Lec 8- Aseptics Flashcards
1
Q
Already
A
- Classess of working area
- The uniform of these environments
- Paperwork your expected to produce dispensing and preparation record-
- Some of the contaminants ‘microbial or non-viable’
- Cleaning of areas
2
Q
Grade A work areas
A
- No difference between rest and operation
- Not possible to get rid of all particles
3
Q
Commonly used Grade A environements
A
- Laminar flow
- Isolator
4
Q
2 types of laminar flow hoods
A
- Vertical flow
- Protect the person creating the material
- Use for cytotoxic drugs
- NB- radioactive must be in an isolator
- Horizontal flow
- Must be used to protect the product
- TPN, Saline etc
5
Q
Horizontal laminar flow hood
A
- Clean air is driven through a HEPA filter
6
Q
First air
A
- Very expensive to produce
- The most contaminant freecair in whole room
- Ideally only first air should be exposed to a product
- May be called laminar flow air= Literally dascribes the motion of air moving
- As soon as the air comes in contact with anything (surface, particulate) it is no longer first air
7
Q
Laminar flow air
A
- Literally describes the motion of air moving- unidirectional (1 direction)
- Friction reduces the air speed against a surface and can result in particles setting
- Turbulence when there are objects in front of air, no air behind this object (transition zone- with no access to first air) why we don’t place items behind one another
- The turbulence will not remove the particles
8
Q
Question- How would you position the items in a horizontal laminar flow hood?
A
- Spaced out
- NOT Behind each other
- Overlapping transition zones deposit particles on other equipment or medication
9
Q
Isolators
A
- Positive or negative pressure
- GMP- sited in a minimum grade D environment
- In practice they are placed in grade C area, if the seal breaks we dont allow the dirtiest air in the clean room into the isolator
- Dedicated room with access control
- No sinks allowed
- Changing must be provided
- Laminar flow is not required air is provided from overhead (housed) supply
- Modern isolators use turbulent air flow, to aid particle removal
10
Q
Positive v negative isolators
A
- Positive or negative pressure
- Positive= pressure much higher inside the isolator than in the clean room- this pressure prevents particles entering
- Negative= pressure inside is much lower so air rushes into the isolator
- We would have a negative isolator= cytotoxic or radioactive material to prevent these particles going out, air rushes into isolator so air containing cytotoxic particles will not go to technician
- No sinks allowed- moisture= increased microbial growth
- Chainging must be provided
11
Q
Clean room
A
- NB- doors must open from dirty air to clean air
- Pressure should be higher in A than B (and B than C etc) so that when doors open the particles will be pushed into the dirtier areas
12
Q
So far we have
A
- Laminar flow- laminar air
- Isolators- positive and negative
- Locations of isolators vs laminar flow hoods
- Contrasting air flow requirements
13
Q
Georges Rx
Q) How long will the infusion last; Can you spot anything to query?
A
- 1= 30 minutes
- Teicoplanin is required to be taken ridigly(patient shouldn’t be allowed) PCA should be used
- If PCA is the only one available MUST be a lock out period
14
Q
Prescription checks
A
- Aseptic prescriptions require the same care as any other prescription, but consider
- All prescribers must be on a record of approved training (trust)
- Rx on approved documentation (trust)
- Administration of substances advisory committee and radioactive medicines regulation
15
Q
Responsibility
A
- Pharmacists are responsible for medication errors from any cause
- Prescribing calculation
- Diluent
- Route or rate
- Presentation or formulation
- Prescription verified for patient
16
Q
Prescription verification
A
- Signitureand date (authorised prescriber)
- Patient details
- Name, hospital Number, the weight
- Calculation of BSA
- Dose calculation
- Compliance with dosage regimen
- Administration
- Route, diluent, volume, rate, duration
- Compatibility of the constituents
- Stability of the formulation
- Correct presentation of the route of administration
- AND any contra-indications or drug interactions
17
Q
Aseptic entry stages
A
- SOP training- everything from entry to dressing and aseptic technique
- Prescription verification
- Print out labels and dispensing and preparation record
- Obtain stock
- General hand wash
- Gown up
- Retrieve stock (from spraying in)- dedicated hatch for things in and things out
- Move to grade A
- NB- drugs are not just walked through the different areas- they are passed through hatches (spray-wipe-spray) then passed through the hatch into the area
- Sepearte hatch for stock coming into the area and going out of the area
18
Q
Gloving
A
- Open packages into first air- never cut or rip MUST peel
- Bare hands should never come into contact with OUTSIDE of the glove
- Only once hand is inside the glove you can use to pull glove over hand
19
Q
Spraying in
A
- 60% of items from stores are contaminated with bacteria
- We spray it allows us to see any cracks in the product
- Allows disinfectant to reach all crevices
- Allows you to check for
- Particels- potential block
- Bubbles- seal fail?
20
Q
Isolator spray in
A
- Isolator has a little hatch
- Once sprayed place into the hatch
- Wait a minute for the air to become sterile in the hatch (was grade c or D air)
- Pass the material into the hatch
21
Q
Critical surfaces
A
- You should not touch critical surfaces
- A critical surfact is any surface that will come in contact with a sterile medication (solution, powder etc)
- Needles, top of vial, plunger top
- Syringe must always be coupled to a needle
22
Q
Needle
A
- Always split
- Luer lock fitting
- Alway try and work in mid air
- Needle in with bevel at angle downward force
- The straighten
- Prevent coring of bung contaminating the vial
- NEVER TWIST OR TURN
23
Q
VIALS
A
- Work with vials upright
- Be careful of hand positioning- but always remember your safety must come first
24
Q
Vial equalisation
A
- Pressure equalisation
- Air in
- Draw solution out (now under moderate preassure)
- Venting needle
- Shown
- White needle will be filter vent
- Green to draw up
