There is sufficient evidence in experimental animals for the carcinogenicity of pure beta-particle emitters (hydrogen-3, phosphorus-32, strontium-90, yttrium-90, yttrium-91 and promethium-147). /Hydrogen, Phosphorus, Strontium, Yttrium, Promethium/
◉ Summary of Use during Lactation:Information in this record refers to the use of yttrium Y-90 microspheres as therapeutic agents. No information is available on the use of yttrium Y-90 microspheres during breastfeeding. However, little (with resin) or no (with glass) yttrium Y-90 attached to microspheres is available to the systemic circulation of the mother after administration via the hepatic artery, and doses less than 17 GBq do not appear to require withholding of breastfeeding. In a study in which external radiation was measured after 143 administrations (124 resin, 19 glass) to 86 patients, only one exceeded the threshold for concern with close infant contact, using conservative methods.
A dose of 185 MBq of yttrium Y-90 citrate injected into the knee for radiosynoviorthesis resulted in high levels of radioactivity in the milk for at least 26 days. The authors recommended cessation of breastfeeding for at least 1 month, which would usually preclude further nursing of the current infant.
Mothers concerned about the level of radioactivity in their milk could ask to have it tested at a nuclear medicine facility at their hospital. When the radioactivity is at a safe level she may resume breastfeeding. A method for measuring milk radioactivity and determining the time when a mother can safely resume breastfeeding has been published.
◉ Effects in Breastfed Infants:Relevant published information was not found as of the revision date.
◉ Effects on Lactation and Breastmilk:Relevant published information was not found as of the revision date.
... /The authors/ investigated: the biodistribution in rats of 90YCl3, [90Y-DOTA0,Tyr3]octreotide, and 90Y-DTPA; possibilities to complex 10% of free 90Y3+ in a [90Y-DOTA0,Tyr3]octreotide containing solution into 90Y-DTPA prior to intravenous injection; and effects of 10% free 90Y3+ in [90Y-DOTA0,Tyr3]octreotide solution, in the presence and in the absence of excess DTPA, on the biodistribution of in rats. The following results are presented: 90YCl3 showed high skeletal uptake (i.e., 1% ID (injected dose) per gram femur, with main localization in the epiphyseal plates) and a 24 h total body retention of 74% ID; 90Y-DTPA had rapid renal clearance, and 24 h total body retention of < 5% ID; added free 90Y3+ in [90Y-DOTA0,Tyr3]octreotide solution could rapidly be incorporated into 90Y-DTPA at room temperature; and accumulation of 90Y3+ in femur, blood, and liver was related to the amount of free 90Y3+, whereas these accumulations could be prevented by the addition of DTPA. In conclusion, the addition of excess DTPA to [90Y-DOTA0,Tyr3]octreotide with incomplete 90Y-incorporation is recommended. /Yttrium-90/
Basic Treatment. Establish a patent airway (oropharyngeal or nasopharyngeal airway, if needed). Suction if necessary. Watch for signs of respiratory insufficiency and assist ventilations if necessary. Administer oxygen by nonrebreather mask at 10 to 15 mL/min. Monitor for shock and treat if necessary. Anticipate seizures and treat if necessary. Perform routine emergency care for associated injuries. ... Perform routine basic life support care as necessary. /Radioactives I, II, and III/
Advanced Treatment. Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious or is in severe respiratory distress. Monitor cardiac rhythm and treat arrhythmias as necessary. Start IV administration of 0.9% saline (NS) or lactated Ringer's (LR) TKO. For hypotension with signs of hypovolemia, administer fluid cautiously. Watch for signs of fluid overload. Treat seizures with diazepam or lorazepam. Perform routine advanced life support care as needed. Use proparacaine hydrochloride to assist eye irrigation. /Radioactives I, II, and III/
