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Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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Flutemetamol F-18 (Vizamyl) - Uses, Dose, Side effects, MOA

Flutemetamol F-18 (Vizamyl) is a radiopharmaceutical agent that is used to estimate the amount of beta-amyloid plaques using PET scan in patients who are being evaluated for Alzheimer disease and other conditions resulting in a gradual cognitive decline.

Flutemetamol F-18 Uses:

Brain imaging:
- It is inidicated to estimate beta-amyloid plaques density in the brain via using PET (positron emission tomography) imaging in adult patients who are being evaluated for Alzheimer disease and cognitive impairment.
- It is used as an adjunct to other diagnostic evaluations.

Note: A positive scan does not reliably establish a diagnosis of AD or other cognitive disorder.

Flutemetamol F-18 (Vizamyl) Dose in Adults

Flutemetamol F-18 (Vizamyl) Dose in Brain imaging:

IV: 5 mCi (185 MBq);
Maximum dose: 20 mcg mass dose

Use in Children:

Not indicated

Pregnancy Risk Factor C

Animal reproduction studies have not included any study of the drug.
Women with reproductive potential must evaluate their pregnancy status.
Elective diagnostic procedures must be postponed until the delivery.

Flutemetamol F-18 use during breastfeeding:

It is unknown if the drug will be excreted into breastmilk.
Elective diagnostic procedures must be postponed until the delivery.
Lactating mothers must discontinue breastfeeding temporarily for 24 hours, and then discard breastmilk.

Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer's labeling.

Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer's labeling.

Side Effects of Flutemetamol F-18 (Vizamyl):

Cardiovascular:
- Flushing
- Increased blood pressure
Central nervous system:
- Dizziness
- Headache
Gastrointestinal:
- Nausea

Contraindications to Flutemetamol F-18 (Vizamyl):

Patients who have had an allergic reaction to any drug or component of the formulation, such as polysorbate 80, should not be treated.

Warnings and precautions

Hypersensitivity
- Within minutes of administering the drug, allergic reactions such as shortness or flushing of the nose and throat have been reported.
- Patients who have never had to be exposed to the drug may experience allergic reactions.
- Any emergency that may arise after the drug is administered should be treated promptly with the appropriate medication.
Malignancy
- Patients are exposed to radiation during the procedure. Radiation exposure is a major factor in the risk of developing malignancies.

Monitoring Parameters:

None mentioned

How to administer Flutemetamol F-18 (Vizamyl)?

IV:

It is administered as a single intravenous bolus injection (within 30 - 40 seconds) in a total volume of 10 ml or less. The injection is followed by a saline flush of 5 to 15 ml.
Patients are instructed to increase the uptake of water after the administration of the drug to minimize the radiation to the bladder.
Patients are instructed to void before and after the imaging and frequently during the first 24 hours after the administration of the drug .
Since, it is a radiopharmaceutical, it should be handled with full precautions.
Waterproof gloves should be worn. Effective shielding including lead glass syringes should be used when handling the drug and during its administration.

Mechanism of action of Flutemetamol F-18 (Vizamyl):

It crosses the blood brain border and binds with b-amyloid plaques, generating a positron signal which is detected by a PET scanner.

Distribution:

- It diffuses through the blood-brain barrier.
- Positive scans show a steady increase in signals between the time the drug is administered and 30 minutes afterward.
- For up to two hours, stable values can be observed afterward.

Excretion: