Development and operation of a pharmacy-based intravenous cytotoxic reconstitution service

Abstract

An intravenous cytotoxic reconstitution service has proved extremely popular with both medical and nursing staff. Since the pharmacy has taken over the responsibility for presenting these medicines in a readily usable form, many potential hazards to inexperienced medical staff have been eliminated, and much time and money have been saved. The pharmacists are in an excellent position to offer advice on many aspects of cytotoxic treatment and are well equipped to spot prescription errors. They are often asked to supply information concerning rates and methods of administration as well as compatibility data of different diluents with various cytotoxic agents. The eventual objective of the service is to provide reconstituted cytotoxic drugs for all patients in the pharmaceutical district receiving chemotherapy. As it is not practical to have pharmacists available 24 hours a day, some form of batch production of syringe-loading drugs could be used. In the immediate future the practicality of storing syringe-loaded drugs in a deep freeze (at -20°C) with rapid thawing will be considered.