ch 17 compounding with hazardous drugs

pg. 293-301

compounding hazardous drugs requires following USP _______

800

a drug is hazardous if it is _________

carcinogenic

teratogenic

toxic to reproduction

genotoxic

toxic to organs

T/F if any manipulation of HD is required, USP 800 requirements must be followed

TRUE

hoods and buffer rooms used for compounding HDs contain the word _________

containment

______ protects the workers from being exposed to the HDs they work with

negative air pressure

what is required if we keep sterile and nonsterile compounding of HDs in the same space?

C-SEC maintains ISO 7

separate sterile and nonsterile C-PECs at least 1 meter apart

_________ are required to have negative air pressure

C-SECs and C-SCAs

in a space where nonsterile HDs are compounded, there must be at least ______ ACPH

12

in a sterile C-SEC, there must be at least ______ ACPH

30

in a C-SCA, there must be at least ______ ACPH

12

garb required for compounding HDs

2 pairs shoe covers

2 pairs chemo gloves

face mask

chemo gown

when do you need to wear eye/face protection?

risk for HD spills or splashes

when working outside of C-PEC

what kind of respirator is appropriate for most activities that need respiratory protection?

fit tested NIOSH-certified N95

when do you need to change your powder-free chemo gloves?

every 30 minutes or when torn, punctured, or contaminated

when do you need to change chemo gown?

per manufacturer’s schedule

every 2-3 hours or immediately after a spill or splash

what should be worn when cleaning up large HD spills, cleaning the undertray of C-PEC, or known/suspected airborne exposure to HD powders/vapors?

fit-tested respirator mask with attached gas canisters

or

a powered air-purifying respirator (PAPR) that blows air through the filter to the user

how many gloves do you need when handling intact capsules or tablets, or receiving and storing HDs?

1

T/F pneumatic tube systems cannot be used to transport any liquid HDs or any antineoplastics

TRUE

when compounding with HDs, do we inject air into a vial?

NO

positive pressure in vial can cause the HD to spray out around the needle

how do we remove HDs from vials?

negative-pressure technique

closed-system transfer device (CSTD)

what label do all hazardous preparations require?

chemotherapy - dispose of properly

what color waste bin does bulk hazardous waste (unused/partially empty IV bags, syringes, and vials) go in?

a. black

b. yellow

c. red

a. black

what color waste bin does trace HD waste (empty vials, empty syringes, empty IV bags, IV tubes, garb) go in?

a. black

b. yellow

c. red

b. yellow

what color waste bin do used syringes from preparing HDs go in?

a. black

b. yellow

c. red

b. yellow

note: the red sharps container is only used for nonhazardous sharps

sanitization steps

1. deactivation

   1. makes compound inert/inactive

   2. peroxide or sodium hypochlorite

2. decontamination

   1. remove HD residue

   2. alcohol, water, peroxide, or sodium hypochlorite

3. cleaning

   1. remove dirt and microbial contamination

   2. germicidal agent

4. disinfection - sterile compounding only

   1. destroy microorganisms

   2. EPA-registered disinfectant or 70% IPA

pharmacies involved in HD compounding should perform _______ of all compounding surfaces initially and every 6 months

wipe sampling

what should you consult if you spill a HD?

safety data sheet (SDS)

how do you manage a HD spill?

limit access to area and post warning signs around perimeter of spill

warning sign - caution: hazardous spill, proceed with care

put on ASTM D6978-rated (chemo) dgloves on, then heavy duty gloves

clean up spilled drug and broken glass (do NOT use brush)

cover liquid with absorbent spill pad

decontaminate the surfaces, move from area of less contamination to greater

put trash in hazardous waste bag and seal - put in black waste bin

spill kit contents

garb: protective gown, latex gloves, N95 respiratory mask, goggles

HD waste bag, scoop and scraper, chemo pads

HD spill report exposure form