What is the immediate-use provision in USP? This is basically an exemption to USP that allows certain sterile products to be prepared compounded without the need for special facilities e. Two key criteria for immediate-use exemption are avoidance of touch contamination and administration within 1 hour. Nevertheless, it is prudent to carry out immediate-use compounding in an area that is kept clean and orderly. Additionally, common aseptic techniques should be followed. However, the handling of immediate-use CSPs must meet all of the following criteria: Immediate-use CSPs are used in those situations where there is a need for emergency or immediate patient administration of a CSP.


We do a concentration of 10mu in ml of LR and 40mu in 1, ml of LR. I can’t remember off the top of my head how long they are good but they are stable in a closed bag at room temp for a good while, IIRC. Spiked and hung is a different story.

*Review > Pharmaceutical Compounding *Hand Sanitizer *Math Review * *As per the FDA *Beyond-Use Date (BUD) “The date or time after which a compounded sterile preparation (CSP) shall not be stored or transported. The date is determined from the.

The first formal issue was in The new version contains important, new requirements that differ substantially from the now-superseded version. Starting with the first edition of USP in , and carrying over into the current edition, USP spells out a comprehensive quality system for the design and operation of sterile compounding areas and their support spaces. The intent of USP is twofold: Click image to download larger version.

Right Detail of the anteroom and compounding rooms.

Cannabis (drug)

Boyle BETHESDA, MD — With increasing shortages of critical chemotherapy drugs — and the funds to buy them — VA pharmacists are constantly looking for ways to enable the medications and money to go farther so that more patients can be treated. As a result, significant amounts of expensive and often hard to obtain drugs are simply thrown away. While the language of USP chapter implies that multiple uses of these vials during the established time frame is permitted, prior to the study, the oncology pharmacy at Walter Reed discarded all unpreserved vials immediately after opening.

Cannabis, also known as marijuana among other names, is a psychoactive drug from the Cannabis plant used for medical or recreational purposes. The main psychoactive part of cannabis is tetrahydrocannabinol (THC), one of known compounds in the plant, including at least 65 other cannabinoids. Cannabis can be used by smoking, vaporizing, within food, or as an extract.

A beyond-use date BUD is the date or time after which administration of a CSP shall not be initiated and is determined from the date or time the preparation is compounded 1. The BUDs described here are based on the risk of microbial contamination, and assume that the CSP components can remain chemically and physically stable. Storage in a refrigerator or freezer has shown to slow the growth of microorganisms allowing for longer BUDs for CSPs stored under colder temperatures versus controlled room temperature.

Preparation characteristics also play a role in determining BUD. Those characteristics include method of achieving sterility, if sterility testing is performed, and if a preservative is added. Thorough preparation combined with enhanced storage conditions refrigeration and freezing can dramatically increase the time that the CSP can be stored before administration.

Some CSPs may be stored under various conditions before use. For example, a CSP may be frozen, thawed in a refrigerator, and then stored at room temperature before administration. Category 2 CSPs can have controlled room temperature BUDs ranging from 4 days to 42 days depending on preparation characteristics, however, regardless of the preparation characteristics, the BUD can be extended to 45 days after preparation if the CSP is stored in a freezer.

Increasing the length of time that the CSP can be used from 4 days to 45 days provides tremendous benefits such as less waste from expired CSPs and greater protection from administering expired CSPs 2. Medical grade refrigerators and freezers provide a uniform environment, as well as help stabilize and maintain temperatures during and after door openings allowing the correct BUDs to be assigned.

Medical grade units will ensure a safe, reliable, and effective way to extend the BUD of a CSP leading to safer administration and reduced costs related to less waste. Written by Miranda Allen Helmer designs, manufactures, and sells reliable medical-grade refrigeration.


This is a great way to receive important updates from the district. Make sure your everyone from your unit is signed up. Find out what your unit can do to help make this happen. Read More Leader Registrations Training has become part of the adult registration process.

§ Did the board adopt USP ? Administration time removed from storage/beyond use dating parameters How to determine your risk level? 1. Sterility of drugs/equipment a. If compounding with any ingredients or supplies that are non-sterile = Risk Level 3 2. Batching preparations that are intended for more than 1 patient?

