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What is the primary purpose of decontamination in the context of hazardous drug exposure?
What is the primary purpose of decontamination in the context of hazardous drug exposure?
What action should be taken after managing a spill of hazardous drugs?
What action should be taken after managing a spill of hazardous drugs?
Which of the following is an example of deactivation in handling hazardous drugs?
Which of the following is an example of deactivation in handling hazardous drugs?
Why is it important to manage glove contact time when dealing with hazardous substances?
Why is it important to manage glove contact time when dealing with hazardous substances?
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During which process would you place the inner glove under the sleeve of a gown?
During which process would you place the inner glove under the sleeve of a gown?
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When should an N95 mask be disposed of?
When should an N95 mask be disposed of?
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What is the correct disposal method for a chemotherapeutic gown?
What is the correct disposal method for a chemotherapeutic gown?
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What type of eye protection is recommended during cleaning and deactivating a biosafety cabinet?
What type of eye protection is recommended during cleaning and deactivating a biosafety cabinet?
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How often should a chemo gown be replaced according to NAPRA standards?
How often should a chemo gown be replaced according to NAPRA standards?
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What should be done with the shoe covers after leaving the cleanroom?
What should be done with the shoe covers after leaving the cleanroom?
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What personal protective equipment is required at all times in the cleanroom?
What personal protective equipment is required at all times in the cleanroom?
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What is the recommended action after a chemical spill?
What is the recommended action after a chemical spill?
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What is required when using a chemical cartridge respirator?
What is required when using a chemical cartridge respirator?
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Which of the following statements is true about glove usage during compounding?
Which of the following statements is true about glove usage during compounding?
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What should be considered when selecting shoes for the cleanroom?
What should be considered when selecting shoes for the cleanroom?
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What is the main route of exposure to hazardous drugs through the skin?
What is the main route of exposure to hazardous drugs through the skin?
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Which of the following practices can help prevent ingestion of hazardous drugs?
Which of the following practices can help prevent ingestion of hazardous drugs?
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What is a key component of a Safe Handling Program for hazardous drugs?
What is a key component of a Safe Handling Program for hazardous drugs?
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What is one critical requirement for rooms designated for hazardous drug preparation?
What is one critical requirement for rooms designated for hazardous drug preparation?
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Which piece of personal protective equipment is recommended for pharmacy staff handling hazardous drugs?
Which piece of personal protective equipment is recommended for pharmacy staff handling hazardous drugs?
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What does medical surveillance include for workers handling hazardous medications?
What does medical surveillance include for workers handling hazardous medications?
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How can the risk of injection exposure in a pharmacy be minimized?
How can the risk of injection exposure in a pharmacy be minimized?
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What is a recommended practice to mitigate inhalation exposure in a healthcare setting?
What is a recommended practice to mitigate inhalation exposure in a healthcare setting?
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Which of the following processes is crucial in managing contaminated waste?
Which of the following processes is crucial in managing contaminated waste?
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What is emphasized in USP standards for handling hazardous drugs in healthcare settings?
What is emphasized in USP standards for handling hazardous drugs in healthcare settings?
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What must be available in an area where hazardous drugs are stored, prepared, and administered?
What must be available in an area where hazardous drugs are stored, prepared, and administered?
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What is a requirement for transporting hazardous products?
What is a requirement for transporting hazardous products?
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Which item is NOT typically included in a spill kit for hazardous drugs?
Which item is NOT typically included in a spill kit for hazardous drugs?
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What is an essential component of a quality control program related to hazardous drugs?
What is an essential component of a quality control program related to hazardous drugs?
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Which statement is true regarding spill management procedures?
Which statement is true regarding spill management procedures?
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What must happen if a spill occurs involving hazardous drugs?
What must happen if a spill occurs involving hazardous drugs?
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Which practice is essential for personnel safety when handling hazardous drugs?
Which practice is essential for personnel safety when handling hazardous drugs?
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What type of container is recommended for transporting hazardous materials?
What type of container is recommended for transporting hazardous materials?
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What is the purpose of using sterile 70% isopropyl alcohol wipes in hazardous drug preparation?
What is the purpose of using sterile 70% isopropyl alcohol wipes in hazardous drug preparation?
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What is a characteristic of a Class II, Type B Biological Safety Cabinet?
What is a characteristic of a Class II, Type B Biological Safety Cabinet?
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Which statement about air pressure in the cleanroom is true?
Which statement about air pressure in the cleanroom is true?
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How often should equipment for preparing sterile hazardous drugs be cleaned?
How often should equipment for preparing sterile hazardous drugs be cleaned?
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What is the maximum volume that can be withdrawn from a syringe during preparation?
What is the maximum volume that can be withdrawn from a syringe during preparation?
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What should be done with any excess drug from an ampoule?
What should be done with any excess drug from an ampoule?
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What is the main function of a pass-through window in a hazardous drug preparation area?
What is the main function of a pass-through window in a hazardous drug preparation area?
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How should leftover hazardous drug in an ampoule be managed?
How should leftover hazardous drug in an ampoule be managed?
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What is the role of alarms in the facilities for preparation of sterile hazardous products?
What is the role of alarms in the facilities for preparation of sterile hazardous products?
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What does the term 'negative pressure' refer to in hazardous drug compounding facilities?
What does the term 'negative pressure' refer to in hazardous drug compounding facilities?
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What is the first step to take when managing a chemo spill?
What is the first step to take when managing a chemo spill?
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Where are spill kits not located?
Where are spill kits not located?
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What should you do if you cannot manage the spill yourself?
