Safe handling of oral antineoplastic medications: focus on targeted therapeutics in the home setting

Details

• Personal Author:
  Cass Y ; Connor, Thomas H. ; Tabachnik A ; Cass Y ; Connor, Thomas H. ; Tabachnik A
• Description:
  Introduction: With the growing number of oral targeted therapies being approved for use in cancer therapy, the potential for long-term administration of these drugs to cancer patients is expanding. The use of these drugs in the home setting has the potential to expose family members and caregivers to them either through direct contact with the drugs or indirectly by exposure to the parent compounds and/or their active metabolites in contaminated patients' waste. Methods: A systematic literature review was performed and the known adverse health effect of 32 oral targeted therapeutics is summarized. In particular, the carcinogenicity, genotoxicity, and embryo-fetal toxicity, along with the route of excretion were evaluated. Results: Carcinogenicity testing has not been performed on most of the oral targeted therapeutics and the genotoxicity data are mixed. However, the majority of these drugs exhibit adverse reproductive effects, some of which are severe. Currently, available data does not permit the possibility of a health hazard from inappropriate handling of drugs and contaminated patients waste to be ignored, especially in a long-term home setting. Further research is needed to understand these issues. Conclusions: With the expanding use of targeted therapies in the home setting, family members and caregivers, especially those of reproductive risk age, are, potentially at risk. Overall basic education and related precautions should be taken to protect family members and caregivers from indirect or direct exposure from these drugs. Further investigations and discussion on this subject are warranted. [Description provided by NIOSH]
• Subjects:
  Antineoplastic Agents Carcinogens Drug Therapy Family Fetus Hazardous Substances Hazardous Waste Home Care Services Manufacturing And Industrial Facilities Neoplasms Occupational Health Safety Urogenital System

  More +
• Keywords:
  Antineoplastic-agents Author Keywords: Oral Antineoplastic Medications Cancer Carcinogenicity Drugs Drug Therapy Embryotoxicity Excretion Families Genotoxicity Hazardous Drugs Hazardous Materials Hazardous Waste Home Health Care Home Setting Humans Materials Handling Oncogenic-agents Reproductive Effects Reproductive Hazards Safe Handling Safety Education Safety Measures Safety Practices Targeted Therapies Therapeutic Agents

  More +
• ISSN:
  1078-1552
• Document Type:
  Text
• Genre:
  Journal Article ; Journal Article
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH) ; National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DART - Division of Applied Research and Technology ; DART - Division of Applied Research and Technology
• Topic:
  Workplace Safety & Health ; Workplace Safety & Health
• Location:
  North America ; North America
• Pages in Document:
  350-378
• Volume:
  23
• Issue:
  5
• NIOSHTIC Number:
  nn:20047831
• Citation:
  J Oncol Pharm Pract 2017 Jul; 23(5):350-378
• Contact Point Address:
  Thomas H Connor, Division of Applied Research and Technology, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 1090 Tusculum Avenue, MS C-23, Cincinnati, OH 45226-1998, USA
• Email:
  tconnor@cdc.gov
• Federal Fiscal Year:
  2017
• NORA Priority Area:
  Healthcare and Social Assistance ; Healthcare and Social Assistance
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Oncology Pharmacy Practice
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:56c4959fdc6001be6b650efc0fcfd60fdf0c838738363d61137411cc8793ec599787a6bed0d5118e43ac3df7406e0f4e381837a29d34ed9e403c0d068f76d8b0
• Download URL:
  https://stacks.cdc.gov/view/cdc/202798/cdc_202798_DS1.pdf
• File Type:
  [PDF - 245.77 KB ]