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    Cytotoxic Drug Reconstitution

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    iqhwan riat
    Cytotoxic drug reconstitution (CDR) involves the aseptic preparation of cytotoxic drugs for chemotherapy. CDR must be done in a qualified clean room according to safety policies to protect handlers and the environment. Trained personnel implement safe preparation, handling, administration and disposal of hazardous drugs. Practical experience in a CDR department provides valuable learning about the design of facilities, reconstitution processes, equipment use, and spill management procedures. Proper training in aseptic techniques and safety protocols is important for working with these dangerous medicines.

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    Cytotoxic Drug Reconstitution

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    iqhwan riat
    208 views6 pages
    Cytotoxic drug reconstitution (CDR) involves the aseptic preparation of cytotoxic drugs for chemotherapy. CDR must be done in a qualified clean room according to safety policies to protect handlers and the environment. Trained personnel implement safe preparation, handling, administration and disposal of hazardous drugs. Practical experience in a CDR department provides valuable learning about the design of facilities, reconstitution processes, equipment use, and spill management procedures. Proper training in aseptic techniques and safety protocols is important for working with these dangerous medicines.

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    Cytotoxic Drug Reconstitution (1)

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    Cytotoxic drug reconstitution (CDR) involves the aseptic preparation of cytotoxic drugs for chemotherapy. CDR must be done in a qualified clean room according to safety policies to protect handlers and the environment. Trained personnel implement safe preparation, handling, administration and disposal of hazardous drugs. Practical experience in a CDR department provides valuable learning about the design of facilities, reconstitution processes, equipment use, and spill management procedures. Proper training in aseptic techniques and safety protocols is important for working with these dangerous medicines.

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    208 views6 pages

    Cytotoxic Drug Reconstitution

    Uploaded by

    iqhwan riat
    Cytotoxic drug reconstitution (CDR) involves the aseptic preparation of cytotoxic drugs for chemotherapy. CDR must be done in a qualified clean room according to safety policies to protect handlers and the environment. Trained personnel implement safe preparation, handling, administration and disposal of hazardous drugs. Practical experience in a CDR department provides valuable learning about the design of facilities, reconstitution processes, equipment use, and spill management procedures. Proper training in aseptic techniques and safety protocols is important for working with these dangerous medicines.

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    © All Rights Reserved
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    Cytotoxic Drug Reconstitution (CDR)

    CDR one of the services and units in pharmacy. This unit are in charge to prepare
    safe and sterile cytotoxic drugs for patients. The reconstitution of cytotoxic drug
    doses aseptically to final product volume as needed with diluents for the
    administration in chemotherapy. There are few services policy that CDR department
    must follow which are the process of reconstitution should be prepared in the
    qualified clean room and for hospitals without CDR facilities, they need to prepare
    the reconstitution process at nearby hospital with qualified clean room or use the
    closed-system drug transfer device. Furthermore, the trained personnel should
    implement the preparation, reconstitution, administration and disposal of hazardous
    drugs to protect the handler, drug and environment and willing to prepare
    customised chemotherapy regimen that complete to every patient’s needs.

    Cytotoxic medicines are used in the treatment of dangerous illnesses. Antineoplastic


    specialists are another name for cytotoxic drugs. They have been discovered to be
    carcinogenic, teratogenic, and mutagenic. These collections of drugs contain
    synthetics that are damaging to cells, and as a result, they can have negative
    consequences for patients and others who are exposed to them.(Continuing
    Pharmacy Education Managing Cytotoxic Drugs. Mps.Org. ,2002)

    The Theoretical and Practical in CDR

    Theory and practical always some difference to a certain degree. In CDR, we just
    learn the theory of safe handling of cytotoxic drug, CDR equipment, proper design of
    CDR unit and CDR work practice without experienced it. Based on my experience, I
    was placed in CDR for two weeks in Institut Perubatan Dan Pergigian Termaju USM,
    I got the experience to see the design of CDR department. As example, I learned the
    design of preparation room and clean room that available at that healthcare institute.
    I also learned how to determine the total number of vials need for the recon, how to
    swab the pass box, gowning cytotoxic medication packing and how to setup spill kit
    equipment and learn about spillage procedure practically which made me easier to
    remember the knowledge that I need to know in CDR department. At addition,during
    my practical, I was informed about the PhaSeal system. The PhaSeal system
    comes in three size which are Protector p14,p21 and p50.These protector is used to
    reduce cytotoxic drug exposure to personnel. Other than that, I got allowed to
    reconstitute in the clean room with the help of a pharmacist. She constantly walks
    me through the reconstitution process which help me to remember the process and
    doing better in reconstitution cytotoxic drugs. However, based on Hikmah experience
    that currently practical at Hospital Seberang Jaya , she said that she never had a
    chance to reconstitute as the hospital doesn’t have cleanroom. They need to go
    Hospital Kulim to reconstitute the cytotoxic drugs for patients. Picture below are the
    daily routine of Hikmah during her practical in cytotoxic drug reconstitution
    department.
    Specific Procedures

    Chemical Spillage

    Spills of chemicals can happen during preparation, transport, or administration.


