Medicinal reference book geotar. Possible side effects. Doses and method of application

Usage: methods for producing radioactive sources intended for medical purposes, in particular, methods for producing the radionuclide thallium-199 in the form of thallium chloride. Essence: the thallium-199 radionuclide is obtained from a gold target irradiated with β-particles. The irradiated target is heated at 800-900 o C in a stream of hydrogen chloride under tight conditions. The thallium chloride formed is taken up in water. Sodium chloride is added to the resulting solution in the amount necessary to obtain an isotonic solution, and the resulting solution is evaporated to dryness, followed by dissolution of the precipitate in water for injection. The time from the beginning of the radionuclide release to the packaging of the drug is 45-50 minutes. In the final preparation, thallium is in the oxidation state (+1). The content of thallium (+3) in the preparation is not significant, the preparation as a whole meets the requirements of an injectable preparation. 1 ill., 1 tab.

The invention relates to the field of conversion of chemical elements and sources of radioactivity, designed specifically for medical purposes, in particular, to methods for obtaining the radionuclide Tl-199 in the form of thallium chloride. Currently, one of the most important tasks in clinical cardiology is the timely diagnosis of coronary heart disease (CHD) and its most severe and dangerous complication of myocardial infarction, since this disease is the main cause of death and disability in the country's population. Being an analogue of potassium (+1) in its biological properties, thallium (+1) is the optimal radionuclide for myocardial imaging. The drugs based on the thallium-201 isotope are currently the most widely used. The nuclear physical properties of thallium-201 limit the use of this drug. Thallium-201 has a low photon energy (70-80 keV), which creates a rather high tissue absorption, resulting in a deterioration in the quality of the resulting myocardial image. The relatively long half-life of the radionuclide (3.06 days) limits the possibility of conducting repeated studies to evaluate the effectiveness of therapeutic measures in the dynamics of myocardial infarction and postoperative treatment due to high radiation exposure to patients. For these reasons, of great interest are the works performed with thallium-199, which has a photon emission energy significantly higher than that of thallium-201, and almost 10 times shorter half-life (7.4 h). The use of thallium-199 can significantly reduce the radiation exposure of patients, improve the quality of the information received and, as a result, improve the accuracy of diagnosis. The most convenient way to obtain thallium-199 is the nuclear reaction 197 Au(,2n) 199 Tl at an energy of -- particles of 28 MeV. Given the short half-life of the 199 Tl radionuclide, the duration of release should be as short as possible of the half-life. A known method for producing thallium-199 chloride by heating a gold target in an air atmosphere and condensing sublimated thallium oxide on a cooled collector, followed by washing it off the collector with 0.1 M HCl. The yield of thallium-199 is more than 90%

The closest in technical essence and purpose to the claimed invention is a method for producing thallium-199 chloride, based on heating an irradiated gold target in air with subsequent collection of thallium oxide sublimate on a cooled collector. Thallium chloride is obtained by washing off thallium oxide from the collector with isotonic sodium chloride solution. The sublimation temperature is approximately 600 o C, at which more than 90% of the radionuclide is removed from the target in 15-30 minutes. The drug has been tested on animals. The method has been transformed into a temporary pharmacopoeial article, where the sublimation of thallium oxide is carried out at a temperature of 650 o C for 30 minutes. The known prototype method has the following disadvantages:

