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is chart is taken from the WRHA Safe Handling of Hazardous Medications (Cytotoxic and Non-Cytotoxic)This chart is tPolicy 110.160.010 July 2012 at http://home.wrha.mb.ca/corp/policy/fi les/110.160.010.pdfp p p y p fPlease refer to this policy for more detailed information about the safe handling of hazardousmedications.

For the most recent version of the drug table, go tohttp://home.wrha.mb.ca/prog/pharmacy/drugs_safehandling.php

Safe Handling of Hazardous Medications Chart

DisclaimerThe WRHA and CancerCare MB “Safe Handling of Hazardous Medications” chart was developed to provide direction in the safe handling of cytotoxic and non-cytotoxic hazardous medications as defi ned in the attached medication listing. The information presented in this chart is intended for use by staff of the WRHA and CancerCare MB only. The authors have made every effort to ensure that the information presented was accurate at the time of publication. As new research and experience broadens our knowledge, changes in handling requirements as well as the medication listing will be required. Neither the authors, reviewers, nor publishers can be responsible for errors, omissions, inconsistencies or continued completeness of the information contained in the chart or medication listing. The information in this chart and medication listing should not be used in place of the skill and professional judgment required when determining appropriate handling of these medications. Information on the medication listing will be reviewed and updated periodically, however ongoing accuracy at particular points in time cannot be assured. The onus is on the user to contact the WRHA Pharmacy Program for updates. January 2013

C YTOTOXIC HAZARDOUS MEDICATIONS NON-CYTOTOXIC HAZARDOUS MEDICATIONS

Precautions Injectable Solid Oral Dosage Form

CompromisedDosage Form

pp*

Injectable Solid Oral Dosage Form

CompromisedDosage Form

pp*

ReceivingProtective wear (unpacking stock from warehouse, manufacturer,external pharmacy)

Exam Gloves Exam Gloves Exam Gloves No special requirements

No special requirements


Protective wear - receiving stock that has been damaged (stock con-tents confi rmed with packing slip)

Chemo Gloves Procedure Mask

Chemo Gown


Chemo Gown


Chemo Gown

Exam Gloves Procedure Mask

Exam Gown


Exam Gown


Exam Gown

Preparation & Transport

Prepared by Pharmacy Pharmacy Pharmacy Except Dissolve & Dose

Nurse (or Pharmacy for

specifi ed medications)Pharmacy Pharmacy

Except Dissolve & Dose

Preparation areaClass II B2 biological

safety cabinet oralternate closed system

Designatedcytotoxic

packaging area

Designatedcytotoxic

packaging areaWard or Pharmacy

Designatedcytotoxic

packaging area

Designatedcytotoxic

packaging area

Protective wear (for staff preparing the area)

Chemo Gloves Shoe Covers None None None None None

Protective wear (for staff preparing medication doses)

Double Gloves (inner is Chemo Glove)

Procedure Mask Chemo Gown Shoe Covers

Chemo Gloves


Procedure Mask Chemo Gown

Sterile Gloves (Pharmacy) Exam Gloves (Nursing) Exam Gloves


Exam Gown

Packaging requirements(by Pharmacy)

Each dose packagedseparately Unit-dose Unit-dose No special

requirements Unit-doseSOLIDS unit-doseLIQUIDS unit-dose or multi-dose

Labeling requirements (for use in patient care area)

CYTOTOXICCYTOTOXIQUE

CYTOTOXICCYTOTOXIQUE

CYTOTOXICCYTOTOXIQUE WEAR GLOVES WEAR GLOVES

DO NOT CRUSHWEAR GLOVES

DO NOT CRUSH

Packaging for transport (topatient care area, other pharmacyarea, external pharmacy)

Double Sealed Container

(e.g. Ziploc® bags)

Sealed Container(e.g. Ziploc® bag)

Sealed Container (e.g. Ziploc® bag)




Clean-up protective wear


N95 Mask Protective Eye Wear

Chemo Gown Shoe Covers

Chemo GlovesChemo Gloves

Procedure Mask Chemo Gown

Exam Gloves Exam GlovesChemo Gloves

Procedure Mask Exam Gown

Administration & Disposal1

Administration restrictions REFER TO SITE-SPECIFIC POLICIES REFER TO SITE-SPECIFIC POLICIES

Administration precautions

Chemo Gloves requiredProcedure Mask/

Chemo Gown recommended

Chemo Gloves


Chemo Gownrecommended

Exam Gloves Exam Gloves Do Not Crush

Exam GlovesDo Not Crush

Medication waste management



Chemo Gloves Chemo Gloves No additional precautions

No additional precautions


Human waste management










Spill managementREFER TO SPILL MANAGEMENT ALGORITHM

(see Appendix B of WRHA Safe Handling of Hazardous Medications(Cytotoxic and Non-Cytotoxic) Policy 110.160.010 July 2012 at

http://home.wrha.mb.ca/corp/policy/files/110.160.010.pdf )







1 Shoe covers & protective eye wear should be worn whenever there is potential for splashing* Compromised Dosage Form: Any solid dosage form (tablet or capsule) that is changed in any way; e.g. splitting or crushing a tablet, opening a capsule to empty the powder, preparing a suspension from tablets. For the purposes of this policy all oral

liquids, topical and inhalation preparations (including commercially prepared products) are considered compromised dosage forms.

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