El Paso - Ambulatory Clinic Policy and Procedure

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Regulation Reference: El Paso - Ambulatory Clinic Policy and Procedure Title: Disposal of Expired Medications Policy Number: EP 3.5 Policy Statement: Effective Date: 8/1/2014 It is the policy of Texas Tech University Health Science Center El Paso (TTUHSC El Paso) to dispose of all expired, unwanted prescription drug medications in a manner that is in keeping with environmental protection and safety of any person who might potentially come into contact with disposed medications. Scope and Distribution: This policy pertains to all staff employed by TTUHSC El Paso and ambulatory clinics. Procedure: 1. Any unwanted, expired medications of any type will need to be set aside and characterized into the following groups. Liquids and Solids will be disposed of through SteriCycle. Medication classified as Hazardous will need to be disposed of though a hazardous chemical disposal hauler and Controlled Substance medication will be disposed of through and authorized controlled substance hauler. (see attached drug disposal poster for examples) 1) Liquids includes but not limited to, cough syrup, ointments, partial vials vaccines, etc. 2) Solids includes but not limited to, pills, capsules with no liquid contents, powders, etc. 3) Hazardous includes but not limited to, inhales, aerosols cans, chemotherapy drugs, nitroglycerin products, epinephrine, Coumadin, etc. This type of medication is processed by a Chemical Transfer Disposal form, and will be treated as hazardous waste. 4) Controlled Substance Medications includes but not limited to, morphine, codeine, muscle relaxants, depressants, etc. This type of medication is processed by the Narcotics Disposal Form. 2. Medication that is ready to be disposed of needs to remain in the Clinic. You need to complete a prescription medication disposal form from Safety Services. The form can be found at http://www.ttuhsc.edu/admin/safety/forms/drugs.aspx. The medication disposal request form is only to be completed by Campus Clinics. The Department of Safety Services will be prompt once the request form is submitted and will pick up this waste from the department. (see attached sample copy) Page 1 of 10

3. Off-site Clinics must dispose using Stericycle disposal boxes. Off-site Clinics must arrange Stericycle pickup. Off-site Clinics do not need to complete the prescription drugs / medication disposal form. You will only need to complete the Hazardous Chemical Transfer form and the Controlled Substance Medication form when you have this type of waste. The forms can be located at this website: http://www.ttuhsc.edu/admin/safety/. Go to Service Request tab located at left side of page. 4. The medications will be disposed of appropriately and the department will be charged their portion of the disposal fee. 5. Departments are to conduct a medication assessment to identify those medications that are classified as hazardous drugs, and maintain an inventory list of these medications. (Attachment A) These typically include: cancer chemotherapy, antiviral drugs, hormone, some bioengineered drugs, and other miscellaneous drugs. NIOSH definition is drugs considered hazardous include those that exhibit one or more characteristics in humans or animals: Carcinogenicity Teratogenicity or other developmental toxicity Reproductive toxicity Organ toxicity at low doses Genotoxicity Structure and toxicity profiles of new drugs that mimic existing drugs determined hazardous by above criteria. 6. is a listing of major hazardous drugs generated by the American Society of Health Pharmacists (ASHP) and AHFS Drug Information. The list is not all-inclusive; departments should check the Safety Data Sheets (SDS) of each medication to evaluate the potential hazard of the drug and determine if it is hazardous or not. 7. Contact the Department of Safety Services if you have any questions or concerns. Page 2 of 10

Medication Inventory Is Waste Hazardous? Item # Product Name Substance Name Concentration CAS # Quantity Unit Hazard Class Location Date Received Date Expired Supplier Yes No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Attachment A Page 3 of 10

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Signature Sheet: Policy Number: EP 3.5 Original Approval Date: 3/1997 Version Number: 8 Effective Date: 8/2011 Signatory approval on file by: Michael J. Romano, M.D. Associate Dean for Clinical Affairs Clinic Operations Committee Chair, El Paso Texas Tech University Health Sciences Center El Paso Page 10 of 10