1. When collecting (washing) sublimate from a cooled surface (collector), a significant part of it is fixed on surfaces not intended for radionuclide condensation. As a result, when more than 90% of the radionuclide is released from the target in the final product (after washing), it may turn out to be less than half of the initial amount. 2. Taking into account the short duration of sublimation, depressurization of the system (to wash off the radionuclide) occurs in a sufficiently high temperature regime, when a significant amount of the radionuclide is in an unfixed state (in the gas phase), which leads to charging of the external space. This danger persists even several hours after the end of sublimation. Therefore, depressurization of the system with this method of radionuclide release is unacceptable from the point of view of ensuring safe working conditions and environmental requirements. 3. Thallium has two oxidation states (valency): (+1) and (+3). An analogue of alkaline elements is thallium (+1). Thallium (+3) in chloride solutions is in the form of anion TlCl - 4 (with a significant concentration of chloride 3-), not suitable for radionuclide diagnostics. Its presence leads only to additional radiation exposure, against which it may be difficult or even impossible to control the behavior of thallium (+1). The sublimation of thallium in air occurs in the form of thallium oxide (+3) Tl 2 O 3, which turns into thallium chloride (+3) when the sublimate is transferred into solution. It has been established that when thallium is heated in air to a temperature of 140 o C, thallium oxide Tl 2 O is formed, and when heated to higher temperatures, thallium oxide Tl 2 O 3 is formed. It is also known that thallium oxide decomposes with the elimination of oxygen only at a temperature of 875 o C. In reality, the sublimate consists of thallium oxides (+1) and (+3), which, when converted into a chloride solution, form, respectively, a mixture of thallium chlorides (+1) and ( +3), the ratio of which will depend on the temperature conditions of distillation, the parameters of the solution, and the time elapsed after the transfer of the sublimate into the solution. Taking into account the need for its almost immediate use due to the short half-life of the radionuclide (excluding the time of transportation), the role of the latter factor can be great. Therefore, the allowable content of thallium (+3) in the preparation of no more than 3% may not be maintained, which reduces its quality. In general, the indication of the content of thallium (+3) in the preparation without indicating the time elapsed from the transfer of the sublimate into the solution to the determination of the content of thallium (+3) is incorrect, since the content of thallium (+3) in the solution may change over time. In this aspect, cases of unusual behavior of the thallium radionuclide in medical practice are explainable. The aim of the invention is to develop a method for producing thallium-199 chloride from a gold target, free from the noted disadvantages, but retaining the advantages of the prototype method, primarily the speed of isolation and its safety, the suitability of the final drug for medical purposes. The goal is achieved by the fact that the selection of the radionuclide thallium-199 is carried out by heating the irradiated - gold target particles and chlorination of the selected radionuclide thallium-199. The isolation of the radionuclide thallium-199 and its chlorination are carried out simultaneously in a stream of hydrogen chloride under tightness conditions, while the target is heated at a temperature of 800-900 o C, thallium chloride is absorbed by water, sodium chloride is added to the resulting solution in the amount necessary to obtain an isotonic solution, and evaporate the resulting solution to dryness, followed by dissolution of the precipitate in water for injection. The technical result of the present invention is as follows:

1. The radionuclide released from the target is completely captured and then sold in the final preparation. 2. The process of separation of thallium chloride is carried out in a device that excludes the ingress of radionuclide into the external space, which meets both the requirements for ensuring safe working conditions and environmental requirements. 3. Thallium in the final product is in the oxidation state (+1), since it is known that when thallium chloride (+3) is heated, already at a temperature of 40 o C, the elimination of chlorine begins with the formation of thallium monochloride. 4. When evaporating a solution of thallium chloride with sodium chloride to dryness, the temperature of the dry precipitate reaches 200 o C, which is a sterilizing factor for the main product before the last operation: dissolving the precipitate in water for injection. The drawing shows a device that implements the proposed method. The method is carried out as follows. The irradiated gold target is heated to a temperature of 800-900 o C. The lower temperature limit (800 o C) is determined by the evaporation temperature of thallium monochloride, the upper (900 o C) is the maximum operating temperature of the nichrome heating element of the electric furnace. Thallium-199, formed in the volume of the gold target as a result of a nuclear reaction, i.e. thallium-199 radionuclide diffuses to the target surface, where it interacts with hydrogen chloride in the passing air current, resulting in the formation of thallium chloride. (Saturation of air with hydrogen chloride is carried out by passing it through a concentrated solution of hydrochloric acid). Thallium chloride is transported by a current of gases into a battery of traps containing water, where it is absorbed. As a result, a hydrochloric acid solution of thallium chloride is formed in the traps. Next, the solution from the traps is evaporated to dryness after the preliminary addition of sodium chloride to it in the amount necessary to obtain the final volume of isotonic (0.9%) solution. The precipitate, consisting of thallium monochloride and sodium chloride, is dissolved in water for injection and packaged. Chlorination of thallium at high temperature and additional heating of the thallium radionuclide precipitate when the solution is evaporated from the traps to dryness contributes to the production of thallium in the form of monochloride due to the low thermal strength of thallium chloride (+3). The device that implements the method (drawing) consists of an input Tishchenko bottle 1 containing 100 ml of concentrated (36%) hydrochloric acid, articulated (on thin sections) quartz cylinders 2 and 3, a tubular electric furnace 4, freely moving on cylinders 2 and 3, a battery traps (5 pieces) containing 4-5 ml of water in each knee, the output (shut-off) bottle Tishchenko 6 containing 100 ml of 5 M KOH solution, necessary to prevent possible breakthrough of traces of radionuclides and trapping at the HCl outlet, followed by water jet pump, the suction speed of which is regulated by a screw clamp 7. The operation of the device is as follows. Before the arrival of the irradiated target, the electric furnace in position 4 is heated to an operating temperature of 800-900 o C. Target 8 is placed in cylinder 2, the cylinders are articulated. A fast current of air (15-20 bubbles per second) saturated with HCl is passed through the system for 10-15 s, then the speed decreases to 2-3 bubbles per second and the electric furnace moves to position 4. After about 10-12 minutes, the electric furnace returns to the initial position 4. The battery of traps 5 is disconnected, and the solution is drained through the inlet polished section. Based on the given specific activity of the final preparation, the required amount of sodium chloride is added to the solution and the solution is evaporated to dryness. The evaporation time is approximately 20-25 minutes. The loss of the radionuclide is not is observed, since sodium is a non-isotopic carrier for thallium (+1). TlCl by this method are illustrated in the following table.The yield of thallium-199 (%) depending on time and temperature p presented in the table. Thus, the proposed method for producing thallium-199 radionuclide in the form of chloride is characterized in comparison with the known method by high efficiency, safety, meets environmental requirements, has sufficient simplicity, speed of isolation and certainty of the chemical composition of the drug, which will allow it to find application in medical radiodiagnostics. The drug obtained by this method is being tested at the Institute of Clinical Cardiology KSC RAMS. The results are positive.

