9% (SD, ±5.6%; P < 0.0001). The extent of adsorption did not change significantly between 30 min and 4 h of incubation. The clinical data showed that the residual activity was 30.6% (SD, ±12.5%) from doses dispensed in silicone-coated syringes and 6.38% (SD, ±2.95%) from doses dispensed in inert nonreactive syringes (P < 0.001).
The inert nonreactive syringes had significantly less residual of (99m)Tc-succimer than silicone-based syringes, making it possible to accurately administer calculated doses of (99m)Tc-succimer to pediatric patients.
有广泛报道称，（99m）锝 - 二巯基丁二酸（99m）Tc - succimer对塑料注射器的吸附作用显著（高达50%），常常导致给药剂量低于预期或给药不准确。这种吸附率在儿科人群中尤其成问题。为了改善（99m）Tc - succimer的给药情况，我们比较了（99m）Tc - succimer在两种类型注射器中的吸附情况：柱塞带有非乳胶橡胶的硅胶涂层注射器和柱塞无硅胶涂层且无橡胶的惰性无反应注射器。
按照制造商的说明配制（99m）Tc - succimer试剂盒。将（99m）Tc - succimer剂量（37 - 185MBq）以1mL体积抽取到3mL（硅胶涂层或惰性无反应）注射器中。30分钟、1小时、2小时和4小时后，在剂量校准仪中对注射器进行检测，排空并用盐水冲洗后再次检测。此外，我们检查了从儿科科室给药的129剂（99m）Tc - succimer收集的数据，其中52剂用硅胶涂层注射器给药，77剂用惰性无反应注射器给药。在注射前后立即对剂量进行检测。用生理盐水冲洗注射器。
（99m）Tc - succimer试剂盒的标记效率超过95%。惰性无反应注射器中残留的放射性活度为0.73%（标准差，±0.18%），显著低于硅胶涂层注射器中残留的放射性活度，后者为20.9%（标准差，±5.6%；P < 0.0001）。在孵育30分钟至4小时之间，吸附程度没有显著变化。临床数据显示，用硅胶涂层注射器给药的剂量残留放射性活度为30.6%（标准差，±12.5%），用惰性无反应注射器给药的剂量残留放射性活度为6.38%（标准差，±2.95%）（P < 0.001）。
与硅胶基注射器相比，惰性无反应注射器中（99m）Tc - succimer的残留量显著更少，从而有可能向儿科患者准确给予计算好剂量的（99m）Tc - succimer。
