Technical services

Question 1

State what aseptic pharmacists do

Answer 1

management
Record keeping and Quality issues
Professional:
Clinical
Protocols and regimens
Medicines info & education
Advice on special situations
Trials and research / audit
‘Usual’ pharmacist roles as well!

Question 2

State facts about guidelines and record keeping in the aseptic unit

Answer 2

Batch manufacture and paperwork
Compliance with guidelines on operating and maintaining equipment
ML requirements

Question 3

Facts about Quality Assurance

Answer 3

ESSENTAIL part of ML
Must ensure quality of:
Equipment (servicing!)
Accuracy of labelling and dispensing
Particles in air
Microbes in environment
Microbes, particles in products
Volume / concentration of products
Etc

Question 4

Facts about cytotoxic prescribing

Answer 4

Most drugs mg/ m2 prescribing.
Calc of Body surface area – (BSA) uses height and weight.
Online calculators, part of electronic Rx.
E.g. 1.75 m tall, weight 75 kg = 1.91 m2
Average approx. 1.6-1.7 m2
Drug doses individualised based on this

Question 5

Facts about medicine information role

Answer 5

Advice to:
Pharmacy staff
Clinicians and nurses, including training!
Patients
Specialist advice on:
Regimens
Drugs and diluents
Drug administration
Storage and expiry
Adjuvant drugs

Question 6

Medicine management issue

Answer 6

Oxaliplatin
Look in BNF appendix 6
“ Continuous in glucose 5%
Dilute requisite dose to a concentration of 200-700 mcg/mL and give over 2-6 hours. Incompatible with alkaline or chloride-containing fluids; avoid equipment containing aluminium.”
So cannot give in NaCl, must be diluted and must be given as a long infusion.

Question 7

What is extravasation Injury

Answer 7

leakage of drug into tissue causing
pain, irritation, tissue damage
dependent on the drug

Question 8

Minor extravasating injury presents as

Answer 8

redness, swelling

Question 9

Major extravasating injury presents as

Answer 9

loss of a limb, loss of function
(potent vesicants or irritants)

Question 10

State how to manage drug toxicity

Answer 10

stop drug if still running
remove cannula only after marking & aspiration
hydrocortisone iv & local & topical
antidote ? (caution)
cover site immediately with gauze
heat or cool according to nature of agent
complete incident form & extravasation sheet

Question 11

Facts about Carboplatin dose calculation

Answer 11

Carboplatin – Pt compound, licensed for ovarian and small cell lung carcinoma.
Very toxic, GI, renal, neuro,ototoxic.
Mainly renal clearance
Use Calvert formula – relates CrCl to AUC to determine dose:
AUC = GFR (mLs/min) + 25 mLs/min
Use multiple of AUR as dose e.g. previously untreated ovarian cancer, single agent carboplatin,
dose = 5 x AUC

Question 12

State facts about product expiry date

Answer 12

ood practice to give all individually manufactured doses a 24 hour expiry as ensures not ‘left around’ on ward.
Many products known to be more stable
May provide advice on extending expiry times/dates.
E.g. MTX 50mg/mL (preserved) stable in syringes for 8/12 at 25 C !
E.g. 5-FU 10mg/mL stable in some pumps for up to 16 weeks at 25 C ! (NB normally give 8/7 exp)