CLAIM

A method for producing thallium-199 chloride, including the isolation of thallium-199 radionuclide by heating a gold target irradiated with β-particles and chlorination of the isolated thallium-199 radionuclide, characterized in that the isolation of thallium-199 radionuclide and its chlorination are carried out simultaneously in a stream of hydrogen chloride under tightness conditions, while the target is heated at 800-900 o C, thallium chloride is absorbed with water, sodium chloride is added to the resulting solution in the amount necessary to obtain an isotactic solution, and the resulting solution is evaporated to dryness, followed by dissolution of the precipitate in water for injection.
thallium(I) acetate(CH3COOTl)

Used in the manufacture of hair removal products; as part of poison for rodents (celvopast).
physical properties. White crystals. T. melt. 110°; dense 338. It dissolves well in water and alcohol.

Thallium(I) bromide(TIBr)

physical properties. Yellow or white crystals. T. melt. 460°; t. kip. 815°; dense 7.557 (17.3°); nD = 2.61; solution, in water 0.05 g/100 g (25°), 0.25 g/100 g (68°). Soluble in alcohol, insoluble in acetone.

thallium(I) iodide(TlJ)

It is applied, it turns out - see T1C1.
physical properties. It forms crystals of two modifications: a (yellow) and b (red). T. melt. 440°; t. kip. 824°; dense 7.09; sol., in water 0.0064 g/100 g (20°), 0.12 g/100 g (100°), Soluble in nitric acid and aqua regia, slightly soluble in alcohol

Thallium(I) carbonate(Tl2CO3)

It is used for the manufacture of optical glasses, jewelry; in pyrotechnics.
Obtained by the interaction of carbon dioxide and thallium(I) hydroxide. physical properties. Colorless crystals. T. melt. 273°; dense 7.11; solution, in water 5.23 g/100 g (18°), 27.2 g/100.g (100°). Insoluble in absolute alcohol, ether, acetone. When heated to 360° decomposes, losing CO2

Thallium(I) malonate formate(CH2(COOT1)2-2HCOOT1)

It is used in mineralogical analyzes and geological and mineralogical works (Clerici liquid).
It is obtained by dissolving metal T1 in a mixture of formic and malonic acids.
physical properties. Light amber liquid. Density. 4.25. It decomposes easily in the light. Miscible with water in every way.

Thallium(III) oxide(T12O3)

Physical and chemical properties. Black crystals (density 10.19) or amorphous mass (density 9.65). T. melt. 717°. At 875° it transforms into Тl2О. Insoluble in water. Reacts with acids and does not react with alkalis.

