Version May 2024
Diagnostic imaging:
Note: The radioactivity needed for pediatric patients is based on body weight and is a fraction of what is needed for adults.
Children ≥6 years and Adolescents: Inhalation: Load a sufficient amount per the Crucible Loading Activity of Sodium Pertechnetate Tc 99m Injection table into the Technegas Crucible to achieve technetium Tc-99m labeled carbon crucible activity to achieve a lung count rate of 500 to 1,000 counts per second (cps) at the end of the last respiration; discontinue technetium Tc 99m-labeled carbon aerosol once achieved.
|
Weight |
Crucible loading activity |
|---|---|
|
10 kg |
133 MBq (3.6 mCi) |
|
12 kg |
154 MBq (4.2 mCi) |
|
14 kg |
175 MBq (4.7 mCi) |
|
16 kg |
196 MBq (5.3 mCi) |
|
18 kg |
217 MBq (5.9 mCi) |
|
20 kg |
238 MBq (6.4 mCi) |
|
22 kg |
259 MBq (7 mCi) |
|
24 kg |
270 MBq (7.6 mCi) |
|
26 kg |
301 MBq (8.1 mCi) |
|
28 kg |
315 MBq (8.5 mCi) |
|
30 kg |
336 MBq (9.1 mCi) |
|
32 kg |
357 MBq (9.7 mCi) |
|
34 kg |
378 MBq (10 mCi) |
|
36 kg |
392 MBq (11 mCi) |
|
38 kg |
413 MBq (11 mCi) |
|
40 kg |
434 MBq (12 mCi) |
|
42 kg |
448 MBq (12 mCi) |
|
44 kg |
469 MBq (13 mCi) |
|
46 kg |
490 MBq (13 mCi) |
|
48 kg |
504 MBq (14 mCi) |
|
50 kg |
525 MBq (14 mCi) |
|
52 to 54 kg |
553 MBq (15 mCi) |
|
56 to 58 kg |
588 MBq (16 mCi) |
|
60 to 62 kg |
623 MBq (17 mCi) |
|
64 to 66 kg |
658 MBq (18 mCi) |
|
68 kg |
686 MBq (19 mCi) |
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
(For additional information see "Technetium Tc-99m labeled carbon: Drug information")
Diagnostic imaging: Inhalation: Load 10.8 to 27 mCi (400 to 1,000 MBq) of sodium pertechnetate Tc 99m into the technetium Tc 99m-labeled carbon crucible to achieve a lung count rate of 1,500 to 2,500 counts per second at the end of the last respiration; discontinue technetium Tc 99m-labeled carbon aerosol once achieved.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Reported adverse reactions are for adults.
>10%: Respiratory: Oxygen saturation decreased (oxygen saturation <90%: 68%; oxygen saturation <85%: 39%)
1% to 10%: Respiratory: Hypoxia (1%)
<1%:
Gastrointestinal: Dysgeusia
Nervous system: Dizziness
Respiratory: Cough, dyspnea, respiratory congestion, throat irritation
There are no contraindications listed in the manufacturer's labeling.
Concerns related to adverse effects:
• Bronchospasm: May result in acute bronchoconstriction, especially in patients with heightened bronchoreactivity (eg, asthma, other lung or allergic disorders).
• Radiation accumulation: Technetium Tc 99m-labeled carbon administration contributes to the patient's overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk for cancer. Ensure safe handling to minimize radiation exposure to the patient and health care providers.
Disease-related concerns:
• Respiratory disease: Patients with respiratory disease may be at increased risk due to decreases in oxygen saturation during or after treatment; supplemental oxygen or interruption of administration may be needed.
Special populations:
• Radiopharmaceutical: Use appropriate precautions for handling, disposal, and minimizing exposure to patients and health care personnel. Use only under supervision of individuals with experience/training in the handling of radioactive materials approved by the applicable regulatory authority. Note: Contents of kit are not radioactive; however, adequate shielding is required after addition of radioactive material.
Other warnings/precautions:
• Appropriate use: If clinically indicated, allow patients to breathe room air throughout procedure and consider administration of supplemental oxygen before or during the procedure.
Technegas: FDA approved October 2023; availability anticipated in 2023.
Radiopharmaceutical; use appropriate precautions for handling and disposal. Use waterproof gloves and effective radiation shielding when handling.
Inhalation:
For inhalation use with an FDA-cleared radionuclide rebreathing system for technetium Tc 99m-labeled carbon aerosol (eg, patient administration set from manufacturer) that connects to the Technegas Plus System. Administer while patient is in the supine position. Refer to manufacturer's labeling and user manual for detailed administration instructions.
Inhalation: For inhalation use with an approved radionuclide rebreathing system for technetium Tc 99m-labeled carbon aerosol (eg, patient administration set from manufacturer) that connects to the Technegas Plus System. Add sodium pertechnetate Tc 99m injection into the technetium Tc 99m-labeled carbon crucible. Administer while patient is in the supine position. It is recommended to have patients inhale the aerosol through the mouthpiece by slow, deep breathing from the residual functional capacity (end of calm expiration) followed by a 5-second breath-hold; patients unable to hold their breath may breathe normally with deep inhalations without breath-holding. Activity present in the lungs will vary after each inhalation; follow pulmonary count rate during oral inhalation using a gamma camera equipped with a standard collimator (low energy, low/medium resolution). Complete inhalation within 10 minutes of preparation. Patients may breathe room air during administration; do not detach the patient administration set from the patient to prevent residual aerosol from being released. Once pulmonary counts are achieved for imaging, have patient continue exhaling air through the patient administration set for 5 to 6 breaths to trap residual aerosol being exhaled. Also refer to manufacturer's labeling for detailed administration instructions.
Radiopharmaceutical; use appropriate precautions for handling and disposal.
Store intact crucibles in original container at 15°C to 30°C (59°F to 86°F).
Diagnostic agent for use in combination with sodium pertechnetate Tc 99m in the Technegas Plus System for visualization of pulmonary ventilation or evaluation of pulmonary embolism when paired with perfusion imaging (FDA approved in ages ≥6 years and adults).
Radiopharmaceutical: Use appropriate precaution for handling, disposal, and minimizing exposure to patients and health care personnel. Use under supervision of experienced personnel. Should be stored in original lead container or adequate radiation shield.
None known.
There are no known significant interactions.
Following maternal inhalation, the reported radiation exposure to the fetus is 0.007 to 0.14 mGy, depending on GA. Adverse fetal effects are not expected following diagnostic procedures with <50 mGy, representing <10 mGy fetal doses.
Refer to the Technetium Tc 99m Sodium Pertechnetate monograph for additional information.
Oxygen saturation levels with continuous pulse oximetry; signs of bronchospasm.
Technetium Tc 99m-labeled carbon particles are inhaled and mechanically deposited on the epithelium of ventilated pulmonary bronchioles and alveoli for imaging.
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