Included in the formulation
АТХ:V.09.I.X Other radiopharmaceuticals for diagnosis of neoplasms
Pharmacodynamics:Radiopharmaceutical preparation, intended for obtaining images of the myocardium, brain and malignant tumors of various locations. Has no adverse pharmacodynamic effects. Degree of accumulation of fluorodeoxyglucose 18F in the cells of malignant tumors correlates with the degree of their malignancy. The drug also allows you to evaluate the effect of the treatment, because with effective treatment, the level of accumulation of the drug in tumors decreases, and when ineffectiveness - does not change or increases. Fluorodeoxyglucose 18F is actively transported to cells by transporter proteins, where it undergoes phosphorylation with the formation of fluorodeoxyglucose-6-phosphate 18F - product, which does not enter into further reactions, and in this form is retained in the cells of malignant tumors.
The optimal ratio of organ / background in the study of the myocardium and brain is reached after 30-40 minutes and remains for 20-30 minutes. The optimal tumor / tissue ratio is observed 45-90 min after administration and is maintained up to 120-150 min. The best conditions for detection of malignant tumors are created with hypoglycemia, achieved with fasting for 4-6 hours and water load (ingestion of 50-800 ml of water after administration of the drug). Fasting promotes increased glucose uptake by cells, and the water load accelerates the removal of a label from normal tissues with urine.
Pharmacokinetics:After intravenous administration, the drug gradually accumulates in the organs and tissues. Accumulation of the drug in the myocardium is 1-4% of the administered amount. The maximum concentration in the brain is noted in the cortex and deep brain structures (in gray matter it is 2 times higher than in white matter). The ratio of heart-lung accumulation is 220: 1, heart-blood and heart-liver - 14: 1 and 10: 1, respectively. Low accumulation of the drug in the liver and its rapid removal from this organ indicates that the drug does not turn into glycogen.It is excreted in the urine (16% - during the first 60 min, up to 50% - after 135 min).
Indications:As a diagnostic tool for positron emissionion tomography (PET): to evaluate myocardial function in patients with ischemic heart disease and left ventricular systolic dysfunction (including in the selection for coronary bypass surgery and endovascular methods of treatment); for the purpose of determining localization and distributionpathological process with cerebrovasculardiseases, epilepsy, craniocerebral trauma and others; for the diagnosis of malignant tumors of various localizations (including the brain), determining their regional distribution and searching for distant metastases; to evaluate the effectiveness of therapy in cardiological, oncological and neurological patients. Identification of foci of hypometabolism in epilepsy, differential diagnosis of parkinsonism, determination of the degree of brain damage in cases of craniocerebral trauma and cerebrovasculardiseases, the definition of the effectiveness of neurological and psychoneurological treatmentpathology.
II.C69-C72.C71 Malignant neoplasm of brain
II.C76-C80.C76 Malignant neoplasm of other and inaccurately marked localizations
V.F40-F48.F48.9 Neurotic disorder, unspecified
VI.G20-G26.G20 Parkinson's disease
VI.G20-G26.G21 Secondary Parkinsonism
VI.G40-G47.G40 Epilepsy
VI.G90-G99.G96.9 Disorder of central nervous system, unspecified
IX.I20-I25.I25 Chronic ischemic heart disease
IX.I30-I52.I50.1 Left ventricular failure
IX.I60-I69.I67.9 Cerebrovascular disease, unspecified
XIX.S00-S09.S06 Intracranial injury
Contraindications:Pregnancy, lactation.
Pregnancy and lactation:The use is contraindicated.
Dosing and Administration:Intravenously fasting (or fasting for at least 5-6 hours), jet, slowly, 5-10 ml. The diagnostic dose for the PET of the brain is 100 MBq / sq. M (140-240 MBq), for the PET of the myocardium - 120 MBq / sq. M (150-250 MBq), for the whole body PET - 200 MBq / 550 MBq).
The calculated radial load on the whole body is 24 ± 3 * 0.001 mSv / MBq, on the bladder (critical organ) is 12.5 ± 2 * 0.01 mSv / MBq, on the spleen is 17 ± 2 * 0.01 mSv / MBq . With the introduction of a diagnostic dose, the radiation load on the entire body is 3.9-13.9 mSv.
Scanning of the myocardium and brain begins in 30-40 minutes, optimal conditions for the study remain for 60-70 minutes after the administration of the drug.The study in the "whole body" mode begins after 60-110 min, optimal conditions for research in cancer patients are preserved for 3 hours after the drug administration.
Side effects:Hypersensitivity reactionstion.
Interaction:Xanthine derivatives, glucocorticosteroids, diuretics increase the risk of hypokalemia (especially in patients with exacerbation of bronchial asthma, hypoxia); beta blockadetora - bronchospasm.
Special instructions:Before examining the entire body, the patient must empty the bladder. If necessary, a pelvic examination is performed using a urinary catheter.
At a diabetes before the research it is necessary to control the concentration of blood glucose (should be normal or reduced).
During work with the drug, the usual precautions should be followed when working with radioactive materials.
Shelf life of the finished product is 8 hours from the moment of preparation.