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Appendix F of the chapter is a table that lists certain activities involving HDs (eg, receiving, stocking) and the PPE that is required. Deviations include differences in brands, concentrations, or formulations of products used; types of containers or devices; risk level; environmental variables; and storage conditions.
If an HD is in a unit dose packaging, there are no further requirements for alteration prior to dispensing to the patient.1 If non-antineoplastic drugs need to be transferred from their packaging to a prescription bottle, they should be counted with equipment (spatula, tray) dedicated for use with these drugs. If the literature addresses only one of these factors, then USP guidance should be followed when assigning a BUD.Hazardous drugs that require refrigeration will need to be placed in a refrigerator in a negative pressure room. NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings 2012. To ensure appropriate compounding practices and assignment of a beyond-use-date (BUD), appropriate resources should be consulted and multiple factors including stability, sterility, compatibility, and risk level should be considered.1-3 This article summarizes steps in determining the most appropriate BUD for a compounded sterile preparation (CSP) or a compounded nonsterile preparation based on United States Pharmacopeia (USP) guidance and best practices.The rooms in which HDs are stored and compounded also require certain air changes per hour (ACPH). See the Table for required ACPH for compounding nonsterile and sterile HDs, as well as a detailed description of other engineering controls. Centers for Disease Control and Prevention website. Compounded sterile preparations include injections, aqueous bronchial and nasal inhalations, baths and soaks for live organs and tissues, irrigations for wounds and body cavities, and ophthalmic drops and ointments.1 Other preparations can generally be classified as nonsterile.2 When compounding nonsterile preparations, stability and compatibility need to be considered.chapter is on primary and secondary containment engineering controls (C-PECs and C-SECs) as related to storage and compounding of HDs.1 The C-PECs are ventilated devices used to minimize worker and environmental exposure to HDs.Biological safety cabinets (BSCs), compounding aseptic containment isolators (CACIs) and containment ventilated enclosures (CVEs) constitute C-PECs.