pasireotide
Print| Trade Name(s): Signifor | |
| Group 3: Reproductive Hazard | AHFS Class: Somatostatin Agonists |
| Formweb: pasireotide | |
| Info Links: Chemotherapy Extravasation Policy | |
Administration:
Injectable = vial, syringe, IV solution, irrig solution, ampule - NN & RR (LH))
| Activity | Glove | Gown | Eye | Mask (N95/PAPR) | CSTD |
| Administration |  |
If splashing possible |
If inhalation possible | ||
| Waste/Disposal of drug | |
If splashing possible |
If inhalation possible |
Nursing Non-Antineoplastic or Reproductive Risk Drug PPE and Work Practices (Link to a file uploaded to Rhazdrugs or to a file on your intranet, or a shared drive.)
Patient Care Activities:
NN & RR - PPE During Handling of Bodily Fluids, contaminated materials (LH)
Handling of bodily fluids and/or contaminated materials
| Drug Form | Glove | Gown | Eye | Mask (N95/PAPR) | Shoe |
| Intact tablet or capsule from UD package | | ||||
| Non-intact, repackaged tablet or capsule | | ||||
| Oral liquid drug or feeding tube | | ||||
| Topical drug |  |  If splashing possible |  If splashing possible |  If inhalation possible | |
| Powder, solution for inhalation | | | | | |
| Vial; ampule; pre-filled syringe | | If splashing possible | If inhalation possible | ||
| Intravenous solutions | | If splashing possible | If inhalation possible | ||
| Irrigation solutions | | If splashing possible | If inhalation possible |
Disposal:
Non-antineoplastics & Reproductive Risk Only Drugs (LH)
Receiving and Storage:
NN & RR-Receiving & Storage (LH)
| Form | Receipt Packaging | Environment | Glove | Storage | Labeling |
| All Forms | No additional action | No additional action | | May be stored within normal inventory, neutral or positive | Cautionary Labeling |
Pharmacy Non-Antineoplastic or Reproductive Risk Drugs PPE and Work Practices
Preparation:
Injectable NN & RR (LH)
| Glove | Gown | Eye | Resp | Shoe | Head | Hood/Cabinet | CSTD |
(outer layer should be sterile) | |  |  |  |
LAFW |
Pharmacy Non-Antineoplastic or Reproductive Risk Drugs PPE and Work Practices
Transport:
Transport of NN & RR (LH)
| Form | Prep Instructions | Pneumatic Tube |
| Intact tablet/capsule from UD package | Sealed plastic bag, single pair of gloves, cautionary labeling |  |
| Non-intact, repackaged tablet or capsule | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Oral liquid drug or feeding tube | Sealed plastic bag, single pair of gloves, cautionary labeling |  |
| Topical drug | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Powder, solution for inhalation | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Vial; ampule; pre-filled syringe | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Intravenous solution | Sealed plastic bag, single pair of gloves, cautionary labeling | |
| Irrigation solution | Sealed plastic bag, single pair of gloves, cautionary labeling | |
Assessment of Risk:
| Dosage Form | Risk of Exposure | Packaging | Pharmacy | Nursing | Risk Level |
| Intramuscular injection (LAR) | May occur during preparation and administration | Injection, powder, for suspension; Kit | Pharmacy will dispense in manufacturer's packaging | Utilizing recommended PPE nurse will prepare and administer dose while avoiding direct contact with the medication | Medium |
| Subcutaneous injection | May occur during preparation and administration | Single dose glass ampule | Pharmacy will dispense in ampule form | Utilizing recommended PPE nurse will prepare and administer dose while avoiding direct contact with the medication | Medium |
PPE:
PPE Guidelines
| |  | | |  | |  |
| Chemotherapy rated/tested (tested to ASTM D6978-05 (2013), Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs) | Disposable
| Should be worn in situations where eye, mouth, or nasal splashing is possible (i.e., during a bladder instillation of a hazardous drug) | Goggles protect the eyes, but not the face, against spraying. | Certified N95 | Powered air purifying respirator | required for compounding sterile and nonsterile hazardous drugs | required for compounding sterile and nonsterile hazardous drugs |
| Powder-free | Shown to resist permeation by hazardous drugs
| N95 offers no protection against gases and vapors. | For events such as large spills when an IV bag breaks or a line disconnects and leaks, or where there is known or suspected airborne exposure to vapors or gases | Double booties required for HD preparation areas, top layer is doffed before exiting the HD buffer room. | |||
| Inspect for visible defects | Must close in the back (no open front) | Surgical masks do NOT provide respiratory protection from drug exposure | Hazardous drugs with potential to vaporize at room temperature: • Carmustine • Cisplatin •Cyclophosphamide • Etoposide • 5-Fluorouracil • lfosfamide • Thiotepa | ||||
| Double gloving is recommended for all activities involving hazardous drugs except for handling intact, unit-dose oral agents, when one pair of chemotherapy-tested gloves is acceptable | Long sleeves with closed cuffs that are elastic or knit | ||||||
| When wearing double gloves, tuck the cuff of the inner glove under the gown sleeve and the cuff of the outer glove over the gown sleeve. | No seams or closures that could allow hazardous drugs to pass through | ||||||
| During medication manipulation/compounding the outer layer should be sterile | In preparation areas gowns should be changed every 2-3 hours or immediately after a spill or splash | ||||||
Change gloves every 30 minutes unless permeation testing has noted shorter time limits
| Gowns worn in hazardous drug handling areas must NOT be worn to other areas |
Sequence for Donning & Doffing PPE
References: Oncology Nursing Society, NIOSH
Mechanism of Action:
Pasireotide activates a broad spectrum of somatostatin receptors, exhbiting a much higher binding affinity for somatostatin receptors 1, 3, and 5 than octreotide in vitro, as well as a comparable binding affinity for somatostatin receptor 2. The binding and activation of the somatostatin receptors causes inhibition of ACTH secretion and results in reduced cortisol secretion in Cushing's disease patients. Also this agent is more potent than somatostatin in inhibiting the release of human growth hormone (HGH), glucagon, and insulin.
Reference: Drug Bank
Exposure Risk:
- Causes skin irritation
- Causes serious eye irritation
- Suspected of damaging fertility or the unborn child
Reference: PubChem
Safety Data Sheet(s):
Supplemental Information:
Only met the NIOSH criteria as a developmental and/or reproductive hazard
