Preparations That Require Special Consideration

Certain pharmaceutical preparations require special precautions in their preparation to minimize product contamination or environmental hazards. The following information may serve as a helpful guideline for a few of these classes of drugs.

Parenteral Nutrition Solutions

Because of their high risk for bacterial growth and their vast potential for drug incompatibilities, these products require special attention. Strict adherence to aseptic technique and frequent sterility testing are essential. Whenever feasible, it is desirable to maintain a separate hood for nutrition solutions to avoid cross contamination with other medicinal agents.

Cytotoxic Agents (Cancer Chemotherapy Agents)

hese agents present an environmental hazard. It is now known that prolonged exposure to these agents may lead to the development of cancers. For this reason special precautions must be taken to minimize the exposure of pharmacy personnel to these agents. These agents should be prepared in a shielded vertical flow hood, so that materials are not blown into the operators face. When possible it is best to have the responsibility for preparing these agents rotated among pharmacy personnel to minimize any one individual's exposure. It is desirable that pregnant women be exempted from preparation of these agents.

Radiopharmaceuticals

These agents also represent an environmental hazard and must be handled carefully. In addition to adhering to the guidelines set forth for cytotoxic agents, one may further reduce his exposure to these agents by working with them in protective lead vial shields. Special storage and disposal of these agents is required.

Antibiotics

Due to the allerginicity of the penicillins, it is desirable to work with them in a shielded vertical flow hood to avoid environmental contamination. When working with any of the antibiotics, it is important to remember that prolonged exposure may lead to infections of exposed areas by nonsusceptible bacteria and fungi. It is recommended that anyone who must prepare large numbers of antibiotic doses wash their hands frequently to avoid infections of the hands and nail beds.