tretinoin, systemic
PrintTrade Name(s): Tretinoin | |
Group 1: Antineoplastic Hazardous | AHFS Class: Antineoplastic Agents |
Activity | Gloves | Gown | Eye/Face | Mask | Notes/Instructions |
Dispensing prepackaged formulations |
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Counting/Repackaging tablets or capsules | Recommended if pregnant, breast feeding, or trying to conceive. | If risk of dust inhalation |
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Repackaging oral liquids | If risk of spill or splash | If risk of inhalation |
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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. |
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Liquid - oral or feeding tube | If potential for splash, vomit or spit up |
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Reference: NIOSH 2016, USP <800>
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>
- Causes skin irritation.
- May damage fertility or the unborn child.
- Very toxic to aquatic life.
- Very toxic to aquatic life with long lasting effects.
Reference: SDS - Cayman Chemical
Only met the NIOSH criteria as a developmental and/or reproductive hazard
Tretinoin binds to alpha, beta, and gamma retinoic acid receptors (RARs). RAR-alpha and RAR-beta have been associated with the development of acute promyelocytic leukemia and squamous cell cancers, respectively. RAR-gamma is associated with retinoid effects on mucocutaneous tissues and bone. Although the exact mechanism of action of tretinoin is unknown, current evidence suggests that the effectiveness of tretinoin in acne is due primarily to its ability to modify abnormal follicular keratinization. Comedones form in follicles with an excess of keratinized epithelial cells. Tretinoin promotes detachment of cornified cells and the enhanced shedding of corneocytes from the follicle. By increasing the mitotic activity of follicular epithelia, tretinoin also increases the turnover rate of thin, loosely-adherent corneocytes. Through these actions, the comedo contents are extruded and the formation of the microcomedo, the precursor lesion of acne vulgaris, is reduced. Tretinoin is not a cytolytic agent but instead induces cytodifferentiation and decreased proliferation of APL cells in culture and in vivo. When Tretinoin is given systemically to APL patients, tretinoin treatment produces an initial maturation of the primitive promyelocytes derived from the leukemic clone, followed by a repopulation of the bone marrow and peripheral blood by normal, polyclonal hematopoietic cells in patients achieving complete remission (CR). The exact mechanism of action of tretinoin in APL is unknown.
Reference: Drug Bank
Experienced Physician, Acute Promyelocytic Leukemia : Increased Risk of ADRs