Thallium(I) sulfate(T12SO4)

It is used as a raw material for the production of other thallium salts; in the production of hair removal products; in the composition of poison for rodents (celiopast).
Obtained by dissolving metallic T1 in sulfuric acid; precipitation from metallurgical waste containing T1.
physical properties. Colorless crystals. T. melt. 632°; dense 6.675; solution, in water 4.87 g/100 g (20°), 18.45 g/100 g (100°). When heated, it decomposes without reaching a boil.

Thallium(TL)

It is used in the composition of some alloys, in the production of special thermometers; isotope 204T1 - in various devices, in particular, to control the thickness of fabrics, paper.
It is obtained from impurities of lead, zinc and other ores by transferring them into soluble salts, followed by cementation with zinc and purification.
Physical and chemical properties. Soft light gray metal, crystallizing in two modifications. T. melt. 303.5°; t. kip. 1472°; flesh. 11.85;
pressure vapor 1 mm Hg. Art. (825°). Oxidizes in air from the surface already at room temperature. It is insoluble in water and aqueous solutions of alkalis; reacts with nitric, sulfuric, hydrochloric acids and halogens.

Thallium(I) chloride(T1S1)

Single crystals of the T1C1 solid solution with TIBr or TlJ are used to manufacture optical lenses and prisms that are transparent to infrared rays.
It is obtained by precipitation from solutions of sulfate or nitrate, thallium.
physical properties. Colorless crystals. T. melt. 427°; t. kip. 720°-
dense 7.00; „nD = 2.38; sol, in. water 0.32 g/100 g (20°), 2.38 g/100 g (100°)
Slightly soluble in hydrochloric acid.

430; 431°C T. kip. 806; 818; 820°C Mol. heat capacity 50.9 J/(mol K) Enthalpy of formation -204 kJ/mol Chemical properties Solubility in water 0.3220; 1.60 80 g/100 ml Classification Reg. CAS number 7791-12-0 SMILES Data is based on standard conditions (25 °C, 100 kPa) unless otherwise noted.

thallium chloride- binary inorganic compound, metal salt of thallium and hydrochloric acid with the formula TlCl, colorless crystals, poorly soluble in water.

Receipt

• Direct interaction of elements:

$\backslash mathsf(2Tl\; +\; Cl\_2\; \backslash \; \backslash xrightarrow(120-150^oC)\backslash \; 2TlCl\; )$

• The action of hydrochloric acid on thallium oxide, hydroxide or carbonate:

$\backslash mathsf(Tl\_2O\; +\; 2HCl\; \backslash \; \backslash xrightarrow()\backslash \; 2TlCl\backslash downarrow\; +\; H\_2O\; )$ $\backslash mathsf(TlOH\; +\; HCl\; \backslash \; \backslash xrightarrow()\backslash \; TlCl\backslash downarrow\; +\; H\_2O\; )$ $\backslash mathsf(Tl\_2CO\_3\; +\; 2HCl\; \backslash \; \backslash xrightarrow()\backslash \; 2TlCl\backslash downarrow\; +\; CO\_2\backslash uparrow\; +\; H\_2O\; )$

• exchange reactions:

$\backslash mathsf(TlNO\_3\; +\; NaCl\; \backslash \; \backslash xrightarrow()\backslash \; TlCl\backslash downarrow\; +\; NaNO\_3\; )$

Physical properties

Thallium chloride forms colorless cubic crystals, space group P m3m , cell parameters a= 0.38421 nm, Z = 1.

Chemical properties

• Photosensitive, under the action of light decomposes reversibly:

$\backslash mathsf(2TlCl\; \backslash \; \backslash stackrel(\backslash xrightarrow(h\backslash nu))(\backslash xleftarrow[\backslash \; \backslash \; \backslash \; ]())\backslash \; 2TlCl\_(1-x)\; +\; xCl\_2\; )$

• Decomposes with concentrated sulfuric acid:

$\backslash mathsf(TlCl\; +\; H\_2SO\_4\; \backslash \; \backslash xrightarrow(20-40^oC)\backslash \; TlHSO\_4\; +\; HCl\backslash uparrow\; )$

• Oxidized with concentrated nitric acid:

