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Sterile Products Exam 2 > Hazardous Drugs > Flashcards

Hazardous Drugs Flashcards

1
Q

What is the purpose of USP <800>?

A

… to describe the practice and quality standards for handling hazardous drugs (HDs) to promote patient safety, worker safety, and environmental protection.

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2
Q

What is a “hazardous drug”?

A

A hazardous drug is any drug that will render the patient harm by hurting their healthy cells causing organ damage, secondary cancers, and rendering them infertile.

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3
Q

Where can you locate the list of hazardous drugs? what all information is given to you?

A

the NIOSH List of antineoplastic Drugs, it gives you the category, explanation of the dangers, and general rules/safety measures

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4
Q

how long does it take secondary cancers to develop?

A

2-10 years

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5
Q

What are three ways to be affected by antineoplastic drugs?

A

inhalation, transfer, absorption through the skin

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6
Q

what kind of room must hazardous drugs be compounded in? what are the air exchanges per minute? what air flow must the PEC have?

A

a negative pressure room so the hazardous air does not flow out into the ante room
- 30 air exchanges per hour and the PEC must have vertical air flow so it is not blowing on the worker

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7
Q

How high must the hazardous air vent be out of the roof?

A

10 feet out of the roof

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8
Q

how often must environmental testing be done?

A

every 6 months

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9
Q

how often do employees need to be tested? what 2 tests do they do?

A

They need to be tested every 6 months and they do a fingertip test and a media fill test

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10
Q

Do the staff need to sign any paperwork?

A

yes, they need to sign paperwork that says they have been properly trained and know what to do in emergency situations, that they know the risks, and how to protect themselves.

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11
Q

What do you have to do to products before they can be transferred?

A

we have to wipe them down and put them in a separate container before they can be transported. we also NEED to label them as a hazardous product

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12
Q

What is special about the garbing in hazardous compounding?

A

The compounders must wear two pairs of gloves and two pairs of booties. They can not reuse their chemo gowns and they must take the gloves and gowns off in the buffer room instead of the ante room. They also must wash their hands after they leave the buffer room.

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13
Q

what is an adsorbent compounding sheet?

A

this is an adsorbent sheet that goes in the designated compounding area

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14
Q

what is a hazardous spill kit?

A

this is an emergency kit that you must have in every place where chemo is! this includes the trucks it is transported in and everything

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15
Q

will chemo always escape while compounding?

A

yes! there is no way it wont no matter how good you are

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16
Q

what is a closed system transfer device?

A

this is a tool that mechanically prohibits the transfer of environmental contaminants into the system and the escape of the hazardous drug or vapor concentrations outside of the system. THEY SHOULD BE USED ALL OF THE TIME UNTIL INJECTION INTO THE PATIENT

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17
Q

does every hazardous drug need to be handled with all of this precaution?

A

no, this is why we need to be aware of what NIOSH says about the drug we are handling

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18
Q

what precautions must we use if the drug is labeled “antineoplastic” by NIOSH?

A

ALL OF THEM

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19
Q

what precautions must we use if the drug is labeled “active pharmaceutical ingredient (API)” by NIOSH?

A

ALL OF THEM

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20
Q

what precautions must we use if the drug is thought to have sufficient risk by the pharmacy?

A

ALL OF THEM

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21
Q

What 3 titles indicate that ALL precautions should be used?

A
  • antineoplastic
  • active pharmaceutical ingredient (API)
  • sufficient risk by the pharmacy’s standards
22
Q

What should you identify within the drugs of risk?

A
  • odds of contact
  • who will be affected
  • how frequently
  • is the product wrapped or contained
  • the length of exposure
  • how severe is the consequence?
23
Q

What do you do if there is a direct exposure that occurs?

A

First seek medical treatment immediately. Clear all personnel from the area and post a sign saying there has been a spill. Cover the spill if possible and call someone who is qualified to clean it up (or clean it up yourself if you can using the spill kit). Decontaminate the spill area if possible. Make sure you’re wearing the proper garbing if you’re the one in the area with the spill.

24
Q

Where should you store chemo drugs? How many air exchanges per hour?

A

in a separate room that is negative pressure and has external vents. it also must have 12 air exchanges per hour

25
Q

can you mix sterile and non-sterile products for chemo in a refrigerator?

