ON3 Aseptics/Chemo Hazards

[blank_start]Sterile[blank_end] means free from all microbiological contaminants i.e. living organisms, particles, and pyrogens. [blank_start]Aseptic[blank_end] means produced from sterile components in a sterile environment – however it does NOT guarantee sterility. Pharmacists generally work in [blank_start]aseptic[blank_end] conditions with [blank_start]sterile[blank_end] starting materials to prepare aseptic products.

Contamination/L • Viable ([blank_start]live[blank_end]): Bacteria, fungi, and viruses. Administration of viable material could result in fever; infection; septicemia; multi-organ failure; death. • Non-viable: [blank_start]Undissolved[blank_end] particulate matter e.g. plastic or rubber material, glass shards, and chemical precipitates. Non-viable material may [blank_start]occlude[blank_end] vessels e.g. if >12 μm they may become trapped in the lungs leading to respiratory failure and death.

What is laminar flow air?

Clean air eg a [blank_start]particle[blank_end]-free working environment, is made by drawing laminar air into the [blank_start]cabinet[blank_end], through the [blank_start]filtration[blank_end] system. • HEPA-filtered air ([blank_start]high-efficiency particulate air[blank_end] filter) • High airflow, [blank_start]constantly[blank_end] filtered and replenished

In horizontal air flow the product is protected but the operator is not. Vertical air flow protects both the product and operator.

Choose the incorrect statement.

Critical Points on a Syringe: Any ‘connection’ point: • Tip of [blank_start]needle[blank_end] • Hub of needle & tip of filter • Hub of filter & tip of syringe • Syringe [blank_start]plunger[blank_end]

Pharmacist involvement: • [blank_start]Preparation[blank_end] of cytotoxics – Preserve safety of self and product • [blank_start]Dispensing[blank_end] of cytotoxics – Calculations – Precise and accurate [blank_start]instructions[blank_end] must be given • Advising nursing staff how to administer cytotoxic products • Providing medicines information and advice

Administration of any IV medicine carries a risk of extravasation ([blank_start]leakage[blank_end] from vein into tissue). This is NOT a side effect. Regarding extravasation: • Common term is “tissued” • Can result in pain, swelling, and [blank_start]damage[blank_end] at the injection site • If the drug is a [blank_start]vesicant[blank_end] (causes blistering) it can cause severe tissue damage and necrosis (and can continue for months after injury) • Oncology nurses take [blank_start]extreme[blank_end] care to ensure extravasation does not occur • Patients must be educated to report any discomfort and/or pain [blank_start]during[blank_end] administration

Central lines (catheters for administration) • Via jugular or subclavian [blank_start]vein[blank_end] with tip at superior vena cava (e.g. Hickman port, double/single lumen). • PICC (peripherally-inserted central catheter), starts at the [blank_start]arm[blank_end] and is placed centrally

Cytotoxic drugs are potentially lethal especially if delivered via the [blank_start]wrong[blank_end] route. • Dose varies [blank_start]greatly[blank_end] between intramuscular (IM), intravenous (IV), and intrathecal (IT – the space that holds the [blank_start]CSF[blank_end]) routes • The formulation may vary between routes eg [blank_start]Methotrexate[blank_end] is often given intrathecally, but [blank_start]vincristine[blank_end] is fatal by this route