Handling of Cytotoxic Agents- Dr.K

USP chapter _____ sets standards for handling hazardous drugs in healthcare settings.

800

What organization maintains a list of HDs (hazardous drugs) used in healthcare?

NIOSH

What organization provides standards for workplace safety?

OSHA

What organization sets regulations for hazardous waste management?

EPA

To be considered a hazardous drug it must exhibit _____ or more of the following:

• carcinogenicity

• teratogenicity

• developmental toxicity

• organ toxicity

• genotoxicity

one

Term that describes things that may cause mutations leading to cancer/tumors:

carcinogenicity

Term that describes things known to cause fetal abnormalities:

teratogenicity

What term is used to describe things that interfere with normal growth, differentiation, development, or behavior?

developmental toxicity

Genotoxicity damages _______.

DNA

NIOSH also classifies HDs into groups. What are the 3 groups?

1. antineoplastic drugs

2. non-antineoplastic drugs

3. drugs that pose a reproductive risk

Exposure to hazardous drugs occurs through _______________, __________________, ______________________, and ___________________.

• inhalation

• absorption

• injection

• ingestion

What are some examples of opportunities where you might be exposed to hazardous drugs?

• dispensing

• compounding

• administration

To minimize exposure to HDs, facility controls are ____________ areas ______________ from non HD for receipt/unpacking, storage, and compounding.

facility controls are designated areas separated from non HD for receipt/unpacking, storage, and compounding.

To minimize exposure to HDs, compounding MUST occur within a __________ located in a _____________.

compounding MUST occur within a C-PEC located in a C-SEC.

What are some examples of C-PEC? (list 2)

1. biological safety cabinet

2. compounding aseptic containment isolator (CACI)

Should C-PEC and C-SEC be externally or internally vented?

• know

externally

Should C-PEC and C-SEC be negative or positive pressure?

• know

negative

All areas where HDs are handled and all reusable equipment must be ______________, __________________, and ________________.

must be deactivated, decontaminated, and cleaned.

If sterile compounding reusable equipment must also be ________________.

disinfected

How many gloves should you put on when handling HDs?

• KNOW

2 - DOUBLE GLOVEEEEEEE

When handling HDs, gowns must be ____________ and resist_________________________.

gowns must be disposable and resist permeability by HDs.

What type of respirator is commonly used when handling HDs?

• know

N95 (NIOSH certified)

Is a surgical mask okay to wear when handling HDs?

NOPE

What situations would you not wear an N95 and wear a full-facepiece chemical cartridge respirator? (3 situations)

1. large spills

2. deactivating, decontaminating, cleaning under PEC

3. known airborne exposure

WHAT IS the most urgent action if accidental exposure occurs?

get the drug/chemical OFF OF THE PERSON

Who must be trained in spill control?

all personal who may be required to clean up a HD spill.

Where should spill kits be located?

all areas where HDs are commonly handled

When should spill kits be cleaned?

IMMEDIATELY

What should HDs be labeled when disposing?

“cytotoxic waste only”

What goes in BLACK bulk chemo bins?

• partially empty bags, vials, syringes

What goes in YELLOW trace chemo bins?

• gloves, gowns, shoe covers

• empty IV bags, syringes, vials

Main difference between things put in yellow and black chemo bins?

in yellow empty syringes, vials, bags etc. , in black only PARTIALLY empty things