History of Nuclear Pharmacy

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The early history of nuclear pharmacy is tied together with nuclear medicine as both groups owe their existence to events that took place before the two disciplines were clearly identified. For example, Henri Becquerel was a key individual as he discovered naturally occurring radioactivity. George de Hevesy introduced the tracer principle. Hermann Blumgart and Soma Weiss performed the first application of radioactive tracers in medical research in a study of the velocity of circulating blood in 1925. After World War II, Abbott Laboratories sold the first radioactive drug in 1950. The advent of the Tc-99m generator and the design of the "scintillation camera" by Hal O. Anger in the 1950's were important events leading to the growth in nuclear medicine which was greatly increased by the introduction of the gamma camera and the commercial availability of the Tc-99m generator in 1964. This was followed by the rapid development in Tc-99m radiopharmaceuticals. These events and others set the stage for the emergence of nuclear pharmacy as a specialty practice and the creation of the Section on Nuclear Pharmacy in 1975.

Pharmacists had been encouraged to become involved with radioactivity used in medicine years long before the formation of the Section on Nuclear Pharmacy. William H. Briner and John E. Christian had written articles and contributed in other ways to set the stage for the emergence of nuclear pharmacy.

William H. Briner		John E. Christian

William Briner started the N.I.H. Radiopharmacy in 1958. He trained many pharmacists that contributed to the development of nuclear pharmacy and established principles and procedures important to the assurance of quality radiopharmaceuticals. In the 1940's John E. Christian was a young professor in the School of Pharmacy at Purdue University. In the Fall, 1947, he developed the first formal lecture and laboratory courses in the United States for teaching the basic principles of radioisotope applications. He published and spoke at national meetings on the importance of pharmacy involvement in radioisotope research and applications in medicine. He was responsible for the first monographs for individual radiopharmaceuticals in the U.S.P. Many individuals trained by John Christian went on to contribute significantly in nuclear pharmacy. John Christian and William Briner were both active on key national committees responsible for the development, regulation and utilization of radiopharmaceuticals.

In the early 1970's several nuclear pharmacy practitioners and educators (not so designated at that time) met at meetings related to nuclear medicine and radiopharmaceuticals. They believed that the need existed for the development of an organization that would allow pharmacy practitioners serving nuclear medicine to come together for the betterment of pharmacists and services to nuclear medicine. Based upon the results of a questionnaire distributed through the network developed by the "Nuclear Pharmacist's Newsletter," the APhA was selected as the organization to approach. The APhA then sponsored the first formal gathering of nuclear pharmacists at the session entitled "Nuclear Pharmacy '74" held on August 8, 1974, at the APhA annual meeting in Chicago. Subsequently, a petition was generated requesting the formation of a Section on Nuclear Pharmacy in the Academy of General Practice (currently, the Academy of Pharmacy Practice and Management). The petition was approved by the APhA Board of Trustees in San Francisco on April 23, 1975. The Section on Nuclear Pharmacy was born.

1974: Stan Shaw, Gordon Born, Bob George, Rodney Ice		1974: J. William Dirkson, James Cooper, Geoffrey Levine

Following approval, several committees were established to aid the Section in achieving goals. One of the first issues was the development of guidelines describing the responsibilities of a nuclear pharmacist. Practice sites, responsibilities and training varied greatly. In 1978, a document entitled "Nuclear Pharmacy Practice Standards" (termed guidelines today) was accepted by the Section on Nuclear Pharmacy. The practice standard document then became the basis for the development of documentation requesting recognition as a specialty by the Board of Pharmaceutical Specialties (BPS). The petition was approved by the BPS in 1978 and nuclear pharmacy became the first formally recognized pharmacy specialty practice in the world.

In order to develop procedures necessary to award board certification in nuclear pharmacy, the BPS appointed a Council on Nuclear Pharmacy. The council was asked to establish knowledge areas, determine requirements for eligibility, prepare an examination, set scores for passing and, finally, administer an examination. The examination was developed based upon the practice standards and with several approaches to assure an examination would meet the standards necessary for national board certification. Following a test exam to assure discrimination between a generalist and a nuclear pharmacy specialist, the first examination for Board Certification in Nuclear Pharmacy (BCNP) was given to 72 pharmacists on April 24, 1982. The BPS officially designated 63 as BCNP on August 25, 1982. In 1998, there were over 430 BCNP in the U.S.

Starting with a small number of practitioners and educators, nuclear pharmacy has increased in services as well as in number of practitioners. The advent of the concept of a commercial centralized nuclear pharmacy that was initiated in 1972 has resulted in the establishment of several hundred centralized nuclear pharmacies that provide the greater part of radiopharmaceuticals used in the U.S. Nuclear pharmacy has a rich history, a list of innovative accomplishments and a bright future as a result of the dedication of the pioneers and those that have followed in the specialty of nuclear pharmacy.