CSPT Hazardous Drug Compounding 5 — Questions and Answers
Question 1: Which statement correctly describes the difference between decontamination and deactivation of hazardous drugs?
- Decontamination neutralizes the drug chemically; deactivation removes it physically
- Deactivation chemically neutralizes the drug; decontamination physically removes residue (Correct answer)
- Both terms are interchangeable and refer to the same process
- Decontamination applies only to antineoplastics; deactivation applies to all HDs
Correct answer: Deactivation chemically neutralizes the drug; decontamination physically removes residue
Deactivation uses agents (e.g., oxidizing agents) to chemically neutralize hazardous drugs, while decontamination involves physically removing the residue from surfaces.
Question 2: A compounder working with an NIOSH Group 1 hazardous drug must wear chemotherapy gloves. How often should these gloves be changed during an extended compounding session?
- Only when visibly soiled or torn
- Every 30 minutes or per manufacturer's permeation data, whichever is shorter (Correct answer)
- Once per shift
- Every 60 minutes regardless of manufacturer guidance
Correct answer: Every 30 minutes or per manufacturer's permeation data, whichever is shorter
Chemotherapy gloves should be changed at intervals not exceeding manufacturer permeation data (often 30 minutes) to ensure continued protection against hazardous drug penetration.
Question 3: USP <800> requires that personnel who routinely handle hazardous drugs undergo medical surveillance. Which of the following is a primary goal of this surveillance?
- Verify employees are physically fit for cleanroom gowning procedures
- Detect early signs of occupational exposure or adverse health effects (Correct answer)
- Confirm employees have received all required vaccinations
- Ensure compliance with state licensure renewal requirements
Correct answer: Detect early signs of occupational exposure or adverse health effects
Medical surveillance aims to identify early health effects from occupational hazardous drug exposure, allowing intervention before serious harm occurs.
Question 4: When using a closed-system drug transfer device (CSTD) during HD compounding, what is the primary safety benefit?
- Eliminates the need for double gloving
- Prevents the escape of hazardous drug vapors and aerosols during transfer (Correct answer)
- Replaces the need for a C-PEC for all HD categories
- Allows compounding of HDs in a standard ISO 5 hood without additional controls
Correct answer: Prevents the escape of hazardous drug vapors and aerosols during transfer
CSTDs mechanically prohibit the transfer of environmental contaminants and prevent the escape of hazardous drug vapors or aerosols during preparation and administration.
Question 5: Which waste container is appropriate for disposal of materials contaminated with trace amounts of hazardous drugs (e.g., used vials, tubing)?
- Standard red sharps container
- Yellow chemotherapy waste container labeled 'Hazardous Drug Waste' (Correct answer)
- Black regulated medical waste bag
- Clear puncture-resistant container with biohazard symbol
Correct answer: Yellow chemotherapy waste container labeled 'Hazardous Drug Waste'
Yellow chemotherapy (RCRA hazardous) waste containers are specifically designated for trace-contaminated HD materials and must be segregated from standard medical waste.
Question 6: A pharmacy is compounding a hazardous drug that poses a reproductive risk but is NOT antineoplastic. According to USP <800>, which personnel may request exemption from handling this drug?
- Any employee who presents a doctor's note
- Personnel who are pregnant, breast-feeding, or actively trying to conceive (Correct answer)
- All employees under age 30
- Only female employees of childbearing age
Correct answer: Personnel who are pregnant, breast-feeding, or actively trying to conceive
USP <800> allows personnel who are pregnant, actively breastfeeding, or actively trying to conceive to request alternative duty and avoid handling reproductive-risk hazardous drugs.
Question 7: What is the correct order of steps when doffing (removing) PPE after hazardous drug compounding?
- Outer gloves → gown → shoe covers → inner gloves → mask/respirator → hand wash
- Shoe covers → outer gloves → gown → inner gloves → head cover → mask → hand wash (Correct answer)
- Gown → outer gloves → shoe covers → inner gloves → mask → hand wash
- Mask → gown → outer gloves → shoe covers → inner gloves → hand wash
Correct answer: Shoe covers → outer gloves → gown → inner gloves → head cover → mask → hand wash
The correct doffing sequence removes the most contaminated outer items first (shoe covers, outer gloves, gown) before removing inner gloves, head cover, and mask to minimize self-contamination.
CSPT Hazardous Drug Compounding 5
Which statement correctly describes the difference between decontamination and deactivation of hazardous drugs?