Degradation and Disposal of some Antineoplastic Drugs

Lunn, George; Sansone, Eric B.; Andrews, A. W.; Hellwig, Louise C.

doi:10.1002/jps.2600780811

Cited by 20 publications

(9 citation statements)

References 13 publications

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“…Antineoplastic drugs were considered, in this program, in 1985 (Castegnaro et al 1985). Since then, several publications have been issued (Barek et al 1987;Monteith et al 1987;Lunn et al 1989;Benvenuto et al 1993;Allwood and Wright 1993). However, the methods proposed in most of these publications involved the use of acid and strong oxidizing agents, such as potassium permanganate, which are not considered acceptable by hospital staff.…”

Section: Introductionmentioning

confidence: 97%

Chemical degradation of wastes of antineoplastic agents: cyclophosphamide, ifosfamide and melphalan

Hansel

Castegnaro

Sportouch

et al. 1996

International Archives of Occupational and Environmental Health

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Handling genotoxic compounds commonly used in cancer chemotherapy generates contaminated wastes that require decontamination before disposal. Chemical methods are an alternative and/or a complement to incineration for the treatment of wastes and spills. As part of a program initiated by the International Agency for Research on Cancer (IARC), three chemical methods readily available in the hospital environment, viz sodium hypochlorite (NaOCl, 5.25%), hydrogen peroxide (H2O2, < or = 30%) and Fenton reagent (FeCl2, 2H2O; 0.3 g in 10 ml H2O2, 30%), were tested for the degradation of three alkylating agents (cyclophosphamide, CP; ifosfamide, IF, and melphalan). Pharmaceutical preparations corresponding to the most highly concentrated administration solutions in either NaCl (0.9%) or dextrose (5%) were inactivated by oxidation volume/volume with each of the methods for at least 1 h. The efficiency of degradation was monitored by high-pressure liquid chromatography. The mutagenicity of the degradation residues was tested by means of the Ames test using tester strains of Salmonella typhimurium TA 97a, TA 98, TA 100 and TA 102 with and without an exogenous metabolic activation system. Complete disappearance of CP was observed after 1 h with all degradation methods. However, direct mutagens were generated by the Fenton oxidation technique in the presence of dextrose (5%). IF was completely degraded by the Fenton reagent and NaOCl methods. No mutagenic residues were detected after 1 h of treatment with the Fenton technique, and after 3 h with the NaOCl method. Direct-acting mutagens remained after the H2O2 treatment in the presence of dextrose (5%). Complete degradation of melphalan was achieved in 1 h by each of the three methods, and no mutagenic residues were produced by any of the treatments. The use of NaOCl (5.25%) proved the most efficient system for degradation of the three alkylating agents.

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Section: Introductionmentioning

confidence: 97%

Chemical degradation of wastes of antineoplastic agents: cyclophosphamide, ifosfamide and melphalan

Hansel

Castegnaro

Sportouch

et al. 1996

International Archives of Occupational and Environmental Health

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“…In most instances, these methods have been inadequate because they only measure the disappearance of the chemical entity and must, as has been recommended, determine the biological activity (usually mutagenicity) of the reaction products.4-6 Other methods, whereas they may eliminate mutagenicity, may result in hazardous by-products. 7 We have devised procedures for the chemical deactivation of mutagenic antitumor agents and have monitored the success of these procedures by HPLC and the Ames mutagenicity assay. These procedures, executed primarily with potassium permanganate and bleach, are readily amenable for inactivating the drugs as solids, in aqueous solutions, and in spills.…”

mentioning

confidence: 99%

X-ray Structural Characterization of Anhydrous Metronidazole Benzoate and Metronidazole Benzoate Monohydrate

Caira

Nassimbeni

Oudtshoorn³

1993

Journal of Pharmaceutical Sciences

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“…Assessing the efficacy of the cleaning methods usually employed in their healthcare facility to eliminate environmental contamination with CP, Touzin et al (55) recommended combining sodium hypochlorite and sodium thiosulfate to obtain optimal results. However, this and many other studies address decontamination of a single cytotoxic agent (48,(55)(56)(57), while in reality surfaces are often contaminated with several agents. Lamerie et al (52) therefore assessed the efficiency of several chemical solutions to decontaminate two types of work surfaces intentionally contaminated with ten cytotoxic drugs.…”

Section: Cleaning Issues and Recommendationsmentioning

confidence: 99%

Occupational exposure to cytotoxic drugs: the importance of surface cleaning to prevent or minimise exposure

Viegas

Oliveira

Carolino

et al. 2018

Archives of Industrial Hygiene and Toxicology

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Healthcare workers who prepare or administer cytotoxic agents run the risk of exposure, and the risks for health are real even at doses lower than those applied in cancer patients, because, in theory, no dose is safe. The most common and problematic route of exposure is through the skin, especially as work surfaces can remain contaminated even after cleaning. This pilot study aimed to demonstrate the importance of having an effective surface decontamination protocol by determining surface contamination with cyclophosphamide, 5-fluorouracil, and paclitaxel as the most common cytotoxic drugs in an oncology day service. Samples were collected before and after drug handling and analysed with high performance liquid chromatography with diode array detection (HPLC-DAD). Of the 29 samples collected before drug handling 23 were contaminated, five of which with more than one drug. Of the 30 samples collected after drug handling 25 were contaminated, eight of which with more than one drug. The two time points did not significantly differ, which evidences a widespread contamination and ineffective cleaning. This calls for revising the cleaning protocol and handling procedure to place contamination under control as much as possible.

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Degradation and Disposal of some Antineoplastic Drugs

Cited by 20 publications

References 13 publications

Chemical degradation of wastes of antineoplastic agents: cyclophosphamide, ifosfamide and melphalan

Chemical degradation of wastes of antineoplastic agents: cyclophosphamide, ifosfamide and melphalan

X-ray Structural Characterization of Anhydrous Metronidazole Benzoate and Metronidazole Benzoate Monohydrate

Occupational exposure to cytotoxic drugs: the importance of surface cleaning to prevent or minimise exposure

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