Antineoplastic Agents - Part 1

Summary

This video provides essential guidelines for pharmacy staff preparing oncology drugs, focusing on the safe handling of toxic antineoplastic agents. It covers crucial procedures such as dilution, reconstitution, and withdrawing solutions using specialized chemotherapy dispensing pins, ensuring the protection of staff from exposure to harmful particles. The video emphasizes the importance of using sterile equipment, wearing protective clothing, and adhering to strict safety protocols within designated rooms. Additionally, it highlights the significance of regular cleaning and decontamination of the biological safety cabinet to maintain a safe environment during drug preparation.

Takeaways

• 😀 Antineoplastics are toxic, cytotoxic agents that require proper handling and safety precautions to avoid exposure and contamination.
• 😀 Personal protective equipment (PPE) is essential, including disposable, lint-free gowns, double gloves, surgical masks, and respirators.
• 😀 Always use sterile equipment when preparing antineoplastic products to prevent contamination and ensure patient safety.
• 😀 A biological safety cabinet (Class 2 vertical laminar airflow) must be used at all times to handle antineoplastic products.
• 😀 The biological safety cabinet must operate continuously 24/7 and be certified by a qualified technician, ideally every 6 months.
• 😀 Gloves must be changed every 30 to 60 minutes of continuous use and immediately if they are punctured or contaminated.
• 😀 You must never remove contaminated objects or materials from the designated room to prevent spreading antineoplastic particles.
• 😀 The biological safety cabinet must be cleaned and decontaminated regularly, including a daily cleaning with isopropyl alcohol and weekly decontamination with detergent and sterile water.
• 😀 Before diluting or withdrawing antineoplastic drugs, disinfect the vial stoppers with alcohol and use the correct techniques for withdrawing fluids.
• 😀 Always ensure that the antineoplastic powder is fully dissolved before using it, and avoid wetting the filter during the process to maintain sterile conditions.

Q & A

What are antineoplastics, and why are they considered dangerous?

Antineoplastics are drugs used to fight cancer, and they are classified as toxic, cytotoxic agents. They are considered dangerous because they can be potentially mutagenic, oncogenic, or teratogenic, which means they can cause genetic mutations, cancer, or birth defects.

Why is it critical for handlers of antineoplastics to wear protective clothing?

It is essential for handlers to wear protective clothing to prevent direct contact with the toxic antineoplastic drugs, which could lead to contamination or exposure to harmful effects such as skin contact, inhalation, or accidental ingestion.

What type of biological safety cabinet is recommended for handling antineoplastic products?

A Class 2 vertical laminar airflow biological safety cabinet, ideally a type B2 or Total Exhaust cabinet, is necessary for handling antineoplastic products. This type of cabinet ensures that 100% of the filtered air is exhausted outside the building.

How often should the biological safety cabinet be recertified?

The biological safety cabinet should be recertified by a qualified technician ideally every 6 months to ensure it meets required safety standards.

What is the procedure for cleaning the biological safety cabinet?

To clean the cabinet, start by wiping all surfaces with sterile gauze soaked in 70% isopropyl alcohol. Regular cleaning should be done at the beginning and end of each day, with more thorough decontamination done once a week using detergent, sterile water, and alcohol.

What personal protective equipment (PPE) should be worn when handling antineoplastics?

Handlers should wear disposable, back-closing, lint-free long-sleeved gowns with tight cuffs, powder-free sterile surgical gloves (double gloving), a surgical mask, and a respirator mask with a high-efficiency filter when cleaning or dealing with spills.

What is the purpose of using a chemotherapy dispensing pin with a hydrophobic filter?

The chemotherapy dispensing pin with a hydrophobic filter is used to prevent contamination when transferring drugs or diluents. The filter helps to avoid particle contamination, ensuring the solution remains sterile and safe to handle.

Why is it important to disinfect the rubber stopper of a vial before withdrawing a solution?

Disinfecting the rubber stopper with alcohol for at least 30 seconds is crucial to prevent any external contaminants from entering the vial and potentially contaminating the drug or solution inside.

What should you check before withdrawing a solution from a vial containing an antineoplastic drug?

Before withdrawing the solution, ensure that the powder has completely dissolved and that the solution is free from foam or undissolved particles. This step is crucial for maintaining the safety and quality of the drug.

What precautions should be taken when withdrawing a solution using a syringe and dispensing pin?

When withdrawing a solution, keep the syringe and dispensing pin assembly at a 70° angle with the filter facing upwards. Be cautious not to push fluid back into the vial, as this could introduce contaminants or alter the drug composition.