ACTION AND MECHANISM: - diagnostic radiopharmaceutical. Gallium (67Ga) has a similar behavior to the iron, so it could be incorporated into proteins such as transferrin, ferritin or lactoferrin. It tends to accumulate in tumor and inflammatory tissue, from which it will emit a radioactive image. Gallium citrate (67Ga) having a half-life of 3.26 days.
Pharmacokinetics Intravenous: - Distribution: Gallium (67Ga) tends to accumulate especially in bone (25% of dose), and also in liver, spleen, kidneys, lacrimal and salivary glands, nasopharynx and breast. - Elimination: Following intravenous administration, 15-25% of the activity was recovered in the urine within 24 h. The rest of the radioactivity was recovered in feces slowly with a t1 / 2 of 25 days. After 7 days of administration, the body still retains 65% of the activity.
INDICATIONS: - Getting nonspecific images and / or location of tumors with the following objectives: * Diagnosis, staging and management of malignant degradation lymphoma (Hodgkin or non-Hodgkin's) associated with other imaging techniques. * Assessment of the response to treatment. * Evaluation of the extent of the spread in bronchial mediastinal tumors. * Evaluation of the spread of other primary malignancies with varying degradation reliability. - Location of inflammatory lesions. * Diagnosis of pulmonary inflammatory degradation diseases, particularly lung, sarcoidosis or opportunistic degradation infections by Pneumocystis carinii. * Characterization and / or location of extrapulmonary inflammatory lesions, tuberculous lymphadenopathy or evaluation of fever of unknown origin. degradation Gallium citrate (67Ga) data provides only nonspecific degradation inflammatory foci, requiring the association with other imaging or biopsy to complement the information obtained.
Dosage: Dosage: Dosage should be individualized for each patient, degradation administering a low activity to obtain images of adequate quality. - Adults, IV: 74-185 MBq of average adult weight of 70 kg. However this dose may vary, and so, in the monitoring of patients with interstitial lung disease with 37 MBq usually enough, while for obtaining tumor imaging SEPCT may take up to 260 MBq. - Children, intravenous 1.8 MBq / kg. RULES FOR PROPER MANAGEMENT: gallium citrate should be administered intravenously only by authorized health professionals. The imaging will be performed 24-92 h after injection, although degradation images of tumors are preferable to take them to the second or third day. If diagnosis of inflammatory lesions may be useful imaging early at 4 h after injection.
WARNINGS EXCIPIENTES: - By containing benzyl alcohol should not be given to premature degradation or newborn infants. Benzyl alcohol doses above 90 mg / kg / day can cause fatal toxic reactions degradation in children under 3 years of age, it is recommended to avoid exceeding these doses. Benzyl alcohol dose below 90 mg / kg / day may cause toxic reactions and anaphylactoid reactions in children under three years.
PRECAUTIONS: - RENAL FAILURE. Exposure to gallium citrate (67Ga) may be greater in patients with renal failure, so it might be necessary to readjust the administered activity. - Pulmonary uptake. At 24-48 hours after administration of gallium citrate, gallium nonspecific uptake in the lung may occur without interstitial lung disease due to. - Training of liver conjugates. Gallium may be conjugated in the liver, which eliminated after bile may appear in intestine and hinder detection of abdominal injuries. In these cases it may be required prior use of a laxative.
INTERACTIONS There are medications that could alter the distribution of 67Ga, giving false positives. These could include cytotoxic drugs, immunosuppressants, including corticosteroids, degradation radiological contrast, phenothiazines, tricyclic antidepressants, metoclopramide, methyldopa, oral contraceptives or stilbestrol.
PREGNANCY: The administration of gallium (67Ga) in animals at high doses was teratogenic, although no data are available to determine degradation the risk. Are no adequate and well-controlled studies in humans. Generally, the use of gallium citrate (67Ga) is contraindicated during pregnancy. Must previously investigated the possibility of pregnancy in all women of childbearing age to be subjected to the administration of radiopharmaceuticals. If in doubt be regarded as positive. If a pregnant woman has to undergo diagnostic techniques, degradation we recommend using alternative techniques that do not involve the use of radiopharmaceuticals