Pharmaceuticals as Workplace Hazards


Drug names

Most drugs and medicines have more than one name. These include trade names or brand names that the manufacturer and distributor use. Even if you consider the “scientific” name, there are usually more than one.

Take for instance Bayer Aspirin. The brand name is Bayer. Only the trademark holder (Bayer AG) can sell aspirin under that name. The generic name is aspirin. Aspirin is a word in the dictionary and vendors can use the name aspirin when they sell that drug. A more scientific name is acetylsalicylic acid. An even more formal scientific name is 2-acetoxybenzoic acid. And there are more complex names. And there is a Chemical Abstracts Service number: 156865-15-5.

Everyone working at a healthcare facility needs to understand these naming conventions. The waste management plan should specify what names to use for the most widely used pharmaceuticals in the facility. What names will be used in manifests? What names will be used in spill logs and pharmaceutical inventory databases? What names (if any) will be used on storage containers? Develop and plan and stick to it.

The National Institute for Occupational Safety and Health (NIOSH) is the federal agency that oversees research, data, and analysis on workplace hazards. They have looked into hazardous drugs that healthcare workers may be exposed to and categorized these compounds into three groups. Group 1 is antineoplastic drugs (roughly, chemotherapy medications). Groups 2 is other drugs (not antineoplastic) that are hazardous, while Group 3 are drugs that may interrupt fertility in women or men or that may get into breast milk.

Group 1

Group 1 (note, for the most part these medicines are classified by the American Hospital Formulary Service system as Classification 10:00)

altretamine
amsacrine
anastrozole
arsenic trioxide
axitinib
azacitidine
Bacillus Calmette Guerin (BCG)
belinostat
bendamustine
bicalutimide
bleomycin
bortezomib
bosutinib
brentuximab vedotin
busulfan
cabozantinib
Embryolethal
capecitabine
carfilzomib
carmustine
chlorambucil
cisplatin
cladribine
clofarabine
crizotinib
cyclophosphamide
dabrafenib
dacarbazine
dactinomycin
dasatinib
daunorubicin
decitabine
degarelix
docetaxel
doxorubicin
enzalutamide
epirubicin
eribulin
erlotinib
estramustine
etoposide
everolimus
exemestane
floxuridine
fludarabine
fluorouracil
flutamide
fulvestrant
gemcitabine
gemtuzumab ozogamicin
goserelin
histrelin
hydroxyurea
idarubicin
ifosfamide
imatinib
irinotecan
ixazomib
ixabepilone
letrozole
leuprolide
lomustine
mechlorethamine
megestrol
melphalan
mercaptopurine
methotrexate
mitomycin
mitotane
mitoxantrone
nelarabine
nilotinib
omacetaxin
paclitaxel
panobinostat
pazopanib
pemetrexed
pentostatin
pertuzumab
pomalidomide
ponatinib
pralatrexate
procarbazine
regorafenib
romidepsin
sorafenib
streptozocin
sunitinib
tamoxifen
temozolomide
temsirolimus
teniposide
thioguanine
thiotepa
topotecan
trametinib
trifluridine/tipiracil (combination only)
triptorelin
valrubicin
vandetanib
vemurafenib
vinblastine
vincristine
vinorelbine
vismodegib
vorinostat
ziv-aflibercept

Group 2

abacavir
alefacept
apomorphine
azathioprine
chloramphenicol
cidofovir
deferiprone
dexrazoxane
diethylstilbestrol
divalproex
entecavir
estradiol
estrogens, conjugated
estrogens, esterified
estropipate
fingolimod
fluoxymesterone
fosphenytoin
ganciclovir
leflunomide
lenalidomide
liraglutide recombinant
medroxyprogesterone acetate
mipomersen
mycophenolate mofetil
mycophenolic acid
nevirapine
ospemifene
oxcarbazepine
paliperidone
phenoxybenzamine
phenytoin
pipobroman
raloxifene
rasagiline
risperidone
sirolimus
spironolactone
tacrolimus
teriflunomide
thalidomide
tofacitinib
uracil
zidovudine

Group 3

acitretin
ambrisentan
bosentan
cabergoline
cetrorelix
clomiphene
clonazepam
colchicine
dinoprostone
dronedarone
dutasteride
eslicarbazepine
ergonovine/methylergonovine
finasteride
fluconazole
ganirelix
icatibant
lomitapide
macitentan
mentropins
misoprostol
nafarelin
oxytocin
pamidronate
paroxetine
pasireotide
pentetate calcium trisodium
peginesatide
plerixafor
ribavirin
riociguat
telavancin
temazepam
testosterone
topiramate
tretinoin
ulipristal
valproate/valproic acid
vigabatrin
voriconazole
warfarin
ziprasidone
zoledronic acid
zonisamide