Approved Hospital Formulary
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Approved Hospital Formulary
3/17/25 Haz-Med Clarifcations
March 17, 2025
UPDATE
This chart summarizes the drugs that were previously considered hazardous (Table 2) but have now been upgraded to Table 1 status. Table 1 now contains a mixture of antineoplastic (chemo) drugs and non-antineoplastic drugs.
A drug qualifies for Table 1 status if it is known to be carcinogenic or if the manufacturer outlined safe handling instructions in the package insert.
Ganciclovir, mycophenolate, and dexrazoxane for example, all have safe handling instructions.
We will continue to prepare these in the chemo room as we did before and use our protective Phaseal devices.
We have purchased new yellow, orange and pink stickers that have removed the words 'antineoplastic' and 'non antineoplastic'.
Our yellow bags still indicate 'chemotherapy' which might lead to confusion if we send a non-chemo med in that bag.
Please label the drugs listed below with a yellow hazardous sticker and transport in a 'hazardous' zip lock bag.
All Table 1 chemo drugs will still be transported in a yellow chemo bag.
All drugs have been recategorized in Rhazdrugs, PK, Cerner and FormWeb.
These changes are especially impactful on nursing. Oncology nurses are well trained in the administration of chemo agents using Phaseal. Nurses on other units are not as familiar.
Nurse educators are in the process of retraining non-oncology nurses on the administration of hazardous drugs.
Should a nurse call you and question, this is the position of nursing leadership:
Table 1 drugs that are not antineoplastic agents can be administered by a regular staff nurse.
Table 1 drugs that are Table 1 antineoplastic (chemo) agents will be handled by an oncology nurse.
If a nurse is uncomfortable with using the Phaseal device, they can contact an oncology nurse for assistance. We will continue to send our documents and instruction sheets along with preparations which nursing says is very helpful.
Please continue to ask questions and share feedback. This is a confusing change for all.
Thanks,
Donna Huggins, RPh.
Manager - Pharmacy Sterile Products
Huntsville Hospital
Office - 256-265-6293
Cell - 662-871-2513
donna.huggins@hhsys.org
Manager - Pharmacy Sterile Products
Huntsville Hospital
Office - 256-265-6293
Cell - 662-871-2513
donna.huggins@hhsys.org