conjugated estrogens
PrintTrade Name(s): Premarin | |
Group 2: Non-Antineoplastic Hazardous | AHFS Class: Estrogens |
Activity | Gloves | Gown | Eye/Face | Notes/Instructions |
Dispensing prepackaged formulations |
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Counting/Repackaging tablets and capsules | Recommended if pregnant, breast feeding or trying to conceive |
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Formulation | Gloves | Gown | Eye/Face | Notes/Instructions |
Tablets and capsules | (If patient requires assistance) | (If patient requires assistance) |
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Topicals, creams, vaginal rings | (If patient requires assistance) | (If patient requires assistance) |
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Type of Instance | Gloves | Gown | Mask | Eye/Face | Notes/Instructions |
Receiving undamaged HD shipping container |
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Receiving damaged HD shipping container | If container must be opened | If container must be opened | If container must be opened |
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Spill Cleanup | Large volume | Large volume |
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Reference: USP <800>
Hazardous Pharmaceutical | Trace Chemo | Biohazardous and Sharps |
1. Non-returnable hazardous, chemo and EPA regulated drugs. (Patient specific prescriptions, partially used blister packs, containers with more than 3% medication remaining) 2. Empty bottles or packaging of P-Listed drugs. (Warfarin, nicotine, epinephrine, nitroglycerin, physostigmine) 3. PPE with visible contamination from hazardous drug. | 1. Waste contaminated through contact with chemotherapeutic agents. (Empty vials, IV bags, syringes and tubing) 2. PPE worn while handling hazardous drugs with NO visible contamination. (Gowns, gloves and masks) 3. Used CSTD devices. | 1. All sharps capable of cutting or piercing the skin. (Needles/syringes, broken ampules, lancets) 2. Items contaminated with blood or other potentially infectious materials. (Tubing, bags or dressings containing blood, contaminated waste from isolation patients) |
Dosage Form | Ship to Institution or Pharmacy | Ship to Locations Outside of ODOC |
Tablets and Capsules |
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Liquid, Topical, and Transdermal |
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PPE | Standards |
Shoe Covers |
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Gowns |
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Gloves |
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Face Shields |
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Goggles |
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N95 Masks |
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Removal and Disposal |
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Reference: USP <800>
- May cause cancer
- May damage fertility. May damage the unborn child
- May form combustible dust concentrations in air
Reference: SDS - Pfizer Inc
conjugated estrogen: NTP "known to be human carcinogen"; Black Box warning for endometrial cancer and cardiovascular risks; Long term use in women and laboratory studies increases frequency of several cancers
The conjugated estrogens, equally to the normal physiological estrogen, work by agonistically binding to the estrogen receptors alpha and beta. The estrogen receptors vary in quantity and proportion according to the tissues and hence, the activity of this conjugated estrogens is very variable.2
The activity made by the conjugated estrogens is driven by the increase in the synthesis of DNA, RNA and various proteins in responsive tissues which in order will reduce the release of gonadotropin-releasing hormone, follicle-stimulating hormone and leuteinizing hormone.8
The specific mechanism of action cannot be described only in terms of total estrogenic action as the pharmacokinetic profile, the tissue specificity and the tissue metabolism is different for each component of the product.7
Reference: Drug Bank