By James Rinehart, RPh, MS, FASHP and James A. Jorgenson, RPh, MS, FASHP

Creating safe handling processes for hazardous medicines 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 medicines such as antineoplastics is well established, NIOSH recently categorised a variety of other drug classes as hazardous. The current NIOSH list includes chemotherapy medications, antiviral drugs, hormones, some bioengineered medicines, and other miscellaneous medicines.

This article discusses issues surrounding the safe handling of these types of medicines 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.

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