This document discusses safe handling procedures for various chemicals commonly used in medical settings, including disinfectants, methyl methacrylate bone cement, chemotherapy drugs, and cytotoxic agents. It notes that gloves and eye protection should be worn when using disinfectants and other irritating chemicals. For methyl methacrylate, it recommends mixing it just before use with scavenging systems to collect vapors, as the vapors can be irritating and toxic. For chemotherapy drugs and other pharmaceuticals, it advises preparing and administering them carefully to minimize unnecessary exposures, and outlines specific procedures for intraperitoneal chemotherapy. Basic guidelines are provided for safely handling cytotoxic agents, including containment, protective equipment, washing hands after contact, and inc

1. Disinfectants
Prep: Amen Ullah

2. Disinfectants
 Some of the disinfectants used to clean or decontaminate
equipment and furniture can be irritating to the skin and eyes.
 Gloves and goggles should be worn when using these chemicals,
and the agents should be used in proper dilution. The fumes from
some agents can irritate the nasal passages.
The following can cause gloves to degrade:
• Isopropyl alcohol
• Phenol
• Sodium hypochlorite
• Glutaraldehyde
• Hydrogen peroxide
• Quaternary amines
• Povidone iodine

3. Methyl Methacrylate
 Commonly referred to as bone cement, methyl methacrylate is a mixture
of liquid and powder polymers.
 It should be mixed at the sterile feld just before use. The vapors released
during mixing are irritating to the eyes and can damage soft contact
lenses.
 The vapors are also irritating to the respiratory tract, and they can cause
drowsiness.
 Methyl methacrylate may be a mutagen, a carcinogen, or toxic to the liver.
 The liquid solvent can cause corneal burns if it splashes into the eyes. It
also can diffuse through latex gloves to cause an allergic dermatitis; gloves
that are impermeable to this solvent are available.
 A scavenging system should be used to collect the vapors during mixing
and to exhaust it to the outside air or absorb it through activated charcoal.

4. Drugs and Other Chemicals
• Antineoplastic cytotoxic drugs used for chemotherapy can be hazardous, as can
laser dyes and other pharmaceuticals.
• All chemical agents should be prepared and administered to minimize unnecessary
exposures for both patients and personnel.
• Chemicals should be combined or mixed with diluents only when this is known to
be a safe practice, as specifed by the manufacturer.Intraperitoneal chemotherapy
can be administered in the OR during laparotomy.
• The surgeon can use the Coliseum technique where the chemical is introduced via
a Tenckhoff catheter and a roller pump with a heat exchanger set at 111.2° F (44°
C).
• The solution remains in the patient’s abdomen for 90 minutes. The surgeon,
wearing two sets of sterile gloves, continually manipulates the intraabdominal
organs to evenly distribute the heated chemical as it continually circulates through
the cavity and is removed through several abdominal drains.
• The air is continually fltered through activated charcoal and a smoke evacuator to
protect the OR environment from aerosolization of the drug

5. Safe Handling of Cytotoxic Agents
 Antineoplastic cytotoxic agents have carcinogenic and
mutagenic properties, and most can cause local and/or
allergic reactions.
 Personnel should avoid inadvertent direct contact with skin or
eyes, inhalation, and ingestion during handling.

6. • Written precautions and procedures for handling, preparing,
administering, and disposing of cytotoxic agents should be
followed.
Basic guidelines for the use of cytotoxic agents include the following:
1. Protect self from skin and respiratory contact. Preferably, prepare
agents under a vertical laminar flow hood.
Whether or not a containment hood is available, wear thick
gloves, a mask, eye protection, and a gown.
2. Wash hands after handling cytotoxic agents and all items that
have been in contact with them, including those used for
administration.
3. Place all cytotoxic waste in sealed leakproof bags or containers.
Incineration is recommended for all materials used in preparing
and administering cytotoxic agents.

7. Thank you