Safety Considerations and Safe Handling of Oral Chemotherapy Agents

Abstract

As a class of drugs, chemotherapy agents have two unique features. They have low therapeutic indexes, which places patients at an increased risk for medication errors, and they are considered hazardous drugs, which places patients and nurses at risk for environmental exposure. Policies and procedures for handling and administering oral chemotherapy agents are essential to promoting patients' and nurses' safety. Risk-reduction measures for administering oral chemotherapy in nontraditional healthcare settings, such as the home, require instituting a two-person dose-verification system, educating everyone who will administer and handle these agents, and developing procedures for securely and appropriately storing oral chemotherapy agents. Currently, no standardized guidelines exist for handling oral chemotherapy agents, and institutions must develop their own policies and procedures. This article discusses oral chemotherapy safety considerations, including safe handling of these agents, and offers recommendations for practice.

Role of the nurse in patient education and follow-up of people receiving oral chemotherapy treatment in Turkey

“…A questionnaire, prepared by the researchers based on the literature [3,7,8,10], was used for data collection. The questionnaire consisted of 16 open-ended and multiplechoice questions on patient demographics (institution, educational status, place of work, position, working years in this clinic, and years in nursing), the most commonly used oral CT agents, availability of policy/guidelines for administration of oral CT agents, education on oral CT, involvement in patient education and information (timing, storage, safety issues, side effects, and symptom management), the reasons for not being involved, and problems/ difficulties nurses face.…”

Safe Handling of Oral Chemotherapeutic Agents in Clinical Practice: Recommendations From an International Pharmacy Panel

“…42,43,45 Minimize the number of individuals coming in contact with the cytotoxic medications. 27 Wash the patient's clothes and bed linen separately from other items. 12,18 * Double-flush the toilet after use, during use of and 4 to 7 d after discontinuing oral chemotherapy.…”

“…23,27 Return wet, damaged, unused, discontinued, or expired medications to the pharmacist or hospital for disposal. 27 Report all medications (prescription and nonprescription as well as complementary and alternative medicines) and any specific dietary requirements to the health care provider/prescriber, at the time of assessment and consultation. Inform other health care professionals that you are on oral chemotherapy (eg, surgeons and dentists).…”

“…Patients who are On receiving your prescription, review the package label, specifically checking medication name and dosage. 27 Leave medication in open areas, near sources of water, direct sunlight, or where they can be accessed by children or pets.…”

“…Some of the existing recommendations to ensure the safe storage, prescribing, dispensing, administration, and disposal of cytotoxic oral chemotherapy drugs are listed in the Appendix (online only). 2,7,12,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] However, the recommendations have not been universally accepted or incorporated into practice. Recent surveys of health care practitioners as well as patients found that the perception of oral chemotherapy being safer than intravenous chemotherapy was prevalent.…”