Work area
(1) Drug reconstitution should be done in a Class II laminar flow biologic safety cabinet.
(2) The exhaust from the hood should be vented to the outside if possible.
(3) The work surface of the cabinet should be covered by a plastic-backed paper to soak up any spilled chemicals. The paper should be replaced after each work shift and disposed of as listed below.
(4) The safety cabinet should be cleaned with 70% alcohol and disposable towels.
(5) A spill kit should be available to absorb a spill.
Personal protective equipment:
(1) Surgical gloves should be worn at all times.
(2) Closed-front surgical gowns with knit cuffs.
(3) Shoe covers.
(4) Some drugs may require the use of chemically resistant and impervious gloves over the surgical gloves.
(5) Eye protection with goggles or safety glasses may be required.
(6) A face mask may be required.
(7) The hands should be washed after gloves are removed.
Material handling:
(1) All vials containing reconstituted drugs should be vented to reduce internal pressure.
(2) A sterile, alcohol dampened cotton pledget should be used to wrap the needle and vial top during withdrawal from the vial septum.
(3) External surfaces of syringes and IV bottles should be wiped clean of drug.
(4) Syringes and IV bottles should be labeled properly and show an appropriate warning label, including instructions for proper disposal.
(5) If breaking the top off of a glass ampule, the neck should be wrapped with a sterile, alcohol-dampened cotton pledget to contain the aerosol produced.
Waste handling:
(1) Waste antineoplastic agents should be disposed of in accordance with applicable regulations for handling toxic chemical waste.
(2) All contaminated bottles, vials, gloves, absorbent paper, disposable gowns, gauze and other material should be placed in a biohazard bag and incinerated.