$\backslash mathsf(TlCl\; +\; 5HNO\_3\; \backslash \; \backslash xrightarrow()\backslash \; Tl(NO\_3)\_3\; +\; 2NO\_2\backslash uparrow\; +\; HCl\; +\; 2H\_2O\; )$

• and chlorine:

$\backslash mathsf(TlCl\; +\; Cl\_2\; \backslash \; \backslash xrightarrow()\backslash \; TlCl\_3\; )$

• Recovered when heated with hydrogen:

$\backslash mathsf(2TlCl\; +\; H\_2\; \backslash \; \backslash xrightarrow(650^oC)\backslash \; 2Tl\; +\; 2HCl\; )$

Application

• Thallium chloride single crystals are used in optical elements for devices of infrared technology, acousto-optics, laser technology, as blanks for obtaining fiber light guides.

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Literature

• Chemical Encyclopedia / Ed.: Knunyants I.L. and others. - M .: Soviet Encyclopedia, 1995. - T. 4. - 639 p. - ISBN 5-82270-092-4.
• Handbook of a chemist / Editorial board: Nikolsky B.P. and others. - 2nd ed., corrected. - M.-L.: Chemistry, 1966. - T. 1. - 1072 p.
• Handbook of a chemist / Editorial board: Nikolsky B.P. and others. - 3rd ed., corrected. - L.: Chemistry, 1971. - T. 2. - 1168 p.
• Lidin R.A. and etc. Chemical properties of inorganic substances: Proc. allowance for universities. - 3rd ed., Rev. - M .: Chemistry, 2000. - 480 p. - ISBN 5-7245-1163-0.
• Ripan R., Chetyanu I. Inorganic chemistry. Chemistry of metals. - M .: Mir, 1971. - T. 1. - 561 p.

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An excerpt characterizing thallium(I) chloride