Medically reviewed on Jun 11, by L. Anderson, PharmD Patients often have questions about drug expiration dates: Can I safely take a medication if it has reached the drug expiration date? Are there recommendations about the best way to store my medications? Which drugs should never be used past their expiration date? For many patients, these questions arise because medications can be expensive and it is costly to frequently replace expired but unused medications.

What does an expiration date mean? The expiration date is the final day that the manufacturer guarantees the full potency and safety of a medication. Drug expiration dates exist on most medication labels, including prescription, over-the-counter OTC and dietary herbal supplements. For legal and liability reasons, manufacturers will not make recommendations about the stability of drugs past the original expiration date.

In all actuality, the stability of the drug may be much longer, but no one tests it.

Hospital Pharmacies

These preparations are compounded in an FDA registered facility using applicable current Good Manufacturing Practices. Our products undergo potency, endotoxin and sterility testing as per USP. We also follow strict environmental monitoring and evaluation procedures for our cleanroom areas and personnel. All pharmacy personnel responsible for preparing sterile preparations receive both didactic and experiential training in sterile preparations and are routinely validated for proper aseptic technique.

In-house rapid microbiological technology provides an immediate, highly sensitive assessment of compounded preparation sterility.

These guidelines were difficult to formulate and slow to be accepted. In a national survey conducted in , only % of hospitals were in compliance with the guidelines. Chapter > became official on January 1, , but its origins and its development are a .

In an effort to simplify some of the basics of the 18 page, single space document outlining the provisions of the new chapter, here are 10 simple things you need to know to fast-track your pharmacy into creating a USP compliant environment. A Positive pressure air system with Hepa filtration and proper garmenting will help you lower particle threshold to below 10, particles per cubic foot. People are the single greatest source of contamination in the cleanroom.

The average person sheds approximately particles per minute performing normal activities. Therefore, proper garmenting to create an effective barrier is essential. This means high particulating cotton lab coats are out and low-particulating polyester reusable garments or microporous disposable garments are in. The greater the coverage of barrier between body and product, the cleaner the product will be.

All environmental surfaces must be kept free of particulate and microbes. Airborne particulation must be suppressed. This means high-linting cotton gauze is out and low-linting polyester and non-woven wipers are in. Proper technique when wiping is critical. A one-pass approach with a quarter-folded wiper is recommended. This gives each wiper an 8-pass life with each folded surface making contact with the work surface just once.

Closed System Transfer Device Reduces Chemotherapy Drug Waste

The changes to USP will apply to all individuals who prepare compounded sterile preparations, as well as those who work in these environments. The Purpose of Change The proposed changes to the chapter are to continue preventing harm through microbial contamination, excessive bacterial endotoxins and inappropriate quality of ingredients.

Additionally, USP will be updated to reduce risk associated with unintended physical and chemical contaminants, as well as variability in intended strength. Currently, USP is enforceable by the U. Furthermore, the BUD cannot exceed 45 days, regardless of a sterility test being performed. Here is a summary of other additional proposed changes to USP

USP > Pharmaceutical Compounding – Sterile Products StABility dating only if shorter than stERility beyond- use dating recommendations Low-risk level product “ABC” in refrigerator would receive Each general chapter of the USP/NF is assigned a number 24 hours if .

Phillips, PharmD, MBA March 15, The increasing cost of health care is a major concern for health systems, patients, and insurance providers nationwide. These devices are designed to contain HD drips, sprays, and vapors that occur during compounding and administration. A study conducted by The University of New Mexico Hospital found that both pharmacy departments and nursing staff preferred Equashield over 2 other products tested. The study was a 4-step process that included a survey of the health care personnel who would be using the CSTDs.

At the end of study, the consensus was that the Equashield components simplified the entire drug compounding and administration processes. The double-membrane design of Equashield is thought to prevent the ingress of bacteria by protecting the coring-free needles from contamination by environmental microbes. Nelson Laboratories used 4 groups of vials that contained growth media. These groups were accessed by Equashield syringes, for 5, 7, or 10 times—depending on the group—over a 7-day period.

To replicate standard hospital compounding, ISO 5 environmental conditions were used throughout. As an additional extreme measure, one-third of the Equashield syringes and vial adapters were products that had expired.

Beyond-Use Dates for Compounded, Non-Sterile Preparations