cytotoxic drugs

Re: cytotoxic drugs

Kate Dawes — Tue, 15 May 2012 11:22:02 GMT

Thanks, will check it out

Re: cytotoxic drugs

David Killick — Mon, 14 May 2012 22:15:03 GMT

Hi,

There is a new company called ChemoPet setting up which might be able to help you. It is run by Iain Grant DipACVIM and Jo Jones RVN. They supply consumables and offer a consultancy service for oncology cases and might be able to advise on chemo safety issues.. They supply the hospira chemo admin system. I have used a number of closed systems including PhaSeal and felt the system by Hospira to be the best. The PhaSeal system is also very good but I would echo the previous comment about it being a bit fiddly because I find it quite bulky particularly for small dogs and cats. If you're interested see http://www.chemopet.co.uk/.

Re: cytotoxic drugs

Kate Dawes — Mon, 14 May 2012 12:42:12 GMT

[quote user="Gillian Mostyn"]

[quote user="Kate Dawes"]we normally dilute it in saline prior to giving iv through a secure catheter.[/quote]

why?

[/quote]

I had this discussion with my boss the other day. He said that before he used to dilute it he used to get problems with cephalic veins becoming very thickened after repeated vincristine doses, and argues that diluting reduces the risk of any problems from extravasation (though as I said we always use iv catheters). I would have thought that flushing with saline before and after would be fine, presumably if vincristine goes extravascularly you're going to have problems regardless of whether it's diluted or not. I've never seen a skin slough, but he has which I guess makes a difference.

Re: cytotoxic drugs

plantagenet — Sat, 12 May 2012 17:25:29 GMT

[quote user="Kate Dawes"]We are also looking at the advice we give to clients re handling of animal waste etc whilst they are on chemo. Again want to make sure clients are well informed of the risks but don't want to put people off.[/quote]

I think we definitely have a responsibility to alert the client to the potentially toxic nature of urine, faeces, vomit even saliva of chemo treated animals, particularly if they have small children (or not so small even) or are pregnant.

From what I gather from posts on VIN, this is taken much more seriously in the US than here.

The safety data makes quite scary reading on most of the data sheets and I, for one, don't take exposure to carcinogens lightly.

Re: cytotoxic drugs

Busybee — Fri, 11 May 2012 20:45:23 GMT

[quote user="Kate Dawes"]The main chemo drug I'm thinking of is vincristine - we normally dilute it in saline prior to giving iv through a secure catheter. Is it possible to dilute using this system or not?[/quote]

When I've used it through Phaseal, I've flushed the catheter, given the vincristine then flushed the line again. Fiddly but works fine!

Re: cytotoxic drugs

Gillian Mostyn — Fri, 11 May 2012 17:46:00 GMT

[quote user="Kate Dawes"]we normally dilute it in saline prior to giving iv through a secure catheter.[/quote]

why?

Re: cytotoxic drugs

Kate Dawes — Fri, 11 May 2012 17:39:29 GMT

thanks, will definitely look into PhaSeal further. We would still use gloves/protective clothing as well, though what we use at the moment probably isn't really sufficient.

The main chemo drug I'm thinking of is vincristine - we normally dilute it in saline prior to giving iv through a secure catheter. Is it possible to dilute using this system or not?

Re: cytotoxic drugs

Martin Atkinson — Fri, 11 May 2012 15:14:49 GMT

[quote user="Mark Hedberg"]

[quote user="Hannah Bose"]

[quote user="Mark Hedberg"]

Someone on here made a funny comment as regards sterile handling - it was about wanting to shake the hand of the bacterium that could withstand vincristine...he called it really evil stuff! (wish I could remember who it was!)

[/quote]

It was .... [drum roll].... Martin Atkinson.

[/quote]

*chuckle* I suppose I should have guessed. : Thanks, Hannah!

[/quote]

I'm happy to take credit for this although I don't remember and to think John Rimmer, on the atopy thread, said he couldn't remember me writing anything funny!

Re: cytotoxic drugs

Mark Hedberg — Fri, 11 May 2012 14:57:21 GMT

[quote user="Hannah Bose"]

[quote user="Mark Hedberg"]

[/quote]

It was .... [drum roll].... Martin Atkinson.

[/quote]

*chuckle* I suppose I should have guessed. : Thanks, Hannah!

Re: cytotoxic drugs

HMC — Fri, 11 May 2012 14:19:10 GMT

[quote user="Mark Hedberg"]

[/quote]

It was .... [drum roll].... Martin Atkinson.

Re: cytotoxic drugs

becka_scotland — Fri, 11 May 2012 12:24:30 GMT

Hi there,

Just a wee note to say I've been using the PhaSeal system in practice now for afew years and its great. We haven't had any problems with it, though it can be a little fiddly to use it for the first time! I have been sourcing the system through Cave Referrals also and find them really helpful and delivery quick which is always useful. My only question to you is the use of chemotherapy outerwear such as gloves and gowns etc? We have chosen to use chemotherapy safe gowns, gloves, face masks and dental goggles in addition to the PhaSeal system. The reason behind this is to avoid any problems if there is a breakdown or spillage then we are already protected. This does add an extra cost onto clients however I feel your own health and that of your staffis most important. I get the clothing through a company called Helapet who are helpful

Re: cytotoxic drugs

Rob Loxley — Fri, 27 Apr 2012 19:40:55 GMT

There are a couple of good In Practice articles on safe use of cytotoxics in general practice, have a search through the archives.

Re: cytotoxic drugs

Kate Dawes — Fri, 27 Apr 2012 15:33:56 GMT

Am not so worried about the sterility (tho obviously important as it's going iv), more about us being exposed to the drug!

Thanks for the info Andrew - had looked at the website and was going to contact them but just wondered if anyone had experience of using it.

Re: cytotoxic drugs

Mark Hedberg — Fri, 27 Apr 2012 14:23:42 GMT

Re: cytotoxic drugs

Andrew Kent — Fri, 27 Apr 2012 12:48:33 GMT

Hi Kate, I think the phaseal range are fantastic if you don't have fume cabinets etc, they are pretty cost effective and would add a few pounds of cost to administration. The range is distributed in UK by cave referrals in Somerset - have a look at their website for costs and ordering. Andy