Which of the following is/are true when it comes to compounding hazardous drugs (HD)? Select all that apply.
A. USP Chapter 800 contains the standards for handling hazardous drugs
B. The list of hazardous drugs is maintained by National Institute for occupational safety and health (NIOSH)
C. When compounding doxorubicin, a vertical laminar airflow workbench (LAFW) should be used
D. A single pair of sterile gloves should be worn when compounding an antineoplastic for intravenous use
E. When compounding sterile hazardous drugs, the beyond-use date (BUD) is found in USP Chapter 797
Answers with rationale:
Answers A, B, and E are correct
When compounding HD, you must follow USP Chapter 797 for sterile compounding and USP 795 for non-sterile compounding in addition to USP Chapter 800 which give standards for proper handling of HD making answer A and E correct.
All pharmacies that handle hazardous drugs must compile an updated list every 12 months using the current NIOSH HD list. The most recent release from NIOSH has been a 2020 draft following the 2016 published list. When compounding hazardous drugs, a biological safety cabinet (BSC) or compounding aseptic containment isolator (CACI) must be used, making answer C incorrect. Furthermore, all hazardous drugs must be stored and prepared in a negative pressure ISO 7 clean room. Answer D is incorrect because when compounding sterile HD, a set of sterile gloves must be worn on top of another pair gloves. Both pairs must be chemotherapy gloves that meet American Society for Testing and Materials (ASTM) standard D6978.
NABP Competency Statements Covered:
5.2 – Techniques, procedures, or equipment for hazardous or non-hazardous sterile products
5.3 – Techniques, procedures, or equipment for hazardous or non-hazardous non-sterile products