Prevention of the exposure by cyclophosphamide oral tablet

Abstract

BackgroundUnintended exposure to antitumor agents from an oral medicine may place healthcare workers and patients taking medicine at risk. In this study, the exposure to blister pack by CP (cyclophosphamide) and appropriate preventive procedures were examined.FindingsCP detected inside the blister pack of the tested seven lots by LC-MS/MS ranged from 8.2 to 199.6 ng. Raman imaging clearly showed that CP ingredient was completely covered by the tablet coating layer and had not leached out of the tablet. In addition, the amount of CP detected inside the vials was suppressed under the lower detection limit until day 28, and only 6.0 ng was detected only at day 56.ConclusionsVarious amounts of CP were contaminated to not only the inside of the blister pack but also the outside. This contamination may be caused not only by the manufacturing environment but also by the CP oral tablets themselves through volatilization of CP. Refrigerated storage of CP oral tablets may protect healthcare workers and patients from contact with CP.Electronic supplementary materialThe online version of this article (doi:10.1186/s40780-015-0020-9) contains supplementary material, which is available to authorized users.

Engineering controls in veterinary oncology: A survey of 148 ACVIM board‐certified oncologists and environmental surveillance in 20 specialty hospitals

“…Exposure to oral HD can occur through contact with contaminated packaging, compounding, counting and repackaging medications, opening capsules, splitting tablets, handling or accidental breaking of capsules or tablets during administration, disposal of contaminated waste, and contact with objects touched with contaminated Personal Protective Equipment (PPE) . In veterinary medicine, risk of exposure during administration may be increased with patients unwilling to consume the drug or resistant to oral administration.…”

Risk of exposure of patients’ family members to lenalidomide at home

“…For oral HDs, such as cyclophosphamide or 5-fluorouracil tablets, the risk of exposure to HDs was evaluated by analysing the amount of drugs on the surfaces of the blister packages, and the amount of HDs that may be inadvertently ingested by caregivers during drug administration using feeding tubes 10–12. In a study of injectable anticancer drugs, Böhlandt et al reported that drugs were dispersed via sweat, saliva, and excrement in the homes of patients treated with anticancer drugs 13.…”

Chemotherapy: some potential risks under antineoplastic drugs handling

“…Капсулированные и покрытые оболочкой препараты представляют меньший риск, однако в случае нарушения оболочки капсулы или разрушения таблетки высока вероятность загрязнения рабочих поверхностей препаратом и поступления его в больничную среду. Цитостатиками может быть за-грязнена наружная поверхность флакона (например, от 0,5 нг до 2,4 мкг на флакон 5-фторурацила), внут-ренняя поверхность упаковки-блистера, при вскрытии которого препарат поступает в зону дыхания работни-ка [6,11,12].…”