Pharmacy technician training- Unit 2, lessons 35-38

Small spill

Less than 5 mL, more becomes large

Standard spill kit

Supplies to absorb at least 1000 mL of liquid

Appropriate PPE: 2 disposable gloves (one outer, heavy duty utility, one inner gloves) + nonpermeable protective garments including gown and face shield

Absorbent, plastic backed sheets or spill pads

Disposable toweling

At least 2 sealable, thick plastic, prelabeled hazardous waste disposal bags

One disposable scoop for glass, one puncture resistant container for glass

ASHP hazardous drugs spill cleanup recommendations

1. Assess scope, size then call for assistance, such as if 2+ spill kits are needed

2. Post signs for spill, limit access

3. Obtain spill kit and respirator, don PPE

4. Remove glass, absorb liquid with spill pads and absorb powder with damp disposable pads or towels

5. Clean from less to more contamination

6. Remove contaminated material into disposal bag

7. Rinse with water then detergent then sodium hypochlorite and then neutralizer, then rise again several times

8. Place all used materials into disposal bags, seal them and place in appropriate labeled waste, remove PPE (inner gloves last and placed into small sealable bag) and do the same

9. Wash hands with soap and water

10. Have area recleaned by housekeeping, janitorial, or environmental services

Compounding aseptic isolator

Used in compounding drugs, for pharmaceutical ingredients, and pharmaceutical preparations

Keeps area sterile and ventilator, has features of glove box

Medical Safety Data Sheet (MSDS)

Includes: the chemical's identification, ingredients, specific hazards, first aid measures, firefighting procedures, accidental release measures, safe handling and storage, exposure controls, physical and chemical properties, stability and reactivity, toxicological and ecological information, disposal considerations, transportation information, and regulatory information

OSH Act of 1970

Protects against workplace violence, especially due to increased risk of robbery in pharmacies, set policies and protections during threats should be made and staff should be trained

Responsibilities of staff to control infection spread

Educate and inform patients about proper use of antiseptics, disinfectants, and sterile products

Promote pharmacy policies, procedures, and quality control programs promoting infection control

Promote responsible use of antimicrobial agents

Educate about antimicrobial agents, vaccines, and infection control techniques

Red, soft plastic bags

Hazard bag for blood and other bodily fluids

Hard red containers

Used for contaminated sharps

Yellow signs and bags

Notes biohazard, chemotherapy, or cytotoxic substances

Proper hand hygene

Decontaminate with alcohol rub until dry, wash with soap and water, do NOT use multi use towels

Geriatric effects

Reduce cardiac output, which decreases kidney function and liver function, metabolism and excretion processes are slowed

Increased susceptibility to side effects due to longer exposure

Bowel mobility is decreased, reduced stomach acid and smaller intestines cause slow absorption and delayed action

Less water percentage slows distribution

Increased fat percentage increases amount of fat soluble drugs distributed and stored in fat cells rather than being metabolized and excreted, causing longer stay and possibly toxicity

Organ size may decrease and amplify these effects

Noncompliance common

Physiological effects of aging

Bone and muscle loss

Decreased lung, kidney, liver function, taste

Increased blood pressure, exercise induced heart rate, thyroid disorders

Overactive bladder function

Intestinal complications

Changes in sleep patterns

Vision, hearing impairment

Declining dental health

Disease-Drug interactions

Interactions due to disease or specific health conditions

In elderly due to less drug receptors that can cause complications such as heart failure, kidney failure, or liver failure

Polypharmacy

Taking multiple medications at once or taking more medications than needed, require complex drug regimens

Common in elderly

Pediatric differences

Decreased blood flow to muscles, IM medications absorbed slower

Lower muscle mass increases risk of muscle and nerve damage with IM medications

Neonates have higher pH in digestive tract than adults can decrease drug bioavailability and decrease blood serum levels of a drug

Jaundice in neonates

Almost half develop in few days after birth, caused by excess bilirubin due to the immature liver

Can cause deafness, cerebral palsy, and brain damage

Treated by phototherapy, which is exposure to special light that can break bilirubin down

Common types of poisoning in children

Type: Cosmetic, analgesics, household cleaners, cold and cough medications, foreign objects, topical preparations, vitamins, antihistamines, pesticides, plants

Biopharmaceuticals

Produced through biotechnology, such as genetic engineering, includes biologics (derived from blood, vaccines, toxins, and allergen products)

FDA Approval process

Preclinical phase: experimental drug tested against disease, lab and animal studies, efficacy and toxicity tested

IND Application: Investigational New application, outlines preclinical phase result, detailed protocols for clinical trials, chemical structure and plans for manufacturing, effective unless disapproved within 30 days, allows proceeding with clinical trials in humans

Controlled human clinical trials

Recombinant DNA

Inserting partial DNA into host DNA, which becomes recombinant DNA, which produces engineered proteins

Can treat rheumatoid arthritis, Crohn’s disease, cancer, diabetes, and more

Genetic engineering steps

Isolate desirable gene, such as resistance to a disease

Insert gene into vector, such virus

Use vector to transform cell of another organism

Isolate transformed and non transformed cells