• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: do not crush tablet
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: malignant tumors observed in male/female mice/rats; genotoxic in in vivo micronucleus tests
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
anastrozole (Arimidex) PO [UD ⇒ UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: do not crush tablet
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
carBAMazepine (Carbatrol, TEGretol) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove and gown
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repacking area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for aplastic anemia, congenital malformations in offspring of mothers who took drug, rapid trans placental passage
Reason for exemption of USP<800> Containment Requirements: Minimal manipulation for dispensing. Does not require additional manipulation for administering. Risk associated when ingested.
cidofovir (Vistide) IV [n/a]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove s, gown , CSTD
• Receiving from Distributor: Standard
• Pharmacy Storage Area: IV CSTD Area
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Double Bag; single CX glove s
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
Reason for exemption of USP<800> Containment Requirements: NIOSH recommends PPE + CSTD for preparation. PPE + CSTD required for administration. Pregnancy Category C. MSHG recommends following NIOSH. Also notes, if cidofovir contacts the skin, wash membranes and flush thoroughly with water. Risks are related to systemic absorption.
clonazePAM (KlonoPIN) PO [Bulk ⇒ Packager]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: CSM
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: minimal
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- Rx Destroyer , packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Increased risk of congenital abnormalities when taken in first trimester
Reason for exemption of USP<800> Containment Requirements: Minimal manipulation for dispensing. Does not require additional manipulation for administering.
colchicine (Colcrys, Mitigare) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: published animal reproduction and development studies indicate it causes embryo-fetal toxicity, teratogenicity and altered postnatal development at exposures within or above the clinical therapeutic range
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
cycloSPORINE (Gengraf, Neoral, SandIMMUNE) PO [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single pair of CX approved gloves; Wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: do not open capsule
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: IARC Group 1 carcinogen; NTP
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX glove s, gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: Do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: yellow bin
• Spill management: n/a
NIOSH Supplemental Information: Hazardous only for women in late pregnancy
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
dronedarone (Multaq) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: Do not handle while pregnant or trying to get pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Teratogenic in laboratory studies at1/2 MRHD
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
dutasteride (Avodart) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration:
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Women warned not to handle
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Handling/preparation PPE Requirements: Double CX glove s, gown
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: do not crush tablet
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Does not require additional manipulation for administration; will comply with USP 800 recommendation for preparation
esterified estrogens and methyltestostorone (Estratest HS) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: CSM
• Packaging/Reconstitution Location: Repacking area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- Rx Destroyer , packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
estradiol (Estrace) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for malignant neoplasms; increased risk of endometrial, ovarian and breast cancer; in laboratory studies, increased frequency of carcinomas of breast, uterus, cervix, vagina, testis, and liver; present in breast milk
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for malignant neoplasms; increased risk of endometrial, ovarian and breast cancer; in laboratory studies, increased frequency of carcinomas of breast, uterus, cervix, vagina, testis, and liver; present in breast milk
estradiol (Estrace, Estragyn) Topical Gel / Cream [Bulk ⇒ Bulk]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX glove s
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for malignant neoplasms; increased risk of endometrial, ovarian and breast cancer; in laboratory studies, increased frequency of carcinomas of breast, uterus, cervix, vagina, testis, and liver; present in breast milk
estrogens, conjugated (Premarin) IV [n/a]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove , gown and CSTD
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Refrigerator
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Double Bag; single CX glove s
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX glove s and gown ; Use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace/packaging- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
NIOSH Supplemental Information: BBW for malignant neoplasms; increased risk of endometrial, ovarian and breast cancer; in laboratory studies, increased frequency of carcinomas of breast, uterus, cervix, vagina, testis, and liver; present in breast milk
Reason for exemption of USP<800> Containment Requirements: NIOSH recommends PPE + CSTD for preparation. PPE + CTSD requires for administration. Pregnancy Category X. Risks are related to systemic absorption.
estrogens, conjugated (Cenestin, Enjuvia, Premarin) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: yellow bin
• Spill management: n/a
NIOSH Supplemental Information: BBW for malignant neoplasms; increased risk of endometrial, ovarian and breast cancer; in laboratory studies, increased frequency of carcinomas of breast, uterus, cervix, vagina, testis, and liver; present in breast milk
estrogens, esterified (Menest) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX glove s and gown ; Use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for malignant neoplasms; increased risk of endometrial, ovarian and breast cancer; in laboratory studies, increased frequency of carcinomas of breast, uterus, cervix, vagina, testis, and liver; present in breast milk
exemestane (Aromasin) PO [Bulk ⇒ Blister UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Double CX glove s, gown
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: do not crush tablet
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Does not require additional manipulation for administration; will comply with USP 800 recommendation for preparation
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: Do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Women should not handle crushed or broken finasteride tablets when they are pregnant or maybecome pregnant, due to potential risks to a male fetus
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
fluconazole (Diflucan) IV [n/a]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
NIOSH Supplemental Information: case reports describe congenital abnormalies in infants exposed in utero to maternal fluconazole (400-800mg/d) during most or all of the 1st trimester, similar to those seen in animal studies
Reason for exemption of USP<800> Containment Requirements: Preg Category C. Risks are related to systemic absorption. For skin contact, remove contaminated clothing, flush area with large amounts of water and soap.
