Determination of exposure of dispensary drug preparers to cyclophosphamide by passive sampling and liquid chromatography with tandem mass spectrometry

Wakui, Nobuyuki; Ookubo, Tetuo; Iwasaki, Yusuke; Ito, Rie; Mitui, Miyuki; Yano, Yuichi; Saito, Koichi; Nakazawa, Hiroyuki

doi:10.1177/1078155212451196

Cited by 10 publications

(18 citation statements)

References 9 publications

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“…13 Therefore, this method leads to safe preparation of the drug and minimum risk of drug exposure among health-care workers, patients, and their family members. The closed oral drug preparation device may be used in hospitals and in home care in the future.…”

Section: Resultsmentioning

confidence: 99%

Development of a closed drug preparation method for oral anticancer drugs

Wakui

Ookubo

Iwasaki

et al. 2013

J Oncol Pharm Pract

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The objective of this article is to reduce the preparation time for oral anticancer drugs, reduce the exposure to drug preparations, and develop drug preparation equipment without external drug leaks in a closed state. In the newly developed closed oral drug preparation device, a 10 mL disposable syringe that was replaced with one projection for crushing tablets and a no-processing 30 mL disposable syringe were connected to a three-way stopcock. Using this instrument, Endoxan(®) tablets (principal components: cyclophosphamide) were crushed and suspended in water in a closed state. The drug was prepared to suspension and flowed out via a feeding tube by switching the handle of the three-way stopcock. To assess human exposure to cyclophosphamide, a high-performance volatile organic compound-solvent desorption passive sampler was attached to the preparer's mouth to collect air drifting in the vicinity, and cyclophosphamide levels were subsequently measured by liquid chromatography with tandem mass spectrometry. Using the developed drug preparation equipment, Endoxan(®) tablets were suspended in a closed state. According to liquid chromatography with tandem mass spectrometry analysis, the exposure of the preparer to cyclophosphamide was greatly reduced when using the developed device; cyclophosphamide was detected in only two of the five samples, though only at trace levels. The closed oral drug preparation device may permit the preparation and administration of toxic drugs to patients while greatly reducing the risk of occupational exposure among health-care workers and caregivers.

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Section: Resultsmentioning

confidence: 99%

Development of a closed drug preparation method for oral anticancer drugs

Wakui

Ookubo

Iwasaki

et al. 2013

J Oncol Pharm Pract

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“…Wakui et al. 43 measured the amount of drug captured by a passive sampler at the mouth of workers crushing cyclophosphamide tablets with a mortar and pestle. Concentrations of cyclophosphamide ranged from 7.6 to 157.7 ng/sample.…”

Section: Discussionmentioning

confidence: 99%

Surface contamination of counting tools after mock dispensing of cyclophosphamide in a simulated outpatient pharmacy

Chaffee

Lander

Christen

et al. 2018

J Oncol Pharm Pract

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Dispensing one or more prescriptions of 40 cyclophosphamide 50 mg tablets contaminates pharmacy counting tools, and an increased number of prescriptions dispensed correlates with increased level of contamination. Counting out three or more prescriptions leads to trays having contamination that surpasses the threshold at which worker exposure may be increased. Pharmacies should consider devoting a separate tray to cyclophosphamide tablets, as cross-contamination could occur with other drugs and the efficacy of decontamination methods is unclear. Employee exposure could be minimized with the use of personal protective equipment, environmental controls, and cleaning trays between uses. Future investigation should assess the extent of drug powder dispersion, the effects of various cleaning methods, and the potential extent of contamination with different oral cytotoxic drugs.

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“…From the aforementioned search, 18 articles were categorized as analytical methods: 16 for surface contamination [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] and two for air contamination [26,27]. The other two articles will not be further examined here as they refer to non-analytical methods for surface contamination assessment [28,29].…”

Section: Literature Searchmentioning

confidence: 99%

“…They opted for NTD since it uses active sampling (while SPME requires passive sampling), which may contribute to higher precision, besides being user-friendly and fast [26]. On the other hand, Wakui et al decided to use a high-performance VOC-SD passive air sampler to overcome problems associated with active samplers, such as difficulty in equipment installation and sampling noise, and because they are easy to carry (which is relevant for personal sampling) [27]. Yet, both studies used carbon molecular sieves as adsorbents.…”

Section: Samplingmentioning

confidence: 99%

Cytostatics in Indoor Environment: An Update of Analytical Methods

2021

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Periodic and adequate environmental monitoring programs are crucial to assess and reduce the occupational exposure of healthcare workers to cytostatics. The analytical methods employed should be rapid, reliable, sensitive, standardized, and include multiple compounds. A critical overview of recent overall procedures for surface and air contamination with cytostatics in workplace settings is presented, with a focus on sampling, sample preparation, and instrumental considerations. Limitations are also addressed and some recommendations and advice are provided. Since dermal absorption is the main exposure route, surface contamination is the preferred indicator of biological uptake and its methods have significantly improved. In contrast, cytostatics’ inhalation is rare; thus, air contamination has been poorly studied, with little improvement. Still, some elements of the analytical methods have not been extensively explored, namely: the amount of wetting solution, the extraction procedure, surface chemistry and roughness, recovery studies from specific surfaces, and cytostatics stability (in surfaces and during shipping and storage). Furthermore, complete validation data (including precision, accuracy, and instrumental and method detection limits) and estimation of global uncertainty are still lacking in most studies, thus preventing method comparison and proposal of standardized procedures.

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Determination of exposure of dispensary drug preparers to cyclophosphamide by passive sampling and liquid chromatography with tandem mass spectrometry

Cited by 10 publications

References 9 publications

Development of a closed drug preparation method for oral anticancer drugs

Development of a closed drug preparation method for oral anticancer drugs

Surface contamination of counting tools after mock dispensing of cyclophosphamide in a simulated outpatient pharmacy

Cytostatics in Indoor Environment: An Update of Analytical Methods

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