By James Rinehart, RPh, MS, FASHP and James A. Jorgenson, RPh, MS, FASHP
Creating safe handling processes for hazardous drugs has received increasing worldwide attention in recent years. In the US, the American Society of Health-System Pharmacists, the Oncology Nursing Society, the National Institute for Occupational Safety and Health (NIOSH), and the United States Pharmacopeia (USP) lead these efforts. Although the hazardous potential of drugs such as antineoplastics is well established, NIOSH recently categorized a variety of other drug classes as hazardous. The current NIOSH list includes chemotherapy medications, antiviral drugs, hormones, some bioengineered drugs, and other miscellaneous drugs.
This article discusses issues surrounding the safe handling of these types of medications with a particular emphasis on special considerations for the handling and storage of monoclonal antibodies, or MABs) which are drugs produced by recombinant DNA technology. MABs as a class generally are not considered to be carcinogenic, mutagenic, or teratogenic for patients or the staff handling them. However, because insufficient evidence currently exists to either support or refute the hazard potential of MABs, it is prudent for health systems to carefully evaluate their safe handling practices.