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Technetium Tc 99m Pyrophosphate
Overview
What is Technescan PYP?
Technescan™ PYP™ (Kit for the Preparation of Technetium Tc 99m Pyrophosphate Injection) is a sterile, non-pyrogenic, diagnostic radiopharmaceutical suitable for intravenous administration after reconstitution with sterile sodium pertechnetate Tc 99m injection or sterile 0.9% sodium chloride injection.
Each 10 milliliter reaction vial contains 11.9 milligrams sodium pyrophosphate, 3.2 milligrams (minimum) stannous chloride (SnCl•2HO) and 4.4 milligrams (maximum) total tin expressed as stannous chloride (SnCl•2HO) in lyophilized form under an atmosphere of nitrogen. Prior to lyophilization the pH is adjusted with hydrochloric acid. The pH of the reconstituted drug is between 4.5 and 7.5. No bacteriostatic preservative is present.
The precise structures of the stannous-pyrophosphate and technetium-stannous-pyrophosphate complexes are not known at this time.
What does Technescan PYP look like?
What are the available doses of Technescan PYP?
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What should I talk to my health care provider before I take Technescan PYP?
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How should I use Technescan PYP?
Technetium Tc 99m Pyrophosphate Injection is a skeletal imaging agent used to demonstrate areas of altered osteogenesis, and a cardiac imaging agent used as an adjunct in the diagnosis of acute myocardial infarction.
As an adjunct in the diagnosis of confirmed myocardial infarction (ECG and serum enzymes positive), the incidence of false negative images has been found to be 6%. False negative images can also occur if made too early in the evolutionary phase of the infarct or too late in the resolution phase. In a limited study involving 22 patients in whom the ECG was positive and serum enzymes questionable or negative, but in whom the final diagnosis of acute myocardial infarction was made, the incidence of false negative images was 23%. The incidence of false positive images has been found to be 7 to 9%. False positive images have been reported following coronary by-pass graft surgery, in unstable angina pectoris, old myocardial infarcts and in cardiac contusions.
Technescan PYP is a blood pool imaging agent which may be used for gated blood pool imaging and for the detection of sites of gastrointestinal bleeding. When administered intravenously 15 to 30 minutes prior to intravenous administration of sodium pertechnetate Tc 99m for in vivo red blood cell labeling, approximately 75% of the injected activity remains in the blood pool. The modified in vivo/in vitro red blood cell labeling method may also be used for blood pool imaging.
The recommended adult doses of Technetium Tc 99m Pyrophosphate Injection are:
Technetium Tc 99m Pyrophosphate Injection is injected intravenously over a 10- to 20-second period. For optimal results, bone imaging should be done one to six hours following administration. Cardiac imaging should be done 60 to 90 minutes following administration. The acute myocardial infarct can be visualized from 24 hours to nine days following onset of symptoms, with maximum localization at 48 to 72 hours. Cardiac imaging should be done with a gamma scintillation camera. It is recommended that images be made of the anterior, left anterior oblique and left lateral projections.
The patient dose should be measured by a suitable radioactivity calibration system immediately prior to administration. It is also recommended that the radiochemical purity be checked prior to administration.
What interacts with Technescan PYP?
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What are the warnings of Technescan PYP?
Meperidine hydrochloride tablets can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing meperidine hydrochloride tablets in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.
Reports indicate impairment of brain images using sodium pertechnetate Tc 99m, which have been preceded by a bone image. The impairment may result in false positives or false negatives. It is recommended, where feasible, that brain imaging precede bone imaging procedures.
Preliminary reports indicate impairment of blood pool images in patients receiving sodium heparin for anticoagulant therapy. This is characterized by a reduction in the amount of injected radioactivity remaining in the blood pool.
Technescan PYP should be injected by direct venipuncture. Heparinized catheter systems should be avoided.
What are the precautions of Technescan PYP?
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What are the side effects of Technescan PYP?
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What should I look out for while using Technescan PYP?
None known.
Reports indicate impairment of brain images using sodium pertechnetate Tc 99m, which have been preceded by a bone image. The impairment may result in false positives or false negatives. It is recommended, where feasible, that brain imaging precede bone imaging procedures.
Preliminary reports indicate impairment of blood pool images in patients receiving sodium heparin for anticoagulant therapy. This is characterized by a reduction in the amount of injected radioactivity remaining in the blood pool.
Technescan PYP should be injected by direct venipuncture. Heparinized catheter systems should be avoided.
What might happen if I take too much Technescan PYP?
Sorry No Records found
How should I store and handle Technescan PYP?
