temozolomide
PrintTrade Name(s): Temodar | |
Group 1: Antineoplastic Hazardous | AHFS Class: Antineoplastic Agents |
Activity | Gloves | Gown | Eye/Face | Mask | Notes/Instructions |
Dispensing prepackaged formulations |
| ||||
Counting/Repackaging tablets or capsules | Recommended if pregnant, breast feeding, or trying to conceive. | If risk of dust inhalation |
| ||
Repackaging oral liquids | If risk of spill or splash | If risk of inhalation |
|
Formulation | Gloves | Gown | Eye/Face | Mask | Notes/Instructions |
Tablet or capsule - from unit-dose package | or Recommended if pregnant, breast feeding, or trying to conceive. |
| |||
Liquid - oral or feeding tube | If potential for splash, vomit or spit up |
|
Reference: NIOSH 2016, USP <800>
Type of Instance | Gloves | Gown | Mask | Eye/Face | Notes/Instructions |
Receiving undamaged HD shipping container |
| ||||
Receiving damaged HD shipping container | If container must be opened | If container must be opened | If container must be opened |
| |
Spill Cleanup | Large volume | Large volume |
|
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 |
|
|
Liquid, Topical, and Transdermal |
|
|
PPE | Standards |
Shoe Covers |
|
Gowns |
|
Gloves |
|
Face Shields |
|
Goggles |
|
N95 Masks |
|
Removal and Disposal |
|
Reference: USP <800>
- Fatal if swallowed.
- Suspected of causing genetic defects.
- Suspected of causing cancer.
- May damage fertility or the unborn child.
- Causes damage to organs {bone marrow} through prolonged or repeated exposure.
Reference: SDS - Cayman Chemical
Temozolomide is not active until it is converted at physiologic pH to MTIC. It is suggested that MTIC then alkylates DNA at the N7 position of guanine, O3 position of adenosine, and O6 position of guanosine, with the most common site being the N7 position. This methylation of guanine residues lead to single and double-strand DNA breaks and subsequent apoptotic cell death. It is suggested that the N7-methylguanine plays a critical role in the antitumor activity of the drug, as there is a correlation between the sensitivity of tumor cell lines to temozolomide and the activity of O6-alkylguanine alkyltransferase, which is the DNA repair protein that specifically removes alkyl groups at the O6 position of guanine. Cells lines that have lower levels of AGT are more sensitive to the cytotoxicity of temozolomide. It is also suggested that cytotoxic mechanism of temozolomide is related to the failure of the DNA MMR system to find a complementary base for methylated guanine. The DNA MMR system is involved in the formation of a number of proteins that remove methylated guanine. Evidence shows that when this repair process is targeted to the DNA strand opposite the O6-methylguanine, its inability to find the correct target leads to long-lived nicks in the DNA. The accumulation of these nicks lead to the inhibition of replication in the daughter cells, thereby blocking the cell cycle at the G2-M boundary.
Reference: Drug Bank