    Worksite precautions to limit the risk of spills and strategies for reacting to chemical
    spills are necessary regardless of the kind or quantity of hazardous chemicals. As a
    result, spill kits should be kept on hand in every place where cytotoxic drugs and
    waste are handled, stored, or transported. Spill kits are collections of absorbents and
    tools for properly cleaning up spills. They're designed for incidents involving
    potentially dangerous chemicals such as chemotherapy and blood.

    Management of cytotoxic spill.

    There are a few steps to manage cytotoxic spill incident.First,the incident area
    where the cytotoxic leakage happened was marked with a warning notice. Then,
    to absorb liquid spills, use gauze or an absorbent pad. If the spill is in powder
    form, first moisten the gauze, then apply the powder. Furthermore, collect any
    shattered glass shards with a brush and dustpan and place them in a sharp bin.
    After removing any sharp object in the incident, wipe the entire area three times
    with Decon 90 and then three times with water. Make sure personnel only use
    70% alcohol to disinfect the clean room and cytotoxic drug cabinet. After that ,
    discard contaminated materials like gauze and first-layer gloves in the cytotoxic
    waste bag. Then, personnel place the cytotoxic waste bag in a second bag and
    secure it with a rubber band. Aftert that, personnel remove the respirator mask,
    gown, shoe cover, and second layer of gloves and discard them in the cytotoxic
    waste bag and place the cytotoxic waste bag in the non-disposable cytotoxic
    waste container after tying it.
    Tips to Survive Training in CDR

    To begin with, we are already aware that we will be dealing with a large
    number of cytotoxic medicines that might injure our bodies in this field. As a
    result, it is critical for trainee students to have a good basis in aseptic
    procedures before joining this department. This is because the procedures
    need professional abilities, and only trained individuals are typically permitted
    to execute them. We must put our safety first in this section since the
    possibility of leakage throughout the procedures is significant and dangerous
    to both ourselves and the environment. Aside from that, the training students
    should be aware of the procedures to follow in the event of a spill, so that we
    can remain cool and take the appropriate action.
    References

    1) Chan, K., Jin-Ying, W., Ming Zhao, L., Yu Qian, K., & Elangovan, S. (2017,
    July 18). Third Year Pharmacy Students Undertake Experiential Learning at
    a Malaysian Private Hospital. IMU News.
    https://imunews.imu.edu.my/people/third-year-pharmacy-students-undertake-
    experiential-learning-at-a-malaysian-private-hospital/
    2) Gobi Hariyanayagam Gunasekaran1 , Wan Mohd Akmal Wan Sabri1 ,
    RubanathanRamasamy1 , Syazwan Faiz Kamal Al Arif1 , Sera Selvanthan
    SundramGunasekaran2 , Shargunan Selvanthan Gunasekaran3. (2020).
    Cytotoxic Drug Reconstitution Convenience Box (CDR-CB): A product
    innovation. Research Gate, 22:20, 1.
    https://doi.org/10.13140/RG.2.2.15814.91205
    3) Safe handling of cytotoxic drugs in the workplace - Health and Social Care.
    (n.d.). Health and Safety Executive (HSE). Retrieved June 19, 2021, from
    https://www.hse.gov.uk/healthservices/safe-use-cytotoxic-drugs.htm
    4) Ministry of Health Malaysia. (2015, November 5). Cytotoxic Drug
    Reconstitution (CDR). Pharmaceutical Services Programme.
    https://www.pharmacy.gov.my/v2/en/content/cytotoxic-drug-reconstitution-
    cdr.html

    5) Ahmad, A. (2002). Continuing Pharmacy Education Managing Cytotoxic Drugs.

    Mps.Org.

    https://www.mps.org.my/publications/Journal_of_Pharmacy3/continuing_pharmacy_

    education.pdf
                      
      

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