Dispense in a tight container as defined in the USP with a child-resistant closure.Catalog Number 094. Technescan PYP is supplied as a lyophilized powder packaged in vials. Each vial contains 11.9 mg sodium pyrophosphate, 3.2 mg (minimum) stannous chloride (SnCl•2HO) and 4.4 milligrams (maximum) total tin expressed as stannous chloride (SnCl•2HO), sealed under an atmosphere of nitrogen. Prior to lyophilization the pH is adjusted with hydrochloric acid. The pH of the reconstituted drug is between 4.5 and 7.5. Kit containing 5 vials is available.Catalog Number 094. Technescan PYP is supplied as a lyophilized powder packaged in vials. Each vial contains 11.9 mg sodium pyrophosphate, 3.2 mg (minimum) stannous chloride (SnCl•2HO) and 4.4 milligrams (maximum) total tin expressed as stannous chloride (SnCl•2HO), sealed under an atmosphere of nitrogen. Prior to lyophilization the pH is adjusted with hydrochloric acid. The pH of the reconstituted drug is between 4.5 and 7.5. Kit containing 5 vials is available.Catalog Number 094. Technescan PYP is supplied as a lyophilized powder packaged in vials. Each vial contains 11.9 mg sodium pyrophosphate, 3.2 mg (minimum) stannous chloride (SnCl•2HO) and 4.4 milligrams (maximum) total tin expressed as stannous chloride (SnCl•2HO), sealed under an atmosphere of nitrogen. Prior to lyophilization the pH is adjusted with hydrochloric acid. The pH of the reconstituted drug is between 4.5 and 7.5. Kit containing 5 vials is available.
Clinical Information
Chemical Structure
No Image foundClinical Pharmacology
When injected intravenously, Technetium Tc 99m Pyrophosphate has a specific affinity for areas of altered osteogenesis. It is also concentrated in the injured myocardium, primarily in areas of irreversibly damaged myocardial cells.
One to two hours after intravenous injection of Technetium Tc 99m Pyrophosphate, an estimated 40 to 50% of the injected dose had been taken up by the skeleton, and approximately 0.01 to 0.02% per gram of acutely infarcted myocardium. Within a period of one hour, 10 to 11% remains in the vascular system, declining to approximately 2 to 3% twenty-four hours post injection. The average urinary excretion was observed to be about 40% of the administered dose after 24 hours.
Technescan PYP also has an affinity for red blood cells. When administered 15 to 30 minutes prior to the intravenous administration of sodium pertechnetate Tc 99m (in vivo red blood cell labeling), approximately 75% of the injected radioactivity remains in the blood pool providing excellent images of the cardiac chambers. When the modified in vivo/in vitro red blood cell labeling method is used, comparable percentages of the injected radioactivity are obtained.
Toxicology data are available upon request.
Non-Clinical Toxicology
None known.Reports indicate impairment of brain images using sodium pertechnetate Tc 99m, which have been preceded by a bone image. The impairment may result in false positives or false negatives. It is recommended, where feasible, that brain imaging precede bone imaging procedures.
Preliminary reports indicate impairment of blood pool images in patients receiving sodium heparin for anticoagulant therapy. This is characterized by a reduction in the amount of injected radioactivity remaining in the blood pool.
Technescan PYP should be injected by direct venipuncture. Heparinized catheter systems should be avoided.
Aminoglutethimide
Amphotericin B Injection and Potassium-depleting Agents
Antibiotics
Anticholinesterases
Anticoagulants, Oral
Antidiabetics
Antitubercular Drugs
Cholestyramine
Cyclosporine
Dexamethasone Suppression Test (DST)
Digitalis Glycosides
Ephedrine
Estrogens, Including Oral Contraceptives
Ketoconazole
Nonsteroidal Anti-Inflammatory Agents (NSAIDS)
Phenytoin
Skin Tests
Thalidomide
Carcinogenesis, Mutagenesis, Impairment of Fertility
Steroids may increase or decrease motility and number of spermatozoa in some patients.
Technescan PYP should not be used more than six hours after preparation.
The components of the kit are sterile and non-pyrogenic. It is essential that the user follow the directions carefully and adhere to strict aseptic procedures during preparation.
The contents of this kit are not radioactive. However, after sodium pertechnetate Tc 99m is added, adequate shielding of the final preparation must be maintained.
The imaging of gastrointestinal bleeding is dependent on such factors as the region of imaging, rate and volume of the bleed, efficacy of labeling of the red blood cells and timeliness of imaging. Due to these factors, images should be taken sequentially over a period of time until a positive image is obtained or clinical conditions warrant the discontinuance of the procedure. The period of time for collecting the images may range up to thirty-six hours.
Any sodium pertechnetate Tc 99m solution which contains an oxidizing agent is not suitable for use in the preparation of Technetium Tc 99m Pyrophosphate Injection.
The contents of the Technescan PYP reaction vial may be used for the preparation of Technetium Tc 99m Pyrophosphate Injection. Technescan PYP may also be reconstituted with sterile, non-pyrogenic normal saline containing no preservatives and injected intravenously prior to labeling of red blood cells with sodium pertechnetate Tc 99m using either the in vivo or modified in vivo/in vitro method.
As in the use of any other radioactive material, care should be taken to ensure minimum radiation exposure to the patient, consistent with proper patient management, and to ensure minimum radiation exposure to occupational workers.
Radiopharmaceuticals should be used only by physicians who are qualified by specific training in the safe use and handling of radionuclides produced by nuclear reactor or particle accelerator and whose experience and training have been approved by the appropriate government agency authorized to license the use of radionuclides.
Several adverse reactions due to the use of Technetium Tc 99m Pyrophosphate Injection have been reported. These were usually flushing, hypotension, fever, chills, nausea, vomiting and dizziness, as well as hypersensitivity reactions such as itching and various skin rashes.
Reference
This information is obtained from the National Institute of Health's Standard Packaging Label drug database.
"https://dailymed.nlm.nih.gov/dailymed/"
While we update our database periodically, we cannot guarantee it is always updated to the latest version.
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