Hazardous drugs

Hazardous drugs, in the realm of pharmacology, are substances that pose significant risk to those who handle or come into contact with them. These risks encompass genotoxicity, carcinogenicity, teratogenicity, and fertility impairment. Given the vast array of potential harm, health professionals must exercise caution when working with these drugs.

Characterization of Hazardous Drugs

Hazardous drugs have the potential to induce various harmful effects, including:

• Genotoxicity: Capacity to mutate genetic material.
• Carcinogenicity: Propensity to induce cancer in humans, animal models, or both.
• Teratogenicity: Ability to interfere with fetal development, leading to birth defects.
• Fertility Impairment: Potential to hamper fertility in individuals.

Typically, these drugs fall into categories like antineoplastics, cytotoxic agents, biologic agents, antiviral agents, and immunosuppressive agents.

Safe Handling of Hazardous Drugs

The inherent risks of hazardous drugs necessitate stringent safety measures throughout the drug's lifecycle, from preparation to disposal.

Guidelines and Practices

Adhering to evidence-based practices (EBP) set by esteemed national organizations can significantly mitigate the risk of occupational exposure. These include:

• Personal Protective Equipment (PPE): Use of disposable gowns, gloves, masks, etc.
• Closed-System Drug Transfer Device: A system that restricts the external environment from coming into contact with the drug, thereby preventing contamination.
• Drug Compounding in Class II BSC: Studies have shown reduced drug contaminants when compounding hazardous drugs in a Class II BSC coupled with a closed-system drug transfer device.[2]
• Awareness of Handling Phases: Protection during drug preparation, administration, and disposal.

Recommendations from Professional Bodies

The Oncology Nursing Society (ONS) underscores the use of a closed-system drug transfer device as one of the most efficacious means to thwart hazardous drug exposure.[3] Conversely, the National Institute for Occupational Safety and Health (NIOSH) opines that even with PPE, there's discernible drug concentration in the urine of healthcare workers handling these drugs.[1] Hence, NIOSH champions the adoption of closed-system transfer devices and iterates that upcoming products should align with NIOSH's definitions and prove their merit via independent studies.

Conclusion

The danger posed by hazardous drugs mandates a comprehensive approach to safety, encompassing stringent guidelines, advanced equipment, and continuous vigilance. As the medical community becomes more informed about these risks, there is hope for further advancements in protection measures for health care professionals.

See Also

• Pharmacology
• Personal Protective Equipment
• Genotoxicity
• Carcinogenicity

External links

• American Society of Health-System Pharmacists (ASHP)
• National Institute for Occupational Safety and Health (NIOSH)
• Oncology Nursing Society (ONS)
• The International Agency for Research on Cancer (IARC) Classification of Hazardous Drugs
• International Society of Oncology Pharmacy Practitioners (ISOPP)

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