fluconazole (Diflucan) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: do not open capsule
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: case reports describe congenital abnormalies in infants exposed in utero to maternal fluconazole (400-800mg/d) during most or all of the 1st trimester, similar to those seen in animal studies
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
fosphenytoin (Cerebyx) IV [n/a]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove , gown , and CSTD
• Receiving from Distributor: Standard
• Pharmacy Storage Area: IV CSTD Area
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: moderate
• Handling/administration PPE Requirements: Single CX glove , gown , use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Omnicell
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin Trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
NIOSH Supplemental Information: IARC Group 1 carcinogen; NTP
Reason for exemption of USP<800> Containment Requirements: Preg Category D. No NIOSH requirements but is highest Group for carcinogen to humans; likely only by systemic absorption. For skin contact, remove contaminated clothing, flush area with large amounts of water and soap.
• Compounding (Non-Sterile/Sterile) Location: Ideal: Negative pressure room- CACI Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Transport container, single CX glove s
Nursing: Storage / Admin.
Exposure Risk: medium
• Handling/administration PPE Requirements: Double CX glove s, gown , use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
NIOSH Supplemental Information: in animal studies - carcinogenic, tetratogenic and caused aspermatogenesis; mfg instructions - handle according to guidelines issued for antineoplastic drugs
Reason for exemption of USP<800> Containment Requirements: Preg Category C. Avoid direct contact of the skin or mucous membranes with CYTOVENE-IV solutions. If such contact occurs, wash thoroughly with soap and water; rinse eyes thoroughly with plain water.
ganciclovir (Zirgan) OPTH [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX glove s and gown
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
NIOSH Supplemental Information: special warning on handling bottles and capsules
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Handling/preparation PPE Requirements: do not handle while pregnant; single CX glove s
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repacking area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Teratogenic in lab studies at 1/10 human dose,marked postnata lsurvival at 1/100 HD; severe liver injury reportedin patients; carcinogenicity observed at doses below HD
Reason for exemption of USP<800> Containment Requirements: Minimal manipulation for dispensing. Does not require additional manipulation for administering.
letrozole (Femara) PO [UD ⇒ UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: do not crush tablet
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
medroxyPROGESTERone (Provera) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repacking area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Minimal manipulation for dispensing. Does not require additional manipulation for administering.
medroxyPROGESTERone (Depo-Provera) IM [Vial ⇒ Vial]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX glove s, gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace/packaging- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form for dispensing, product is drawn up by nursing on unit, proper protections in place for administration
megestrol (Megace) PO [UD ⇒ UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Tablet crushed via RxCrush. Soln to be drawn up by nursing at bedside
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
NIOSH Supplemental Information: Nursing should be discontinued if megestrol is required. Women at risk of pregnancy should avoid exposure
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
mercaptopurine (Purintehol, Purixan) PO [Bulk ⇒ Blister UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Double CX glove s, gown
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Does not require additional manipulation for administration; will comply with USP 800 recommendation for preparation
methIMAzole (Tapazole) PO [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: appears in human breast milk
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
methotrexate (Otrexup, Rasuvo, Rheumatrex, Trexall, Xatmep) PO [UD ⇒ UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: do not crush tablet
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
Methotrexate (Trexall) IM [Vial ⇒ ]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: moderate
• Handling/preparation PPE Requirements: Single CX glove , gown , and CSTD (as dosage form allows)
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous, Chemo zip locking bag
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Double bag Single CX glove s
Nursing: Storage / Admin.
