Search

The safe handling of cytotoxic agents is intimately related to the technical aspects of drug preparation, dispensing, and administration. The appropriate equipment, supplies, protective clothing, and waste disposal systems must be available to the health care worker who is called upon to prepare cytotoxic agents. In addition, the health care worker must be adequately trained in and familiar with the safe use of these products and equipment and the preparation techniques or manipulations necessary during cytotoxic drug compounding. The article describes in detail and reviews the technical considerations, such as aseptic technique, proper use of the biological safety cabinet, gowning and gloving, labeling, and waste disposal, that are essential to the safe preparation and dispensing of chemotherapy.

Understanding the toxicities associated with cancer chemotherapeutic agents is essential to pharmacists involved in the clinical management of oncology patients. Anticipation of various treatment-related toxicities may provide the opportunity for pharmacists to develop intervention strategies that could minimize or eliminate an expected side effect of chemotherapy such as myelosuppression, nausea, or emesis. Effective management of chemotherapy toxicities may lead to decreased lengths of stay in the hospital or administration of chemotherapy in the outpatient setting. This article addresses the onset of chemotherapy toxicities, the major organ system toxicities, and the management of many of these chemotherapy-induced toxicities. Chemotherapy dose modifications are discussed as well as maximum lifetime doses and the use of prophylactic medications to prevent various side effects.