Questions and Answers
What does USP 800 refer to?
Handling hazardous drugs in healthcare settings for safety and environmental protection.
What are hazardous drugs?
Carcinogenic, teratogenic, reproductive toxicity, organ toxicity, geotaxis.
What does NIOSH stand for?
National Institute for Occupational Safety and Health.
What is the full name of NIOSH list of antineoplastic and other hazardous drugs in healthcare settings?
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How are NIOSH drugs divided?
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Name some common drugs on the NIOSH list.
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Most pharmacies do not stock at least one of the medications on the NIOSH list.
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The NIOSH list is continuously updated.
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What are two ways to evaluate hazardous potential?
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Which of the following is NOT a route of unintentional entry of hazardous drugs into the body?
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What does 'receipt' refer to in hazardous drug handling?
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What does 'dispensing' mean in the context of hazardous drugs?
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What does 'compounding/manipulation' involve?
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What are some patient care activities that involve hazardous drugs?
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What are the potential hazards associated with hazardous drugs?
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What should facilities do regarding hazardous medications?
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What is considered low risk when dispensing hazardous drugs?
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What is the risk level associated with repeatedly counting, cutting, or crushing tablets?
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Which of the following is true about compounding IV products of hazardous drugs?
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What types of drugs must follow USP 800 regulations?
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What types of drugs do not have to follow USP 800 regulations?
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What are engineering controls in hazardous drug handling?
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What does CPEC stand for?
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What is the purpose of HEPA filtration?
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Which of the following is an example of sterile CPEC?
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What is an example of non-sterile CPEC?
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What does CSEC refer to?
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Study Notes
USP 800 Overview
- USP 800 regulates the safe handling of hazardous drugs (HD) in healthcare to ensure safety and environmental protection.
Hazardous Drugs
- Drugs classified as hazardous due to potential carcinogenic, teratogenic, reproductive, organ toxicity, or other harmful effects.
NIOSH List
- The National Institute for Occupational Safety and Health maintains a list of antineoplastic and other hazardous drugs used in healthcare settings.
NIOSH Drug Categories
- Drugs are divided into three groups:
- Antineoplastic drugs
- Non-antineoplastic drugs
- Drugs that pose reproductive risks
Common Hazardous Drugs
- Frequently found drugs on the NIOSH list include estrogens, clonazepam, phenytoin, and valproic acid, among others.
Pharmacy Practices
- Most pharmacies stock at least one medication from the NIOSH list, highlighting the prevalence of these drugs.
NIOSH List Updates
- The NIOSH list is not continuously updated, so facilities must routinely assess new hazardous drugs and their risks.
Evaluating Hazardous Potential
- Evaluate hazardous drugs by checking Safety Data Sheets (SDSs) and reviewing product labeling.
Routes of Unintentional Exposure
- Hazardous drugs can enter the body through:
- Dermal/mucosal absorption
- Inhalation
- Injection
- Ingestion
Contact Points for Hazardous Drugs
- Receipt of hazardous drugs may leave residues on containers, work surfaces, and floors.
- Dispensing activities can result in contact during tablet processing.
- Compounding or manipulation involves direct contact with hazardous drugs.
- Administration may involve IV setups or specialized aerosol procedures.
- Patient care activities include handling contaminated body fluids.
Spill Management
- Spills require effective management and disposal strategies to minimize exposure risks.
Drug Transport
- Healthcare settings must manage the transport of hazardous drugs carefully to prevent exposure.
Waste Disposal
- Safe collection and disposal of hazardous drug waste is critical for environmental safety.
Facility Responsibilities
- Each healthcare facility must identify hazardous medications and establish procedures for safe handling.
Risk Levels by Activity
- Dispensing a single, intact tablet or capsule is low risk (gloves recommended).
- Repeatedly counting, cutting, or crushing tablets increases risk, necessitating double gloves, gowns, and respiratory protection.
- Compounding IV hazardous drugs is very high risk and requires rigorous controls including double gloves and containment devices.
USP 800 Compliance
- Only hazardous drugs that are active ingredients in compounding or require manipulation are subject to USP 800.
- Final dosage forms that only require counting or repackaging do not need to follow USP 800.
Engineering Controls
- Containment Primary (CPEC) and Secondary (CSEC) Engineering Controls are essential to protect staff from hazardous exposure.
CPEC Definition and Function
- CPECs are ventilated devices designed to minimize worker and environmental exposure to hazardous drugs.
CSEC Definition
- CSEC is the designated room where CPECs are located, ensuring controlled environments for hazardous drug handling.
Supplemental Engineering Controls
- These provide additional protection, such as closed-system drug transfer devices, which minimize exposure during drug transfer.
HEPA Filtration
- High-Efficiency Particulate Air (HEPA) filters are crucial, capturing 99.97% of particles larger than 0.3 microns, creating sterile environments.
Sterile Compounding CPECs
- BSCs and CACIs are examples of CPECs for sterile compounding, ensuring protection against contamination.
Non-Sterile Compounding CPECs
- Examples include Containment Ventilated Enclosures (CVE) and Class I and II BSCs, providing protection for the compounder.
Importance of CSEC
- CSECs are necessary for containing CPECs and ensuring both sterile and non-sterile compounding safety.
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Description
Explore key concepts related to USP 800 and the safe handling of hazardous drugs in healthcare settings. This quiz covers definitions and important organizations like NIOSH relevant to hazardous drug management. Enhance your knowledge and ensure safety in healthcare environments.
