Department
of Pharmacy Policies & Procedures
Number: 5:09
Effective Date: September 2009
Revisions:
Reviewed:
Approval: 10/09
Subject: PNEUMATIC TUBE DRUG DELIVERY
Policy
The pneumatic
tube system is designed to facilitate rapid delivery of sensitive materials,
such as medications, to patient care units around the hospital. However, not all types of medications can be
delivered by the tube system. Education
of all users about this medication delivery method is essential to ensure safe
and proper handling and to prevent any delays due to breakage or protein
alteration. These guidelines were
developed in an effort to maximize safety and effectiveness of patient care by
decreasing transportation error.
Procedure
Reasons
for not delivering medication via pneumatic tube systems:
·
Alteration: There is potential for alteration of the
active ingredient or vehicle, such as protein denaturation,
cracking of emulsions, etc.
·
Breakage: Use caution with medications in glass bottles
or large containers that cannot be adequately secured or padded during
transport due to the chance of breakage.
·
Chemotherapy: Biohazardous
material including chemotherapy, radiopharmaceuticals, or other cytotoxic medications may contaminate the entire tube
system.
·
Expense: Substantial monetary or labor loss if the
medication is “lost” during the transport process.
·
Flammable: Explosive or flammable substances should not
be transported.
·
Living: Living therapeutic modalities may be harmed
during transport.
Medications
that will not be tubed
from pharmacy or nursing station:
·
Any IV chemotherapeutic/cytotoxic medications
·
Any albumin
containing IV/TPN
·
Any IV in a glass
bottle
·
Any
investigational/non-formulary drugs where shaking is not advised
·
Any blood products
·
Any medication found
in Table 1
Table 1:
A comprehensive list of all medications that cannot be delivered through
the pneumatic tube system
|
Drug |
Brand Name |
Reason |
|
Abciximab |
ReoPro |
Alteration |
|
Aldesleukin |
Proleukin - Interleukin II |
Alteration |
|
Alemtuzumab |
Campath |
Alteration |
|
Alprostadil |
Caverject, Prostin VR |
Alteration |
|
Alteplase (thawed) |
Activase |
Alteration |
|
Antithymocyte Globulin, Rabbit |
Thymoglobulin |
Alteration |
|
Argatroban |
Alteration |
|
|
Asparaginase |
Elspar |
Alteration |
|
Basiliximab |
Simulect |
Alteration |
|
Bevacizumab |
Avastin |
Alteration |
|
Bortezomib |
Velcade |
Alteration |
|
Botulinum Toxin Type A |
Oculinum |
Alteration |
|
Botulinum Toxin Type B |
Myobloc |
Alteration |
|
Cetuximab |
Erbitux |
Alteration |
|
Chorionic Gonadotropin |
Follutein, Ovidrel |
Alteration |
|
CMV Immune Globulin |
Cytogam |
Alteration |
|
Cyclosporine oral
solution |
Gengraf, Neoral, Sandimmune |
Alteration |
|
Daclizumab |
Zenapax |
Alteration |
|
Darbepoetin |
Aranesp |
Cost |
|
Dornase alfa |
Pulmozyme |
Alteration |
|
Drotrecogin alfa |
Xigris |
Alteration |
|
Epoetin |
Epogin, Procrit |
Alteration |
|
Eptifibatide |
Integrilin |
Alteration |
|
Estrogen |
Alteration |
|
|
Etanercept |
Enbrel |
Alteration |
|
Filgrastim (G-CSF) |
Neupogen |
Alteration |
|
Follitropin beta |
Follistim AQ |
Alteration |
|
Gemtuzumab Ozogamicin |
Mylotarg |
Alteration |
|
Infliximab |
Remicade |
Alteration |
|
Interferon Alfa-2a |
Roferon-A |
Alteration |
|
Interferon Alfa-2b |
Intron-A |
Alteration |
|
Interferon Alfacon-1 |
Infergen |
Alteration |
|
Interferon Beta-1a |
Rebif |
Alteration |
|
Interferon Beta-1b |
Betaseron |
Alteration |
|
Interferon Gamma-1b |
Actimmune |
Alteration |
|
Lepirudin |
Refludan |
Alteration |
|
Menotropins |
Pergonal |
Alteration |
|
Muromonab CD3 |
Orthoclone OKT 3 |
Alteration |
|
Nesiritide |
Natrecor |
Alteration |
|
Nitroglycerine spray |
Nitrolingual spray |
Explosive/Flammable |
|
Octreotide LAR |
Sandostatin |
Alteration |
|
Omalizumab |
Xolair |
Alteration |
|
Oprelvekin |
Neumega |
Alteration |
|
Palivizumab |
Synagis |
Alteration |
|
Panitumumab |
Vectibix |
Alteration |
|
Pegfilgrastim |
Neulasta |
Alteration |
|
Peginterferon Alfa-2a |
Pegasys |
Alteration |
|
Quinupristin-Dalfopristin |
Synercid |
Alteration |
|
Ranibizumab |
Lucentis |
Alteration |
|
Rasburicase |
Elitek |
Alteration |
|
Rituximab |
Rituxan |
Alteration |
|
Sargramostim (GM-CSF) |
Leukine |
Alteration |
|
Tenecteplase |
TNKase |
Alteration |
|
Trastuzumab |
Herceptin |
Alteration |
|
Urokinase |
Abbokinase |
Alteration |