Risk of exposure of patients' family members to lenalidomide at home.

IF 1.6 4区 医学 Q3 PHARMACOLOGY & PHARMACY European journal of hospital pharmacy : science and practice Pub Date : 2024-10-25 DOI:10.1136/ejhpharm-2022-003632
Yuta Takahashi, Ayumu Nagamine, Akiko Kaneta, Hideaki Yashima, Kyoko Obayashi, Takuya Araki, Koujirou Yamamoto
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Abstract

Objectives: Lenalidomide, a hazardous drug, has strict distribution controls. However, the risk of contamination with lenalidomide when patients take the drug has not been studied and the risk of drug exposure to people in the patient's living environment is unknown. Thus, we investigated the amount of lenalidomide that could be dispersed during the period between removal of the capsule and returning the used blister packages, and we considered the conditions under which lenalidomide could be dispersed and countermeasures.

Methods: The amount of lenalidomide contamination was measured on the outside of the unused blister packages returned by the patients, on the surface of the capsule, and on the inside of the package immediately after removal of the capsule. In addition, the amount of contamination was measured on the blister packages used by the patients and on the gloves worn by the pharmacists on receipt of the packages. Lenalidomide was analysed by liquid chromatography-tandem mass spectrometry.

Results: Lenalidomide amounts on the outside of the unused blister packages returned by the three patients were <10, <10, and 26.8 ng/pack, those on the capsule surface immediately after removal from the packages were 297, 388, and 297 ng/capsule, and those on the inside of packages immediately after removal of all capsules were 143, 184, and 554 ng/pack, respectively. A median of 15.6 ng/pack lenalidomide was detected on the surface of packages used by the patients (n=18). The lenalidomide remaining in the packages immediately after capsule removal (~200 ng/pack), except for the 15.6 ng/pack detected in the packages used by the patients, may have been dispersed in the patient's living environment (~90% or more). The maximum amount of lenalidomide on the surface of the packages used by the patients was over 2500 ng/pack.

Conclusions: The amount of lenalidomide contamination per package was found to be at least 100 ng less after collection by the pharmacist than immediately after removal of the capsules. Therefore, it is recommended to clean the surrounding area and wash one's hands after taking the capsules.

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患者家属在家中接触来那度胺的风险。
目标:来那度胺是一种危险药物,有严格的分销管制。然而,目前尚未对患者服药时受来那度胺污染的风险进行研究,也不清楚患者生活环境中的人接触药物的风险。因此,我们调查了从取下胶囊到归还用过的泡罩包装之间来那度胺的散布量,并考虑了来那度胺散布的条件和对策:方法:我们测量了患者退回的未使用过的泡罩包装外部、胶囊表面以及取下胶囊后包装内部的来那度胺污染量。此外,还测量了患者使用的泡罩包装和药剂师收到包装后所戴手套上的污染量。来那度胺采用液相色谱-串联质谱法进行分析:结果:三名患者退回的未使用过的泡罩包装外部的来那度胺含量均为结论:发现药剂师收集来那度胺后,每个包装上的来那度胺污染量比取下胶囊后的污染量至少少100纳克。因此,建议在服用胶囊后清洁周围区域并洗手。
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来源期刊
CiteScore
3.40
自引率
5.90%
发文量
104
审稿时长
6-12 weeks
期刊介绍: European Journal of Hospital Pharmacy (EJHP) offers a high quality, peer-reviewed platform for the publication of practical and innovative research which aims to strengthen the profile and professional status of hospital pharmacists. EJHP is committed to being the leading journal on all aspects of hospital pharmacy, thereby advancing the science, practice and profession of hospital pharmacy. The journal aims to become a major source for education and inspiration to improve practice and the standard of patient care in hospitals and related institutions worldwide. EJHP is the only official journal of the European Association of Hospital Pharmacists.
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