Safe Handling of Oral Chemotherapy and targeted Agents. ภญ.อภ รมย เหล าเจร ญเก ยรต ฝ ายเภส ชกรรม โรงพยาบาลศ ร ราช
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1 Safe Handling of Oral Chemotherapy and targeted Agents. ภญ.อภ รมย เหล าเจร ญเก ยรต ฝ ายเภส ชกรรม โรงพยาบาลศ ร ราช
2 Chemotherapy Agent. Low therapeutic index. -Increase risk for medication error. Hazardous drug. -At risk for environment exposure.
3 Hazardous Drug : The American Society of Health- System Pharmacist defined a hazardous drug as any agent that carried the potential to cause cancer,developmental or reproductive toxicity or harm to organs in animal or human studies.
4 Hazardous Drug. Hazardous Drugs include a variety of agents such as cancer chemotherapy,antiviral drugs, hormones. The definition may not accurately reflect the hazardous risks of more-recent agents.
5 Hazardous Drug. 2004: The National institute for Occupational Safety and Health (OSHA) revised the definition of hazardous drug.
6 Hazardous Drug. Any drug that exhibits one or more of the following characteristics in human and animal. Carcinogenicity. Mutagenicity,Genotoxicity. Teratogenicity or other developmental toxicity. Reproductive toxicity. Organs toxicity at low doses.
7 Potential for Exposure to Hazardous Drugs. Exposure to hazardous agents can occur during Preparation. Administration. Disposal.
8 Route of Exposue. Inhalation. Skin contact or absorption. Ingestion.
9 Activities That May Result in Exposure to Hazardous Drugs Counting out individual, uncoated oral doses and tablets from multidose bottles. Unit-dosing uncoated tablets in a unit dose machine. Crushing. Contact drug containers,counting trays,work surface.
10 Activities That May Result in Exposure to Hazardous Drugs. Handling contaminated wastes. Generated at any stage of drug preparation. Unused hazardous drugs. Drug- contaminated wastes.(bottles) Cleaning drug-preparation area. Transporting Removing or disposing of personal protective equipment after handling of hazardous drugs or waste.
11 Safety Considerations and Safe Handling of Oral Chemotherapy Agents. Oral Chemotherapy Agents can be administered in many nontraditional settings,including patient s home,nursing home. ( Experienced oncology nursing staffs are not available.) Currently,no standardized national guideline for the safe handling of oral chemotherapy Agents.
12 Safety Considerations and Safe Handling of Oral Chemotherapy Agents. Policies and procedures to reduce risk among all personnel involved in oral chemotherapy treatment is essential. Education about oral chemotherapy administration and patient management is essential.
13 Policy for Safe Handling of Oral Chemotherapy Agents. Identification of chemotherapy agents. Provide list of drugs. (update annually) Provide list of drugs that are handled only by trained personnel. Safety in the work area.
14 Policy for Safe Handling of Oral Chemotherapy Agents. Safe Handling Prepare oral agent in pharmacy or designated area. Manipulation of tablet and capsule should be done by trained personnel in Bio-Safety Cabinet. PPE :Double gloves, Gown,Eye protection.(goggle)
15 Policy for Safe Handling of Oral Chemotherapy Agents. Safe Handling(con t) Use separate counting tray,clean it after use while wearing PPE. Wash hand before putting glove on and after removing gloves.
16 Policy for Safe Handling of Oral Chemotherapy Agents. Safe administration. Wear gloves when administering. Wash hand before putting glove on and after removing gloves. Wear gown when administering liquid oral agent.
17 Policy for Safe Handling of Oral Chemotherapy Agents. Safe administration. Tablet are tipped from container directly to disposable cup. Dispose of empty oral chemotherapy container and unused oral cytotoxic agent in chemotherapy Disposal container.
18 Policy for Safe Handling of Oral Chemotherapy Agents. Patient must receive the correct doses of medication at the correct times for the correct amounts of time. Medication must be prepared and administered correctly. Patients, staff and families must know how to identify and manage side effect.
19 Policy for Safe Handling of Oral Chemotherapy Agents. Safe and appropriate storage. Store securely and out of reach of children. Maintain storage in original container. Do not keep outdated or unused medication. Waste and spill management.
20 Policy for Safe Handling of Oral Chemotherapy Agents Accidental overdose / Wrong person. Contact physician. Go to nearest emergency department. Call poison control center.
21 Handling targeted drugs Hazardous drug. (?) Example : Trastuzumab. Aseptic technique. Waste disposal.
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