Beyond use dating for compounded pharmaceuticals

Table 2: CDC Recommendations for Safe Medication Preparation and Administration · Use aseptic technique to avoid contamination of sterile injection equipment.

· Do not administer medications from a syringe to multiple patients, even if the needle or cannula on the syringe is changed.

It is important to note that some CSPs are prepared and administered in clinics, at the bedside, in procedural areas, and in operating rooms with little direct pharmacy oversight.

While quality and safety programs exist within other health care professions, pharmacy knowledge and involvement in these activities ensures compliance with best practices and also provides an opportunity for pharmacy to take ownership of the complete medication use process.

The publication of the USP in 2004 represents the first official enforceable standard for sterile compounding in the United States.

Prior to its publication, there was little monetary or official support for pharmacies looking to improve their compounding processes, despite thousands of cases of septicemia from exposure to compounded intravenous (IV) from the 1970s on.

into state legislation and adoption of a policy of enforcement by the Joint Commission encouraged swift action and compliance on the part of hospitals and pharmacies across the country.

The chapter stratifies the compounding of all sterile products, including irrigations and ophthalmic preparations, into 3 risk levels based on the sterility of the bulk ingredients and the degree of manipulation required to make the final product.

Health care practitioners, including nurses and physicians, gained experience compounding products in patient areas without a strong pharmacy presence.Best practice is using pharmacy services when possible to minimize immediate-use compounding.The use of a central pharmacy offers a number of advantages over immediate-use compounding in a patient area.Consider a syringe or needle/cannula contaminated once it has been used to enter or connect to a patient’s intravenous infusion bag or administration set.· Use single-dose vials for parenteral medications whenever possible.

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