Adverse reactions to radiopharmaceuticals.

Spanish Royal Legislative Decree 1/2015 of July 24 considered radiopharmaceuticals to be drugs subject to current legislation on this matter. After Radiopharmaceuticals are prepared in Radiopharmacy Departments, they are administered to patients to observe alterations or  their abnormal distribution in the body depending on the pathology. Unlike conventional drugs, radiopharmaceuticals rarely cause adverse reactions: however, when they do occur, they often cause alarm both to the patient and health care staff. They are typically administered to patients only once or a limited number of times. Most adverse reactions to radiopharmaceuticals are mild and require minimal or no treatment. Such reactions, although rare, can occur, and include sensitivity reactions with systemic symptoms. In general, the most common adverse reactions to radiopharmaceuticals are the following: nausea, dyspnea, bronchospasm, decrease in blood pressure, itching, flushing, hives, chills, cough, bradycardia, muscle cramps, and dizziness. The incidence of reported adverse reactions to radiopharmaceuticals is low. The objective of this review is to describe the most common published adverse reactions to diagnostic or therapeutic radiopharmaceuticals and their characteristics.

El Real Decreto Legislativo 1/2015, de 24 de julio, consideró los radiofármacos como medicamentos sometidos a la legislación vigente en esta materia. Los radiofármacos, una vez preparados en las unidades de radiofarmacia, son administrados a un paciente para observar  las alteraciones o su distribución anormal. A diferencia de los fármacos  convencionales, los radiofármacos raramente provocan reacciones adversas; sin embargo, cuando ocurren, suelen causar alarma tanto al  paciente como al personal sanitario, además son administrados a los pacientes una sola vez o un número limitado de veces. La mayoría de las  reacciones adversas a radiofármacos son leves y requieren tratamiento mínimo o no lo requieren. Dichas reacciones, aunque raras, pueden ocurrir, e incluyen reacciones de sensibilidad con síntomas sistémicos. En general, las reacciones adversas a radiofármacos más comunes son: náusea, disnea, broncoespasmo, disminución de la tensión arterial, picor, rubor, urticaria, resfriado, tos, bradicardia, calambres musculares y mareo. La incidencia de reacciones adversas a radiofármacos comunicadas es baja. El objetivo de esta revisión es describir las reacciones adversas a radiofármacos publicadas más comunes y sus características, administrados con fines diagnósticos o terapéuticos.

Cardiac and Skeletal Muscle Metastases From Squamous Cell Carcinoma of the Bladder: Positron Emission Tomography-Computed Tomography Findings.

We describe the positron emission tomography-computed tomography (PET-CT) findings of a patient who presented to the emergency room with chest pain and palpitations and underwent a radical cystectomy 6 months earlier because of a squamous cell carcinoma of the bladder (SCCB). Cardiac catheterization ruled out coronary artery occlusion, but PET-CT showed multiple F-18-fluorodeoxyglucose-avid lesions involving multiple skeletal muscles and the heart, consistent with metastases. A CT-guided biopsy of 1 skeletal muscle lesion confirmed a metastasis with the same pathologic features as the SCCB. To our knowledge, this is the first reported case of an SCCB with metastases to multiple skeletal muscles and myocardium detected with PET-CT.