A

yes, hazardous drugs just need to have their own refrigerator away from the non-hazardous drugs

26
Q

what must you do to a hazardous drug before you transport it?

A

you must put it in another container for transportation and label it as hazardous

27
Q

what is a pneumatic tube and can you put hazardous drugs in it?

A

it is a shooting tube that transports drugs all over the hospital. and NO, because if the hazardous drugs break open it is a mess to clean up.

28
Q

where should crushed hazardous medications go?

A

in the hazardous drug storage room that is negative pressure

29
Q

where should NON-crushed hazardous medications go?

A

they can go on the regular shelf

30
Q

can you use a pill counter for non-crushed hazardous medications?

A

NO, because they could develop powder that will be dangerout

31
Q

When using vials and syringes to compound hazardous products, should we add air to maintain equilibrium?

A

no, we should let the vacuum form because that will keep hazardous drug in the vial. WE WANT IT TO HAVE NEGATIVE PRESSURE.

32
Q

when we add the hazardous drug liquid to the fresh vial, should be take out air?

A

yes. we always want to take too mush air out of the vials so it keeps the negative pressure.

33
Q

should we push out air bubbles until drug does into the cap when compounding hazardous drugs?

A

no. we don’t want to expel any drug out into the air

34
Q

how long will the patient shed chemo after they receive a dose?

A

48 hours

35
Q

should the patient share towels or clothing when receiving chemo?

A

no

36
Q

should the patient be around young babies or children while on chemo drugs?

A

no

37
Q

how long must the patient wait to have sex after receiving chemo treatment?

A

48 hours

38
Q

how many times should the patient flush the toilet while on chemo medications?

A

twice per toilet use

39
Q

can the dog drink out of the toilet that a chemo patient is using?

A

no, we need to make sure this doesn’t happen because the dog will be harmed

40
Q

How should we treat the patient that is taking the chemo?

A

we should treat them like a normal persona and talk about normal things like the weather and sports. we also should be very open with them about what is happening and tell them all that is going on. keep them involved in their treatment.

41
Q

What are the four steps when cleaning hazardous drug residue?

A

1) put on gear as if you’re doing hazardous drug compounding
2) use an appropriate oxidizing agent to deactivate and decontaminate the hazardous drug residue
3) clean with the proper germicidal detergent
4) disinfect with 70% isopropyl alcohol

42
Q

What are the four steps to Assessment of Risk for handling hazardous grugs?

A

First you need to identify the drugs that actually need to be assessed. Then you assess the risk of the drugs needed. Then you treat the risk by creating a plan to minimize the risk of having the drug around or handling the drug. Then you put the plan into action and monitor and review the risk with the plan is place to make sure it is working.

43
Q

What are things you look for when you “assess the risk”?

A
  • the odds of contact
  • who will be affected
  • how frequently it is used
  • is the product wrapped or contained in some way
  • the length of exposure to have an effect
  • the severity of the consequences once someone is exposed
44
Q

What is the hazard communication program?

A

this is training that is documented that all hospital workers and potential health hazard workers have to go through that explains to them the risk of the drugs they are working with and what needs to be done in the case of an accident.

45
Q

what is the ISO class of a hazardous drug buffer room?

A

ISO 7

46
Q

What is the ISO class of a hazardous drug PEC?

A

ISO 5

47
Q

What is the order of doffing the apparel in hazardous compounding?

A

first you take off the first pair of gloves that touched the hazardous drug. Then you take off one outer booty at a time stepping over the doffing line as your do so. then take the gown off being careful not to let it touch your garbing underneath and you put it in a yellow pharmaceutical waste bin. then remove inner gloves and put them in the yellow waste can. not exit the buffer room and perform hand hygiene

48
Q

What do you do with the air when you are drawing out a liquid from a container?

A

do not add extra air in it, we want the vacuum to develop

49
Q

What do you do with the air when you are putting liquid into a container?

A

draw out air first, we want there to be a vacuum before we add the new liquid into it

50
Q

can you split chemo tablets in the normal pharmacy air?

A

no, it must be done in a negative pressure room

51
Q

can you count non-crushed hazardous medications on the same counter tray as normal drugs?

A

no they need their own and it needs to be cleaned often

Sterile Products Exam 2 (5 decks)

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