Exposure Risk: moderate
• Handling/administration PPE Requirements: Double CX glove , gown
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: 1 vial per syringe - label accordingly
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin Trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Wear CX glove s; items used to clean up spill should be placed in a sealed bag and put in yellow bin
Reason for exemption of USP<800> Containment Requirements: The act of drawing up an IM dose of methotrexate and giving it immediately is considered administration.
methylergonovine (Methergine) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
methylergonovine (Methergine) IM [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Refrigerator
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: medium
• Handling/administration PPE Requirements: Double CX glove s, gown
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: Use Negative Pressue Technique when pulling up dose
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: yellow bin
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
Reason for exemption of USP<800> Containment Requirements: Following USP 800 recommendations
miSOPROStol (Cytotec) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: if tablet is split must add PPE of gown and mask
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. May cause infertility. May cause harm to unborn child.
mitoMYcin (Mitosol) OPTH [UD ⇒ UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Chemo
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Transport container, single CX glove s
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Double CX glove s and gown
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration:
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
mycophenolate mofetil (Cellcept) PO [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: do not handle while pregnant; single CX glove s
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: do not open capsule, do not handle while pregnant
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: do not open capsule, do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for embry of fetal toxicity,malignancies,and serious infections,increased risk of first-trimester pregnancy loss and increased risk of congenital malformations; Special Warning: Tablets should not be crushed and capsules should not be opened or crushed. Avoid inhalation or directcontact with skin or mucous membranse of the powder contained in capsules and oral suspension. If such contact occurs,wash thoroughly with soap and water, rinse eyes with plain water
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
mycophenolic acid (Myfortic) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repackaging area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for first trimester pregnancy loss and increased risk of congenital malformations, BBW for lymphomas and other malignancies; genotoxic in vitro and in vivo
Reason for exemption of USP<800> Containment Requirements: Minimal manipulation for dispensing. Does not require additional manipulation for administering.
OXcarbazepine (Oxtellar XR, Trileptal) PO [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Tumors observed in lab studies at 1/10 MRHD
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
oxytocin (Pitocin) IV [n/a]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove s, gown
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
NIOSH Supplemental Information: Harzardous only of women in 3rd trimester
• Handling/preparation PPE Requirements: Single CX glove , gown and CSTD . Do not prepare if pregnant.
• Receiving from Distributor: Standard
• Pharmacy Storage Area: IV area
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: medium
• Handling/administration PPE Requirements: Single CX glove s, gown
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: Do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
NIOSH Supplemental Information: Embryo-fetal toxicities at doses below recommended human doses
Reason for exemption of USP<800> Containment Requirements: Preg Category D. Impervious gloves and gown are recommended in MSDS.
PARoxetine (Paxil) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: do not crush tablet
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Increased risk of congenital abnormalities when taken in first trimester; complications in pregnancy when taken in 3rd trimester
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
phenytoin (Dilantin) IV [n/a]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove , gown , and CSTD
• Receiving from Distributor: Standard
• Pharmacy Storage Area: IV CSTD Area
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Double bag, single CX glove s
Nursing: Storage / Admin.
Exposure Risk: medium
• Handling/administration PPE Requirements: Single CX glove , gown , use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
NIOSH Supplemental Information: IARC Group 1 carcinogen; NTP
Reason for exemption of USP<800> Containment Requirements: Preg Category D. No NIOSH requirements but is highest Group for carcinogen to humans; likely only by systemic absorption. For skin contact, remove contaminated clothing, flush area with large amounts of water and soap.
phenytoin (Dilantin, Phenytek) PO [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace/packaging- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
NIOSH Supplemental Information: IARC Group 1 carcinogen; NTP
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
progesterone (Endometrin, Prometrium) PO [Bulk ⇒ Packager]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: Repackage area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Minimal manipulation for dispensing. Does not require additional manipulation for administering.
propylthiouracil (PTU) PO [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: IARC Group 2B; NTP***
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Abortion and developmental abnormalities seen at low doses in lab studies, evidence of tumors at low doses
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for tumorogenicity in lab studies
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Increased risk of lymphomas and other malignancies; reproductive effectsseen in lab studiesbelowMRHD; excreted in breast milk
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
tamoxifen (Nolvadex, Soltamox) PO [UD ⇒ UD]
Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Designated area/ CX glove s
• Pharmacy Storage Area: Hazardous
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: Done in Pharmacy
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: n/a
NIOSH Supplemental Information: IARC Group 1 carcinogen; NTP***
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
temazepam (Restoril) PO [UD ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: CSM
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- Rx Destroyer , packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: increased risk of congenital malformationsassociated with treatment during 1st trimester
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
temazepam (Restoril) PO [Bulk ⇒ UD]
Non - Antineoplastic
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: Single CX glove s, wash hands after handling
• Receiving from Distributor: Standard
• Pharmacy Storage Area: CSM
• Packaging/Reconstitution Location: Repackage area
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- Rx Destroyer , packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: increased risk of congenital malformationsassociated with treatment during 1st trimester
Reason for exemption of USP<800> Containment Requirements: Minimal manipulation for dispensing. Does not require additional manipulation for administering.
testosterone (Depo-T) IM [n/a]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: CSM
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove s, gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- Rx Destroyer , packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
NIOSH Supplemental Information: Children should avoid contact with unwashed or unclothed application sites on skin
topiramate (Topamax) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
valproic acid (Depacon) IV [n/a]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: Single CX glove , gown , and CSTD
Do not prepare if pregnant.
