Labeling (specific case)

• IV
• Syrenges
• Small containers
• When its not needed

• IV: label can be read when hung
• Syrenges: Top of label towards syrenge tip
• Small containers: May not have complete directions for use
• Not needed if immediately administered by preparer

• Name of medication
• Concentration
• Instructions for use
• BUD
• Initials of preparer and pharmacist check
• Warning or auxilery labels

Trissel's temperatures

• Excesive heat
• Room temp
• Cool
• Cold
• Freezer

• hot: 40 C
• Room: 20-25 C
• Cool: 8-15 C
• Cold: 2-8 C
• Freezer: -25 - -10 C

(PEC)

• AKA
• ISO

• AKA: hood.  Includes CAI & CACI
• ISO: 5

Ante room

• AKA
• ISO

• AKA: Secondary engineering Controls
• ISO: 8
• Garbing, handwashing, order entry, labeling.  Suplies wiped and sent to clean room

Clean room

• AKA
• ISO

• Buffer area (contains PEC)
• ISO 7
• Cleaned by trained or cleaning staff

• No more than 3 ingredients in 1 hour
• Administer within 1 hour of prep or discard
• Labeled unless given immediately

• 3 or less components
• ISO5 compounding in ISO7 room.
• Single prep, not a batch

• Complex preparation
• ISO5 in an ISO7 room

• Non sterile ingredients
• Non ISO5

Low risk BUD

• Room temp
• Refrigerator
• Freezer

• Room: 2 days
• Refrigerator: 14 days
• Freezer: 45 days

Medium risk BUD

• Room temp
• Refrigerator
• Freezer

• Room: 30 hours
• Refrigerator: 9 days
• Freezer: 45 days

High risk BUD

• Room temp
• Refrigerator
• Freezer

• Room: 1 days
• Refrigerator: 3 days
• Freezer: 45 days

During air sampling, action should be taken if CFU excedes

• ISO5
• ISO7
• ISO8

• ISO5: 1 CFU
• ISO7: 10 CFU
• ISO8: 100 CFU

Media fill procedure

(low risk)

• 10 ml syringe
• 20 ml of growth media to 3X30 ml vials
• transfer done 5 ml at a time (12 transfers, 4 transfers per vial)

Media fill procedure

(medium risk)

• Transfer 6X100 ml aliquots
• Into 6 containers
• Seperate into 3 sets of 2 containers
• Remove 5 ml from each container and inject into 3 10ml vials
• Incubate

Intradermal

• Where
• Needle size
• Volume

• Where: forearm
• Needle size: 27g, 3/8 to 5/8 CC
• Volume: 0.1ml

Subcutanious (SC)

• Where
• Needle size
• Volume

• Where: upper arm, thigh, abdomin
• Needle size: 24-29g, 3/8 to 5/8 cc
• Volume: 0.1ml

Intramuscular (IM)

• Where
• Needle size
• Volume

• Where: butt, thigh, upper arm
• Needle size: 20-22g.  1-1.25cc
• Volume: <3 ml

Intravenous (IV)

• Where
• Needle size
• Volume

• Where: everywhere
• Needle size: 19-25g
• Volume: -

HEPA air filter

• Efficacy
• Filtered particles

• 99.97& efficient
• filters out 0.3 microns

Glass

+

-

<+>

• Non reactive
• See through
• Can be steralized

<->

• Break
• Heavy
• Rubber stopper reactive
• Need venting tubing

PVC bagging

+

-

<+>

• Not breakable
• Cheap
• Less trash

<->

• Leaches plastics,
• Not moisture/air proof
• Not for lipid soluble drugs

Polyovaline/EVA

+

-

<+>

• Same as PVC
• Less reactive
• OK for lipids

<->

• more expensive than PVC

Polypropylene (syringes/hard plastic)

+

-

<+>

• Less reactive than PVC

<->

• more trash than PVC

PEC

(cleaning frequency)

• AT start
• Q30M

Buffer area counters, surfaces

(cleaning frequency)

• Counters
• Floors
• Shelves

• Countrs: QD
• Floors: QD (when not compounding)
• Shelves: QW

 Buffer area: walls, ceilng, shelves

(cleaning frequency)

Ante room

(cleaning frequency)

• surfaces
• Floors
• Shelves

• Surfaces: QW
• Floors: QD
• Shelves: QM

During surface sampling, actions should be taken if CFU excedes:

• ISO5
• ISO7
• ISO8

• ISO5: 3CFU
• ISO7: 5CFU
• ISO8: 100 CFU