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Chapter 76. Compounding USP Chapter 800—Hazardous Drug Handling in Health Care Settings

Which of the following primary engineering controls (PECs) should NOT be used to prepare hazardous medications?

a. Biological safety cabinet (BSC)

b. Compounding aseptic containment isolator (CACI)

c. Horizontal-positive Laminar Airflow Workbenches (LAFW)

d. All of the above are appropriate to prepare hazardous medications.

Answer c is correct. Positive LAFW should never be used to compound hazardous preparations.

Answer a is incorrect. BSC should be used for hazardous drug compounding.

Answer b is incorrect. CACI should be used for hazardous drug compounding.

Answer d is incorrect. Not all three should be used for hazardous drug compounding.

Which of the following statements regarding hazardous drug compounding per USP 800 is correct? Select all that apply.

a. Personnel need additional training when handling hazardous medications.

b. Closed system transfer devices (CSTDs) can be used in place of primary engineering controls (PECs) and secondary engineering controls (SECs), as they provide sufficient amount of protection to the compounder.

c. Proper personal protective equipment (PPE) must be worn when unpacking shipment of chemotherapeutic agents.

d. When gowning for hazardous drug compounding, one must use an impervious gown to avoid/limit any exposure.

Answers a, c, and d are correct. Personnel needs additional training when handling hazardous medications and proper PPE must be worn when unpacking shipment of chemotherapeutic agents. Additionally, when gowning for hazardous drug compounding, one must use an impervious gown to avoid/limit any exposure.

Answer b is incorrect. Closed system transfer devices (CSTDs) do not replace the use of primary engineering controls (PECs) and secondary engineering controls (SECs), only further reduce chance of exposure.

Which of the following steps are applicable when preparing for implementation of USP Chapter 800? Select all that apply.

a. A person who will be responsible for management and implementation of USP Chapter 800 needs to be identified as “designated expert” within the organization.

b. A list of hazardous drugs (HDs) needs to be prepared based on the most current National Institute for Occupational Safety and Health (NIOSH) HD list.

c. A training program needs to be developed specifically focused on HD handling including unpacking, cleaning, and all handling of HDs.

d. To provide ...

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