Transcript Oral Chemotherapy: Facts and Precautions

Oral Chemotherapy
Facts and Precautions
Objectives
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State the Facts
Precautions
Administration
Proper disposal
Preparation of Med
• Manipulation of tablets such as cutting, crushing or
opening of capsules should be done by trained
personnel in the pharmacy, under a bio-safety
cabinet. (BSC)
Facts/Precautions
• Oral chemotherapy drugs are hazardous, just
as any type of chemotherapy
• Increased risk apply for women who are:
• Breastfeeding
• Pregnant
• Planning on becoming pregnant
Safe Handling
It is generally assumed that patients receive
chemotherapy in traditional health care settings
However, with increased use of oral chemotherapy
this paradigm is shifting from primarily ambulatory
infusion clinics and physicians offices, to include:
self administration at home
assisted living facilities
long-term care facilities
Administration of Oral Chemo
• Wash hands prior to donning gloves
• Nitrile gloves should be worn while dispensing
• Gown if oral chemotherapy is liquid and splashing
may occur
• Goggles if splashing may occur
• Medication wrapper must go in yellow chemo
container
• All other PPE should be disposed of yellow chemo
container
Chemo Waste Container
• Discard wrappers in a disposable chemo waste bag
after opening oral chemo medication. If you need
these on your unit please call Nancy Jacobs at 3568736 or Kelly Lawson at 356-7594.
How Alert Appears on Mars
0040 History Missing Schedules!!! (from 8/20/2009 11:00:00 PM)MI ADR a.FLUDARABINE 50mg VIAL
(Fludara(Fludarabine))27.5 mg b.0.9% NaCl (0.9% NaCl 100ml IV SOL`N)100 ml INTRAVENOUSLY
EVERY 24 HOURS
Infuse over 30m, Rate: 202ml/h
27.5 mg, 100 ml IV EVERY 24 HOURS Pharmex Warning a.0141 Discard unused portion & change
tubing every 12 hours.
0142 Nurse: Pregnant women should avoid contact with this medication.
0174 CAUTION: Follow procedures for proper handling and disposal of hazardous drugs.b.0005
Take this medication with plenty of water.c.0044 Do NOT chew or crush before swallowing.d.0005
Take this medication with plenty of water.
0010 Take with food.
0036 Do not chew or crush. Swallow whole.e.0144 Roll gently in your hands to mix well before each
injection.f.0062 May cause dizziness Pharmex Warning (per Administration Guideline)
Caution: Chemotherapy-<------------ This is the alert on the EMAR that states this is a
chemotherapeutic drug.
DRUG ORDER VERIFIED BY TWO NURSES Start: 08/18 11:00, Stop: 08/21 10:59* NOT GIVEN TODAY *
08/19 09:42 Not earlier than 08/20 09:42!
List of Most Common Oral Chemotherapy
Medications
Brand Names
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Tykerb
Xeloda
Tarceva
Temodar
Gleevac
Sutent
Nexavaar
Methotrexate
Generic Names
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Capecitabine
Erlotinib
Temazolomide
Imatinib
Lapatanib
Sunitinib
Sorafenib
Rheumatrex
Light Sensitive
• Some oral chemotherapy medications may be sent
from pharmacy in brown packaging due to their
sensitivity to light
Oncology Resource Team
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Rachelle Collins RN, OCN
Sheryl Grooms RN, OCN
Linda Horner BSN, OCN, PCCN
Nancy Jacobs RN, PCCN, OCN
Kelly Lawson RN, OCN
Kristie Meeker RN, BSN, OCN
Connie Wolf RN, OCN
Traci Boland RN, OCN
356-7490
356-7426
356-8543
356-8736
356-7594
356-7466
356-7490
356-7490
References
Goodin, S., (2007, September 7 ). Safe handling of Oral Chemo Agents in Community
Settings http://www.pharmacytimes.com/issue/pharmacy/2007/2007-09/2007-09-6789
Center for Disease Control and Prevention. National Institute for Occupational Safety and
Health. Preventing Occupational Exposure to Antineoplastic and other Occupational
Hazardous Drugs in Health Care Settings. NIOSH publication 2005-165. September
2004. Available at cdc.gov/niosh/docs/2005-165
Any questions?
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