Hazardous Drugs and Chemo Preparations Flashcards
Define Hazardous drugs
Chemical for which there is evidence that acute or chronic health effects may occur with exposure
Hazardous medication are meds that can cause:
Genotoxicity, carcinogenicity, fetility impairment, organ damage at low doses
Exposure include:
Inhalation
Dermal (touch)
Ingestion
Injection (accidentally stab yourself)
Sources of contamination:
Vial surface
Work surface
Administration and waste handling
Poor technique
Control your environment via
Designated storage location (away from other drugs with ventilation and negative pressure)
Use distinct labels
Designate preparation area
Primary engineering controls
Completely vented outside through HEPA filter
Maintain sterility and protect operator (air barrier and negative pressure)
Biological safety cabinets and compounding aseptic containment isolators
Air sent to outside environment
BSC class II
Open front
Dependent on air barrier
Should be vented 100% outside
BSC class III
Essentially isolator
Gas-tight unit
Maintained under negative pressure
Compounding Aseptic Containment Isolators (CACI)
Similar to BSC type III
Designed to isolate hazardous medications and prevent workers from being exposed to airborne meds
CACI Ideally:
Unidirectional airflow
Vented outside
Cleaning of CACI
Use wipers and detergent
Linear overlapping strokes use cleaning tools for areas beyond reach of gloves
- Rinse away detergents with IPA or deionized water
- Then disinfect
PPE must be worn for:
Receiving Shelving Compounding Administration Cleaning Disposal Waste handling
Gloves should be changed:
Every 30 minutes
Immediately when damaged or contaminated
When operator exists the PEC
CACI PPE
Gloves inside the fixed gloves/gauntlets
Fixed gloves must be surface cleaned
Inner gloves should be used for labeling and placing the final preparation in transport bag
CACI Final Check requires
Fresh gloves
Negative pressure + Spills
Volume of air injected less than volume trying to pull out this will minimize spills
3/4 Rule =
Volume to be pulled out should be 3/4 of the syring volume
Define Deactivation
Render a compound inert or inactive
- Oxidizers
Define decontamination
Remove inactivated residue
- Sterile alcohol/water
Must be done inaddition to cleaning and disinfecting
Define Cleaning
Removing organic and in organic material
Define Disinfection
Removal of microorganisms
Alcohol + Hazardous Drugs =
Alcohol does not deactivate hazardous drugs
It actually spreads contaminates
If a spill is greater than 5 mL,
Call environmental services
Skin contact =
Wash for 20 minutes
Eye contact =
Wash for 15 minutes
Disposal of contaminated PEC
All contaminated materials should be disposed and sealed in the PEC and then placed in a hazardous drug waste container which must be closed