What should you do if you cannot manage the spill yourself?
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What is the correct order for donning PPE for a spill?
What is the correct order for donning PPE for a spill?
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What method should be used for cleaning a liquid spill?
What method should be used for cleaning a liquid spill?
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What should be done after the spill has been cleaned?
What should be done after the spill has been cleaned?
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What is the purpose of using water soaked spill towels for powder spills?
What is the purpose of using water soaked spill towels for powder spills?
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Which type of waste bag should be used for disposal of materials used in cleaning a hazardous spill?
Which type of waste bag should be used for disposal of materials used in cleaning a hazardous spill?
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What step should be taken before removing your PPE?
What step should be taken before removing your PPE?
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Which of these is NOT a recommended way to clean reusable PPE?
Which of these is NOT a recommended way to clean reusable PPE?
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Study Notes
Hazardous Drugs: Preparation and Handling
- Hazardous drugs include chemicals, cancer drugs, biologic agents, antiviral agents, hormones, immunosuppressants, toxic agents, and irritants.
- Hazardous drugs exhibit characteristics like carcinogenicity, teratogenicity, reproductive toxicity, organ toxicity at low doses, and genotoxicity in humans or animals.
- Cytotoxic drugs are hazardous and affect living cells but not all hazardous drugs are cytotoxic.
- All hazardous drugs must be prepared in a Class 2 biological safety cabinet by trained personnel.
Who is at Risk for Exposure?
- Healthcare professionals (physicians, nurses, pharmacy staff) are at risk.
- Delivery personnel (porters, drivers, inventory personnel) may also be exposed.
- Housekeeping staff, family members, and friends might be exposed.
When Can Exposure Occur?
- Exposure can happen during receiving inventory (from suppliers or manufacturers), doses delivered to patient care areas, storage of hazardous products, preparation, administration of chemotherapy, clean-up of hazardous spills or contaminated patient waste.
Routes of Exposure
- Skin absorption: Direct contact with contaminated surfaces or materials.
- Ingestion: Eating contaminated food or putting contaminated objects in the mouth.
- Injection: Accidental needle stick injury from contaminated needles/objects.
- Inhalation: Breathing in contaminated particles or aerosols from the environment.
Protection from Hazardous Drugs
- General Considerations: Conduct regular training and equipment audits to evaluate daily operations and handling practices.
- Workplace Evaluation: Assess equipment, physical layout, drug types, and volumes. Include decontamination procedures and waste management.
- Safe Handling Program: Establish policies for identifying hazardous drugs, labelling, and personnel training.
Personal Protective Equipment (PPE)
- Specific PPE requirements for various tasks are listed.
- PPE includes N95 masks, chemical cartridge respirators, gowns, eye protection, gloves, and shoe covers.
- PPE should be worn according to specific procedures, including times, locations, and methods of removal.
- Disposal methods for contaminated PPE are specified.
Decontamination and Deactivation
- Decontamination involves transferring hazardous drug contaminants to disposable surfaces (like wipes).
- Deactivation involves treating hazardous drugs to reduce their hazard level.
- Examples of solutions for deactivation are sterile 70% isopropyl alcohol and accelerated hydrogen peroxide.
Facilities for Preparation of Sterile Hazardous Products
- Separate areas for sterile hazardous product compounding.
- Adequate air changes per hour (ACPH) with negative pressure relative to surrounding areas.
- Air and ventilation controls to prevent cross-contamination.
- Pass-through windows and alarms for monitoring air pressure changes
Equipment for Preparing Sterile Hazardous Drugs (C-PEC)
- Class II Type B biological safety cabinets with specific design features.
- ISO class 5 cleanroom environment with dedicated use.
- Vertical HEPA filtered air flow, external venting, and frequent cleaning/deactivation methods.
Chemotherapy
- Chemotherapy drugs can be referred to as anti-neoplastic agents, cytotoxic agents, or cancer chemotherapy agents.
- Chemotherapy can be a combination of one or more cytotoxic agents designed to treat particular cancers.
- Protocols may include medication for side effects (nausea, analgesics), hydration (IV fluids), and electrolytes.
Hazardous Spill Management
- Policies and procedures for spill prevention, response, and cleanup are required.
- Spill kits must include designated items, warnings, worker training, provisions for contaminated medical assistance, and a procedure for proper disposal.
- Cleanup methods are described (e.g., for liquid and powder spills), including the correct use of absorbent pads, wipes, and cleaning solutions.
- There's a procedure for removing contaminated PPE and cleaning equipment/areas.
Quality Control Programs
- Quality control programs involve personnel training, equipment maintenance, environmental monitoring, and checks on product stability and disposal.
Cancer
- Cancer is abnormal and uncontrolled cell growth that spreads via the blood and lymphatic systems.
- Various types of cancer exist, each affecting different organs or cell types.
Cancer Treatments
- Cancer treatments aim to kill, shrink, or slow malignant tumor growth.
- Treatments may include surgery, radiation therapy, chemotherapy, or combinations.
Pharmacologic Classifications of Cancer Drugs
- Specific drugs are classified as alkylating agents, antibiotics, plant extracts, and anti-metabolites.
- Examples of drug classifications are shown, with their specific components (cisplatin, carboplatin, cyclophosphamide, etc).
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Description
This quiz covers the essential information regarding hazardous drugs, including their characteristics, risks associated with exposure, and guidelines for safe preparation. It highlights the importance of safety protocols for healthcare professionals and others who may be at risk. Test your knowledge on how to handle these substances safely.
