Hazardous drugs are medications having toxic chemicals as the constituents and produces health hazards when exposed.
A health hazard is defined as a chemical for which there is statistically significant evidence, based on at least one study conducted in accordance with established scientific principles that acute or chronic health effects may occur in exposed employees.
It includes chemicals that are carcinogens, toxic or highly toxic agents, reproductive toxins, irritants; corrosives, sensitizers, and agents that produce target organ effects.
ASHP and OSHA have proposed certain criteria to determine which drugs should be considered hazardous and the related safe handling programs for them.
According to them, any drug which has carcinogenicity, teratogenicity, developmental toxicity, reproductive toxicity, organ toxicity at low doses, genotoxicity, comes under the list of these drugs.
Moreover, any new drug having structure and toxicity profile similar to these standards are considered as hazardous.
However, safe handling guidelines put forward that each healthcare setting should create its own list of hazardous medications based on specific criteria and following related guidance.
When drugs are purchased for the first time, they must be evaluated to determine whether they should be included in the facility's list of hazardous drugs.
As the use and number of these drugs increase, so is the healthcare worker exposure possibility.
Investigational drugs must be evaluated according to the information provided to the principal investigator.
If the information provided is deemed insufficient to make an informed decision, the investigational drug should be considered hazardous until more information is available.
A key element of the safety program for handling these drugs is the Material Safety Data Sheet (MSDS).
Employers are required to have an MSDS available for all hazardous agents in the workplace.
A comprehensive safety program must include a process for monitoring and updating the MSDS database.
When a hazardous drug is purchased for the first time, an MSDS must be received from the manufacturer or distributor.
The MSDS should define the appropriate handling precautions, including protective equipment, controls, and spill management associated with the drug.
Many MSDSs are available online through the specific manufacturer or through safety-information services.