Crushing Hazardous Medications

Madiha Syed's picture


Do you allow nursing to crush one time doses of hazardous medications on the floor to administer via g-tube or do you require pharmacy to crush in a controlled environment per USP 800?

If you allow nursing to crush on the floor, what device do you use for crushing and what additional PPE requirements do you have for them?

We are struggling to determine if pharmacy needs to take over crushing activities for hazardous medications (non-antineoplastics and reproductive risk).

Thank you,

Monoclonal Antibody handling

Emily Kay D'Anna's picture



Our institution has started a discussion around what PPE and preparation precautions should be in place for monoclonal antibodies (in both the inpatient and ambulatory setting). We recognize that the only monoclonal antibodies that fall on the NIOSH hazardous drug list include those that are conjugated to an antineoplastic (eg, gemtuzumab)... whereas other commonly used mAbs (eg, infliximab, omalizumab-outpatient) are not present in the list. (I did attach two articles that leaned towards treating these agents as hazardous medications.)

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