• Receiving from Distributor: Standard
• Pharmacy Storage Area: IV CSTD Area
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Double bag, single CX glove s
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove , gown , use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
NIOSH Supplemental Information: BBW for teratogenicity; congenital malformations, including neural tube defects; teratogenic in muliple species
Reason for exemption of USP<800> Containment Requirements: Preg Category D. Risks are related to systemic absorption. Skin contact - wash immediately with soap and water.
valproic acid (Depakene, Depakote) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: BBW for teratogenicity; congenital malformations, including neural tube defects; teratogenic in muliple species
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Double bag, single CX glove s
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove , gown , use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Picked up from Pharmacy
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
Reason for exemption of USP<800> Containment Requirements: Preg Category D. Release to the environment should be minimized per MSDS.
voriconazole (Vfend) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Mouth - Single pair of CX approved gloves. Tube - double CX glove s and gown . Wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single pair of CX approved gloves Wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Developmental toxicity, including possible teratogenic effects at doses similar to human therapeutic doses; an increase in the number of pups borndead and a decrease in postnatal survival at less than MRHD
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
ziprasidone (Geodon) IM [n/a]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: low
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: Single CX glove , gown Wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: n/a
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: Wear CX glove s, items used to clean up spill should be placed in a sealed bag and put in blue bin
NIOSH Supplemental Information: Developmental toxicity, including possible teratogenic effects at doses similar to human therapeutic doses; an increase in the number of pups borndead and a decrease in postnatal survival at less than MRHD
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form for dispensing, product is drawn up by nursing on unit, proper protections in place for administration. Wash off immediately with plenty of water for at least 15 minutes. *This chemical is not considered hazardous by the 2012 OSHA Hazard Communication Standard (29 CFR 1910.1200)
zoledronic acid (Reclast - Ready to hang) IV [n/a]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimial
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: medium
• Handling/administration PPE Requirements: Single CX glove and gown
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: Do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
NIOSH Supplemental Information: Number of stillbirths increased and survival of neonates decreased in lab studies at low doses
Reason for exemption of USP<800> Containment Requirements: Preg Category D. For skin contact, remove contaminated clothing, flush area with large amounts of water and soap.
zoledronic acid (Zometa) IV [n/a]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: medium
• Handling/preparation PPE Requirements: Single CX glove and gown ; use of CSTD Do not prepare if pregnant.
• Receiving from Distributor: Standard
• Pharmacy Storage Area: IV Room
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: Ideal: Positive pressure room Required: Med Prep Area with Immediate Use Preparation standards
• Omnicell Load: No
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: medium
• Handling/administration PPE Requirements: Single CX glove , gown , use of CSTD
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer
• Signage on Patient Door Required: Yes
• Manipulation of Dosage Form: n/a
• Special Manipulation for Administration: Do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- black bin , trace- yellow bin
• Disposol of Used PPE: yellow bin
• Spill management: Manage like antineoplastic agents
NIOSH Supplemental Information: Number of stillbirths increased and survival of neonates decreased in lab studies at low doses
Reason for exemption of USP<800> Containment Requirements: Preg Category D. For skin contact, remove contaminated clothing, flush area with large amounts of water and soap.
zonisamide (Zonegran) PO [UD ⇒ UD]
Reproductive Risk
Pharmacy: Receiving / Storage / Preparation
Exposure Risk: minimal
• Handling/preparation PPE Requirements: n/a
• Receiving from Distributor: Standard
• Pharmacy Storage Area: Carousel
• Packaging/Reconstitution Location: n/a
• Compounding (Non-Sterile/Sterile) Location: n/a
• Omnicell Load: Yes
Transport
• Transport (dose is placed inside a plastic sealable bag): Standard
Nursing: Storage / Admin.
Exposure Risk: low
• Handling/administration PPE Requirements: PO- Single CX glove s, tube- double CX glove s and gown , wash hands after handling
• Storage of Finished dose in Nursing Area/Procedural Area: Patient Med Drawer, Omnicell
• Signage on Patient Door Required: No
• Manipulation of Dosage Form: Standard
• Special Manipulation for Administration: Do not handle while pregnant
Disposal / Spills
• Disposal of Drug Waste: Full- blue bin , trace/packaging- trash
• Disposol of Used PPE: trash bin (inside plastic bag)
• Spill management: n/a
NIOSH Supplemental Information: Teratogenic in multiple miscellaneous animal studies
Reason for exemption of USP<800> Containment Requirements: Purchased in final dosage form; packaged as unit dose. Does not require additional manipulation for dispensing.
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