- Mon cher, si vous vous conduisez ici, comme a Petersbourg, vous finirez tres mal; c "est tout ce que je vous dis. [My dear, if you behave here as in Petersburg, you will end up very badly; I have nothing more to say to you.] The count is very, very sick: you do not need to see him at all.
Since then, Pierre has not been disturbed, and he spent the whole day alone upstairs in his room.
While Boris entered him, Pierre was walking around his room, occasionally stopping in the corners, making threatening gestures to the wall, as if piercing an invisible enemy with a sword, and sternly looking over his glasses and then starting his walk again, pronouncing obscure words, shaking shoulders and arms outstretched.
- L "Angleterre a vecu, [End of England]," he said, frowning and pointing his finger at someone. - M. Pitt comme traitre a la nation et au droit des gens est condamiene a ... [Pitt, as a traitor to the nation and the people right, sentenced to ...] - He did not have time to finish Pitt's sentence, imagining himself at that moment as Napoleon himself and, together with his hero, having already made a dangerous crossing through the Pas de Calais and having conquered London, - as he saw a young, slender and handsome officer entering him He stopped. Pierre left Boris a fourteen-year-old boy and decidedly did not remember him, but, in spite of this, with his characteristic quick and cordial manner, he took him by the hand and smiled amiably.
- Do you remember me? Boris said calmly, with a pleasant smile. - I came with my mother to the count, but it seems that he is not completely healthy.
Yes, it looks unhealthy. Everything disturbs him, - Pierre answered, trying to remember who this young man was.
Boris felt that Pierre did not recognize him, but did not consider it necessary to identify himself and, without experiencing the slightest embarrassment, looked into his eyes.
“Count Rostov asked you to come and dine with him today,” he said after a rather long and awkward silence for Pierre.
- BUT! Count Rostov! Pierre spoke happily. “So you are his son, Ilya. You can imagine, I didn't recognize you at first. Remember how we went to Sparrow Hills with m me Jacquot ... [Madame Jaco ...] a long time ago.
“You are mistaken,” Boris said slowly, with a bold and somewhat mocking smile. - I am Boris, the son of Princess Anna Mikhailovna Drubetskaya. Rostov's father's name is Ilya, and his son's name is Nikolai. And I m me Jacquot didn't know any.
Pierre waved his arms and head as if mosquitoes or bees had attacked him.
- Oh, what is it! I confused everything. There are so many relatives in Moscow! You are Boris...yes. Well, here we are with you and agreed. Well, what do you think of the Boulogne expedition? Surely the English will have a hard time if only Napoleon crosses the canal? I think the expedition is very possible. Villeneuve would not have blundered!
Boris did not know anything about the Boulogne expedition, he did not read the newspapers and heard about Villeneuve for the first time.
“We are more busy here in Moscow with dinners and gossip than with politics,” he said in his calm, mocking tone. I don't know anything about it and don't think so. Moscow is busy with gossip the most,” he continued. “Now they are talking about you and the count.
Pierre smiled his kind smile, as if afraid for his interlocutor, lest he say something that he would begin to repent of. But Boris spoke distinctly, clearly and dryly, looking directly into Pierre's eyes.
“Moscow has nothing else to do but gossip,” he continued. “Everyone is busy with who the count will leave his fortune to, although perhaps he will outlive us all, which I sincerely wish ...
- Yes, it's all very hard, - Pierre picked up, - very hard. - Pierre was still afraid that this officer would inadvertently get into an awkward conversation for himself.
“And it must seem to you,” Boris said, blushing slightly, but without changing his voice and posture, “it must seem to you that everyone is only busy getting something from the rich man.
"So it is," thought Pierre.
- And I just want to tell you, to avoid misunderstandings, that you will be very mistaken if you count me and my mother among these people. We are very poor, but I, at least, speak for myself: precisely because your father is rich, I do not consider myself his relative, and neither I nor my mother will ever ask for anything and will not accept anything from him.
Pierre could not understand for a long time, but when he understood, he jumped up from the sofa, grabbed Boris by the arm from below with his characteristic speed and awkwardness, and, blushing much more than Boris, began to speak with a mixed feeling of shame and annoyance.
– This is strange! I really ... and who could have thought ... I know very well ...
But Boris interrupted him again:
- I'm glad I said it all. Maybe it’s unpleasant for you, you’ll excuse me, ”he said, reassuring Pierre, instead of being reassured by him,“ but I hope that I didn’t offend you. I have a rule to say everything directly ... How can I convey it? Are you coming to dine at the Rostovs?
And Boris, apparently having shifted from himself a heavy duty, himself getting out of an awkward position and putting another in it, became again completely pleasant.
“No, listen,” said Pierre, calming down. - You are an amazing person. What you just said is very good, very good. Of course you don't know me. We haven’t seen each other for so long… children yet… You can assume in me… I understand you, I understand you very much. I wouldn't do it, I wouldn't have the spirit, but it's wonderful. I am very glad that I got to know you. Strange,” he added, after a pause and smiling, “what you supposed in me! He laughed. - Well, so what? We will get to know you better. You are welcome. He shook hands with Boris. “You know, I have never been to the Count. He didn't call me... I feel sorry for him as a person... But what can I do? Dosage form:  Solution for intravenous administration. Compound: 1 ml of the drug contains:

Active substance:

Thallium-199 - not less than 110 MBq

Excipients:

Sodium chloride

Water for injections

Description: Colorless transparent liquid. Pharmacotherapeutic group:radiopharmaceutical diagnostic tool ATX:  

Other radiopharmaceuticals for the diagnosis of diseases of the cardiovascular system

Pharmacodynamics:

Physicochemical characteristics

thallium chloride,199 TI- a radiopharmaceutical preparation is prepared by dissolving thallium-199 sublimate isolated from a gold target in a 0.9% sodium chloride solution.

Isotope199 TIdecays by electron capture with a half-life of 7.4 hours. The most intense radiation has energies: 0.072 MeV with a quantum yield of 94.5%, and gamma radiation: 0.158 MeV (4.9%); 0.208 MeV (12.8%); 0.247 MeV (9.2%), 0.3339 (1.6%); 0.455 MeV (12.3%).

Thallium-199, being a biological analogue of potassium, is actively accumulated by healthy cardiomyocytes, which allows using planar scintigraphy or single-photon emission computed tomography to assess myocardial blood supply in various pathological processes that lead to impaired perfusion.

Pharmacokinetics:Thallium-199 after intravenous administration quickly leaves the vascular bed and after 3-5 minutes its content in the circulating blood is no more than 4% of the administered amount.

