Pheochromocytoma Therapy Administration

-  Refer to  Dose Estimation  for the amount to give. Keep bone marrow radiation dose below 2 Gy.

-  I-131 MIBG is given iv in an inpatient basis. Infusion should be administered slowly in 2-3 h. Some institutions use slow intravenous infusion of 100 mCi in 250cc of dextrose 5% or NaCl 0.9% in 2-3 hours, repeated after 24 hours.

-  If hypertension ensues during the infusion, stop it momentarily, and give angiotensin-converting enzyme inhibitors sublingually (captopril) or alternatively calcium channel blockers (sublingual nifedipine).

-  Detail in written form radiation protection directions to patient, relatives and health care personnel.

-   Additionally,  2-3 more cycles in an interval of 4-6 weeks may be administered, depending on the recovery of bone marrow and circulating platelets count.

References:

Diez L, Mitjavila M, Tumores Neuroendocrinos: Estudios con meta-yodo-bencil-guanidina, p: 549-561 in: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.

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