sisa metabolit obat kemoterapi prima kft 051215

Prima Ayu Riami, M.Farm-Klin, Apt.Komite Farmasi Terapi, RS Awal Bros Batam

Chemotheraphy chemotherapy drugs or cytotoxic drugs, these agents

disrupt the cell cycle and kill cells that are rapidly dividing (e.g. cancer cells).1

Prima Ayu Riami, M.Farm-Klin, Apt., KFT-Awal Bros Hospital Batam

Workers may be exposed to a drug through out its life cycle—from manufacture, to transport and distribution, to use in health care or home care settings, to waste disposal. The number of workers potentially exposed to all hazardous drugs exceeds 5.5 million.


A meta-analysis of 14 studies performed from 1966 to 2004in the United States and Europe described an associationbetween exposure to anti neoplastic drugs and adversereproductive effects in female health care workers.

The most common reproductive effects found in thesestudies were increased:

fetal loss,

congenital malformations,

low birth weight ,

congenital abnormalities,

infertility.


The adverse effects found in many of these studies occurred before the adoption of safe handling guidelines


Personnel collecting and transporting waste materials in institutions should wear recommended PPE and follow institutional policies. All materials that come in contact with the drugs and patient waste (urine, blood, sweat, feces, and vomit) should be considered to contain the drugs and/or their metabolites and should be handled as hazardous.

These materials include used vials and intravenous sets, syringes, gloves, gowns, bedpans, linen, underpads, and similar materials and must be disposed of accordingly.


Many institutions have special requirements for linen handling, such as double washing and washing contaminated linen separately from other linen.


Body Fluids from patients receiving chemotheraphymay contain traces of cytotoxic drugs and their active metabolites.

Precaution should be taken for up to 7 days after treatment, as it known that majority of cytotoxicdrugs will be excreted within this time.


Pekerja yang memiliki risiko terpapar adalah merekayang kontak langsung dengan cairan tubuh, pakaianyang terkontaminasi, linen, dan hal lain yang berhubungan dengan pasien kemoterapi.

Farmasi, Perawat, Dokter, Cleaning service, PekerjaLaundry.


Cont…


Kewaspadaan selamaPeriode Kontaminasi

Selama 7 hari setelah terapi, gloves, mask, and Personal Protective Equipment (PPE) harus digunakan ketikamenangani ekskresi pasien post kemoterapi.

PPE juga harus digunakan ketika membersihkan toilet bekas pasien kemo.

Penanganan yang sama juga berlaku untuk pasien yang menggunakan obat kemoterapi di rumah (di luar RS) secara oral edukasi memegang peran sangat penting


Reference1. NIOSH (National Institute for Occupational Safety and Health). 2012. NIOSH list of

antineoplastic and other hazardous drugs in healthcare settings 2012. http://www.cdc.gov/niosh/docs/2012-150/pdfs/2012-150.pdf

2. National Institute for Occupational Safety and Health. NIOSH Alert: Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings. DHHS (NIOSH)Publication No. 2004-165. Washington DC: US Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention; 2004.

3. Dranitsaris G, Johnson M, Poirier S, et al. Are health care providers who work with cancer drugs at an increased risk for toxic events? A systematicreview and meta-analysis of the literature. J OncolPharm Pract 2005;11:69–78.

4. Connor T, Mc diarmid. Preventing occupational exposures to antineoplastic drugs in health care settings. CA cancer J Clin 2006;354-65.

5. Knobloch, Mohring, Nolte E, Hamscher G, et all. Cytotoxic drugs residues in urine dog receiving anticancer chemotheraphy. J Vet Intern Med 2010;24:384-90.


sisa metabolit obat kemoterapi prima kft 051215

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