The maximum accumulation of the drug in a healthy myocardium is observed at 6-8 minutes after injection and is 4-5% of the administered dose. This level of myocardial capture remains unchanged for 30-35 minutes, which determines the optimal timing for planar scintigraphy or single photon emission computed tomography, which is 6-10 minutes after intravenous administration of the drug

Indications: The drug is used in adults to diagnose heart diseases associated with impaired blood supply: coronary atherosclerosis, transient myocardial ischemia, postinfarction cardiosclerosis, myocardial infarction, etc. Contraindications:There are no specific contraindications to the use of the drug. The use of Thallium-199 is limited by general clinical contraindications to the use of radionuclide studies. The use of the drug during pregnancy is contraindicated. Breast-feeding mothers should refrain from feeding the baby for 24 hours after the administration of the drug. Dosage and administration:When assessing the blood supply to the myocardium under conditions of a stress test and at rest with an interval in studies of about 24 hours, the thallium-199 preparation is administered intravenously in the amount of 110-185 MBq for each study.

Before the study, the gamma camera is tuned to the photopeak of radiation 199 TI(60-80 keV) with a differential discriminator window width of 20%; the study is recommended to be carried out using a high-energy (300 keV) parallel collimator.

6-10 minutes after the administration of the drug, planar (in three projections) scintigraphy or single-photon emission computed tomography (SPECT) of the heart is performed. To determine the redistribution of the drug in the myocardium, 2-3 hours after the injection, a second study is performed (planar scintigraphy or SPECT).

Radiation exposure to the organs and the whole body of the patient when using the drug Thallium chloride, 199 TI

Organs and systems	Absorbed dose, µGy/MBq
Whole body
Gonads
A heart
kidneys

Side effects:No side effects have been identified when using the drug for diagnostic purposes. Interaction: When conducting diagnostic studies, no interaction with other drugs was found. Release form / dosage:Solution for intravenous administration. Package: In hermetically sealed vials for medicines with a capacity of 10 or 20 ml in portions of 925, 1850 MBq on the date and time of manufacture (primary packaging), placed in a transport packaging kit (secondary packaging). Storage conditions:The drug is stored in accordance with the "Basic Sanitary Rules for Ensuring Radiation Safety" (OSPORB-99). Shelf life: The shelf life of the drug is 14 hours from the date and time of manufacture.

Do not use after the expiration date.

Conditions for dispensing from pharmacies: For hospitals Registration number: LSR-001561/08 Date of registration: 14.03.2008 Registration certificate holder: NII YaF FGNU

The use of the drug is possible only after a doctor's prescription.

Pharmacological group

Radioisotope agent (65)

Dosage form

solution for intravenous administration [with active volume at the date of manufacture]

Pharm.Action

The accumulation of thallium-201 in cardiomyocytes makes it possible to visualize the myocardium during a scintigraphic study.

Usage

For visualization of the myocardium in various pathological changes leading to disruption of its blood supply (including acute myocardial infarction, postinfarction scar, cardiosclerosis, transient myocardial ischemia, etc.).

Contraindications for use

Pregnancy, lactation.

Possible side effects

Not identified.

Doses and method of application

IV, 55.5-74 MBq (1.5-2 mKu). Scintigraphic examination of the myocardium is carried out after 6-10 minutes. Before the study, the gamma camera is tuned to the radiation photopeak in the range of 60-80 keV with a differential discriminator window width of 20%. Myocardial scintigraphy should be performed in several projections: anterior, direct, left anterior oblique (45 degrees C) and left lateral. Reliable interpretation of scintigrams is possible only when they are processed on a computer with the obligatory subtraction of background radioactivity and a relative quantitative analysis of the distribution of thallium-201 in various parts of the myocardium. The volume of primary information in each projection should not be less than 150,000 pulses. Normally, when examining at rest, only the myocardium of the left ventricle is visualized. The image usually has the shape of an ovoid with a relatively uniform distribution of thallium-201 around the periphery. Zones of impaired myocardial perfusion appear on scintigrams as areas of reduced drug accumulation. A decrease in the accumulation of the drug by more than 25% to the maximum is considered a reliable sign of impaired blood supply to the myocardium. Assessment of changes in myocardial perfusion during exercise or pharmacological tests should be carried out by separate administration of the indicator at rest and at the maximum of the functional test with a mandatory interval between studies of at least 3 days.

Other instructions

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

Trade name description

Thallium chloride 201Tl

Draw your attention to! Before using any medication, be sure to consult your doctor!