Clinical and pharmacological group: & nbsp

Other diagnostic tools

Included in the formulation
  • M-iodobenzylguanidine, 123-I
    solution in / in 
  • IIBG, 123I
    solution in / in 
  • АТХ:

    V.09   Diagnostic radiopharmaceuticals

    Pharmacodynamics:
    Radiopharmaceutical yoyenguan 123I has a similar molecular structure with the adrenergic hormone norepinephrine. The kinetics and distribution of radiopharmaceuticals are similar to the kinetics and distribution of norepinephrine. Accumulating in the endings of postsynaptic sympathetic neurons and competing with norepinephrine, the drug, however, does not have the mediator properties of norepinephrine, it does not have a pharmacological effect on the activity of the sympathetic nervous system and does not cause hemodynamic effects. Radiopharmaceutical yoyenguan 123I is an indicator used as a diagnostic tool for visualization of the state of the sympathetic nervous system and by means of which the integrity and functional state of the adrenergic nerve endings of various organs and tissues is assessed.
    The accumulation of denguanga 123I in the adrenergic nerve endings of various organs and tissues is described by two mechanisms:
    - volatile - sodium-dependent path;
    - non-volatile - the path of mechanical diffusion.
    In radionuclide diagnostics, the doses administered are so small that the capture mechanism is dominated by a sodium-dependent route. After entering the cell, most of the denguanga 123I in neuroblastomas remains in the cytoplasm in its free form; with pheochromocytoma and paragangliome, the drug is actively transported into granules of catecholamines, but not metabolized by enzymes that metabolize catecholamines.
    Pharmacokinetics:

    It's like norepinephrine. After intravenous administration, the highest increase in concentration radiopharmaceutical is observed in the liver, heart, salivary glands, lungs. Tissue concentration,% dose / g: liver - 0.76, heart - 0.64, lungs - 0.17, muscles - 0.02, blood - 0.02.

    The drug is excreted by the kidneys - 40-55% for 24 hours and 70-90% for 96 hours, mostly unchanged.

    Indications:

    It is used as a diagnostic tool for visualizing the state of the sympathetic nervous system, by means of which the integrity and functional state of the adrenergic nerve endings in various organs and tissues is assessed.To assess the functional state of the sympathetic nervous system of the heart and to diagnose its disorders in various cardiac pathologies (myocardial infarction, arrhythmias, heart failure, cardiomyopathies of various origins, including diabetic, ischemic and stress damage of the myocardium). For the diagnosis of catecholamine tumors (including primary neuroblastomas, pheochromocytomas, apudes (carcinoids), sympathetic paragangliomas, medullary thyroid cancer, as well as their metastases and bone marrow infiltration in neuroblastomas).

    Repeated studies conducted during and after treatment provide prompt information on the effectiveness of the measures taken, which allows us to timely change and optimize the tactics of treating the patient.

    XXI.Z00-Z13.Z12   Special screening examination to identify malignant neoplasms

    XXI.Z00-Z13.Z13.6   Special screening examination to identify cardiovascular disorders

    Contraindications:

    General clinical contraindications for radionuclide studies; hypersensitivity to the drug or its components; pregnancy; periodlactation.

    Carefully:No data.
    Pregnancy and lactation:The use is contraindicated.
    Dosing and Administration:

    Intravenously, in the position of the patient lying or sitting.

    Mandatory preliminary blockade of the thyroid gland with sodium iodide (100 mg per day) 3 days before the study and 2 days after the study.

    Recommended doses: adult patients - 110-300 MBq.

    If necessary, the drug can be diluted with 0.9% sodium chloride solution.

    The diagnostic equipment is a gamma camera planar or rotational (SPECT) with a round (not less than 400 mm in diameter) or a rectangular crystal.

    Adjustment of the amplitude analyzer 0.159 MeV, 20% window. The collimator should be used for energy above 0.15 MeV, since the X-ray radiation produced by the scattering of gamma quanta on the collimator material is not absorbed by the walls of the channels of the standard technetium collimator and the image becomes very noisy. Data collection and processing system - any of the existing data acquisition matrices of at least 128 × 128 elements.

    Scintigraphy of the myocardium is carried out in 20-30 minutes and 4 hours after intravenous injection radiopharmaceutical in planar or rotary modes.The image processing on the computer includes background subtraction, 9-point smoothing or filtering with an adequate filter, correction of the frame of the late study for iodine-123 decomposition and determination of the parameters: heart / mediastinum ratio, radiopharmaceutical from the myocardium, an evaluation of the nature of the distribution radiopharmaceutical in relation to the region of maximum accumulation.

    Visualization of the adrenal glands and the entire body is performed 24 hours after intravenous administration of the drug. After standard image processing, the presence of foci of hyperfixation radiopharmaceutical and bone marrow imaging. The level of accumulation in the outbreak is estimated by a standard method by comparing symmetrical areas: the adrenal region with the level of accumulation in the liver (the normal accumulation limit is 120-125%).

    Normally, the whole body is visualized as a shadow. Increased accumulation radiopharmaceutical observed in salivary glands, in the heart, in the liver, in the bladder; weak accumulation in the intestine; the skeleton is not visualized. The visualization of the thyroid gland is carried out 10 minutes after the administration radiopharmaceutical on a gamma camera in the patient's position lying on his back by the standard method.

    Side effects:With the use of the drug may develop allergic reactions.
    Overdose:No data.
    Interaction:2 weeks before the study with the drug yoyenguan 123I should stop taking sympatholytic, antihypertensive drugs, calcium channel blockers and beta-blockers, as these drugs reduce the level of accumulation yoyenguana 123I in the myocardium and catecholamine tumors.
    Special instructions:

    Work with the drug should be carried out in accordance with the "Basic Sanitary Rules for Ensuring Radiation Safety" (OSPORB-99).

    The drug is stored in accordance with the observance of the "Basic Sanitary Rules for Working with Radioactive Substances and Other Sources of Ionizing Radiation" OSP-72/87.

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