Safe Protocols for Chemotherapy

Re: Safe Protocols for Chemotherapy

Martin Atkinson — Thu, 07 Nov 2013 09:34:03 GMT

[quote user="John Flynn"]What is the actual risk (to the human) that requires all the added precautions when using these drugs?[/quote] In practice with common sense and some basic protective clothing very little and considering that if you had cancer they would be shoving them into you at far higher doses than we give our pets let alone what you may contact with a little spillage maybe a bit over-stated. But heck there are H&S laws..

[quote user="John Flynn"]Does it vary between drugs and are there drugs that require less precuations than others?[/quote] Very much so, some can cause a very severe local reaction if accidentally self-injected and some are excreted almost unchanged in urine and other body fluids. Some can be very simply injected sub-cut and others require paraphernalia for slow intravenous injection/drip, some require barrier nursing post treatment.

[quote user="John Flynn"]From a risk analysis point-of-view, does the frequency of use come into play w.r.t. the risk posed?[/quote] Like everything there is likely to be a problem with accumulative dose. However, If you're accidentally self-contaminating on every usage I would be seriously concerned over technique!

Re: Safe Protocols for Chemotherapy

Rob Loxley — Wed, 06 Nov 2013 20:13:59 GMT

[quote user="Andy Elliott"]I would prefer to use water-proof disposable gowns designed for chemotherapy but am not sure where to purchase them. [/quote]

You can get long sleeved gowns with thumb loops from JAK. The standard for protective clothing is probably from Berner, they have a UK distributor (but the name currently eludes me - they were at BSAVA this year)

Re: Safe Protocols for Chemotherapy

Rob Loxley — Wed, 06 Nov 2013 20:11:28 GMT

[quote user="Andy Elliott"]I would like to write a protocol for the safe use of chemotherapy in the practice (for the protection of the staff at the clinic) and have a hand-out to give clients regarding their safety with respect to handling their dog and cleaning up urine and faeces etc after chemotherapy when the dogs return home[/quote]

Sounds sensible. There were a couple of good In Practice articles on safe use of chemotherapy in practice which are worth looking up

Re: Safe Protocols for Chemotherapy

Elisabeth Knappett — Tue, 05 Nov 2013 21:47:58 GMT

I second Chemopet - excellent and very informative advice and support, quick supplies of both medication and drugs.Our clinic offers chemotherapy within reason, doxorubicin administration is referred to hospitals that have the correct equipment to deal with it! I'll have a look and see if I can find our protocols tomorrow when I'm back in for you.

John - I've been told that even small exposures to chemotherapy agents can increase the risk of multi-drug resistant cancers, especially leukaemias in humans, so adequate protective clothing for you, your staff and any owners involved must be a given. There are drugs that are higher risk doxorubicin being the one that springs to mind and obviously low risk from exposure to prednisolone. I can't remember exactly whether there is a increased risk with frequency of exposure or whether it is a critical dose that is needed, will double check and see if I have a reference for you.

Re: Safe Protocols for Chemotherapy

Andy Elliott — Tue, 05 Nov 2013 21:16:33 GMT

[quote user="John Flynn"]

This is going to sound like a really stupid question from someone who doesn't really engage in chemotherapy personally...

What is the actual risk (to the human) that requires all the added precautions when using these drugs?

Does it vary between drugs and are there drugs that require less precuations than others?

From a risk analysis point-of-view, does the frequency of use come into play w.r.t. the risk posed?

I know this is a really basic question, but have never had much involvement with chemo cases.

[/quote]

All chemo drugs need to be handled with great respect as they can be associated with some very nasty things including inducing cancer and interfering with pregnancy. We do have a duty of care to our own health and the health of our staff to minimise risk as much as possible. These are probably the most dangerous substances we handle in our clinic!

Re: Safe Protocols for Chemotherapy

Andy Elliott — Tue, 05 Nov 2013 21:11:40 GMT

[quote user="Claire Fisher"]

I can recommend using Iain Grant's chemopet service - they will courier pre prepared doses of drugs to you which makes life easier without a fume cupboard. They also supply gowns, gloves, masks ect.

[/quote]

Thanks Claire - I did find Chemopet after trawling the internet for an hour this afternoon. I will give them a try.

Re: Safe Protocols for Chemotherapy

John Flynn — Tue, 05 Nov 2013 20:22:47 GMT

This is going to sound like a really stupid question from someone who doesn't really engage in chemotherapy personally...

What is the actual risk (to the human) that requires all the added precautions when using these drugs?

Does it vary between drugs and are there drugs that require less precuations than others?

From a risk analysis point-of-view, does the frequency of use come into play w.r.t. the risk posed?

I know this is a really basic question, but have never had much involvement with chemo cases.

Re: Safe Protocols for Chemotherapy

Claire Fisher — Tue, 05 Nov 2013 20:11:41 GMT

I can recommend using Iain Grant's chemopet service - they will courier pre prepared doses of drugs to you which makes life easier without a fume cupboard. They also supply gowns, gloves, masks ect.