Hazardous Medication Disposal Questions encountered by a consultant pharmacist Tom Simpleman Consultant Pharmacist RPh, CGP, FASCP, CPHQ www.fawks.com 720-281-3512
Commercially Available Disposal Systems • Can we really just throw it away in normal trash?
Commercially Available Disposal Systems • Cactus sink • Drug Buster • Rx Destroyer • Medsaway • C2R • Kitty litter
Disposal of an open vial • 10 ml vial of insulin • Use 0.5 ml • Meets the BUD (beyond use) date to discard • Weight of drug vs. vial • How do I dispose of the remainder? • Why is Insulin a RCRA drug?
Disposal of an open vial • I changed from 2 ml vials to 1 ml syringes of Mitomycin ophthalmic. • I use less than the full syringe. How do I dispose of the remainder and syringe
ASC location • ASC located adjacent to a hospital building. • Can we use their medication disposal system? • Are we responsible for maintaining records of how the medical wasted is disposed? • If so, what records are we responsible for keeping and how long?
Medication Disposal Companies • How can I find medication disposal companies? • Are they expensive?
How much? • How frequently do I need to send it to the disposal company? • Do I need to inspect the containers they are stored in regularly? • Can I return the RCRA waste to a pharmacy and not have to track it?
Tracking • What documentation is needed? • Is simply stating I sent it to the disposal company enough? • Why do I have to keep this documentation? • Is it OK if only one person does everything?
Pharmaceutical Waste
Training • What education is required? • How many should be trained? • Should responsibilities be assigned? – If so which ones? • What about non-RCRA meds such as antibiotics?
Common ASC D list • Albuterol inhaler • Ethyl Alcohol – ignitable • Vecuronium • Insulin • Ventolin Aerosol • Silver Nitrate – ignitable • Verapamil HCl • Desflurane • Diazepam injectable ignitable • Novapolus Suprane • Ammonia inhalant – ignitable
Common ASC P list • Physostigmine • Warfarin
ASC (Extended Care) U-list Lindane Chemotherapy Selenium • Mitomycin Warfarin Nicotine Florescein Sodium
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