Hazardous and Non-Hazardous Drug Handling and Safety
Risk Assessment and Controls
Understand the hierarchy of controls for hazardous drugs: elimination/substitution, engineering controls (closed-system transfer devices, biological safety cabinets, isolators), administrative controls (work practices, training), and personal protective equipment. Know that a containment ventilated enclosure or Class II BSC is used for hazardous compounding, and that a negative-pressure room protects the environment.
Exposure and Spill Management
Candidates must know routes of exposure (inhalation, dermal, ingestion, injection), the need for appropriate gloves (often two pairs), gowns, and respiratory protection when required. Spill kits, deactivation, and disposal in hazardous waste containers are testable. Receipt, storage, and transport of hazardous drugs should be segregated and labeled.
Traps
A frequent trap is treating all hazardous drugs the same regardless of formulation - some require special handling based on risk assessment. Another is assuming a standard laminar flow hood protects the worker; only a BSC or isolator with proper airflow protects the operator. Questions may also test that closed-system transfer devices reduce but do not eliminate exposure.
Rule of Thumb
For any hazardous drug question, apply the hierarchy: engineering control first, then work practice, then PPE - and never rely on PPE alone.