Developing guidelines for working with antineoplastic drugs

Implementation of a safety program for handling hazardous drugs in a community hospital

“…[1][2][3] Only in the past two decades have guidelines and recommendations been established for the safe handling of hazardous drugs by health care workers. One of the first articles addressing the safe handling of antineoplastics was published in 1981, 4 with subsequent articles further defining the risk of and additional practice standards for handling antineoplastic agents. 5 It was not until 1985 that practitioners were provided guidelines for the safe compounding and administration of hazardous drugs.…”

Guidelines for Handling Parenteral Antineoplastics

“…12 Methotrexate, mercaptopurine, and, possibly, alkylating agents are known to be fetotoxic. Alkylating agents (including nitrosoureas and procarbazine) have been implicated most often.…”

“…12 2. Contaminated needles and sy¬ ringes should be disposed of intact to prevent aerosol generation by clip¬ ping needles.…”

Evaluation of Drug Contamination Levels in an Admixture Preparation Area

“…Many of the antineoplastic agents are known to be mutagenic or carcinogenic in animals, and great concern has been expressed about the hazards for health care personnel handling these drugs (4-7). Several studies deal with the potential risks of air contamination in the handling of toxic substances (8)(9)(10)(11)(12). However, few attempts have been made to measure drug contamination levels in the admixture preparation area.…”