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Chapter 40

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INTRODUCTION

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The following tables describe appropriate handling and storage, and drug product preparation and administration procedures for antineoplastics and other selected medications often used concomitantly. The tables describe drug use under a variety of commonly encountered conditions, but do not identify all applications or conditions of product stability and compatibility. Likewise, the tables are not an exhaustive list of marketed products and should not be construed as an endorsement for any manufacturer's products or discriminating against products that were not specifically identified. Clinicians are advised to refer to product labeling for more complete information about individual products and up-to-date reference sources for information about drug compatibility and stability

The information contained in this chapter is derived from contemporary product labeling approved by the U.S. Food and Drug Administration (FDA), pharmaceutical manufacturers' websites, and, in some cases, from published studies and personal communications with pharmaceutical manufacturers

Occasionally, the package insert component of product labeling for drugs that have received FDA approval for commercial use is prefaced by prominent precautionary and warning summaries circumscribed by a rectangular border, commonly referred to as black box warnings, or, simply, boxed warnings. The boxed warnings reproduced in this chapter faithfully recapitulate the most current versions of manufacturers' product labeling available lacking only referent citations to information located elsewhere within product labeling. Referents are replaced here by an ellipsis (…). Health care providers are urged to consult the most current versions of product labeling and primary medical publications for more information

In 2001, the FDA Office of Generic Drugs requested manufacturers of sixteen similarly named drug pairs to voluntarily revise the appearance of those established drug names by enhancing distinguishing elements of otherwise very similar (look-alike) names. The Name Differentiation Project of 2001 encouraged manufacturers to supplement their applications with revised labeling that incorporated "Tall Man" letters within drug names to aid visual differentiation between those drug names with a goal toward minimizing medication errors by inappropriate drug selection, ie, capitalizing letters that aid in distinguishing between similar generic and proprietary drug names. With the exception of section titles, labeled identities, compendial names, and boxed warnings, drug names appear in this chapter with the Tall Man names and conventions established and recommended by the FDA (URL: http://www.fda.gov/Drugs/DrugSafety/MedicationErrors/ucm164587.htm [accessed February 14, 2014]) and the Institute for Safe Medication Practices, Horsham, PA. (URL: www.ismp.org [accessed, February 14, 2014])

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Key to Abbreviations

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Key to Abbreviations
0.45% NaCl 0.45% Sodium chloride injection, USP
0.9% NS 0.9% Sodium chloride injection, USP
1/6-M SLI Sodium lactate injection, USP (1/6 molar [1.9%] sodium lactate)
3% NaCl 3% Sodium chloride injection (hypertonic)
AKA Also known as
ANC Absolute neutrophil count
AUC Area under the concentration versus time curve
B0.9% NS Bacteriostatic (antimicrobially preserved) 0.9% sodium chloride injection
BSA Body surface area
BWFI Bacteriostatic water for injection, USP
CYP A prefix denoting cytochrome P450 enzymes
CSF Cerebrospinal fluid
D10W 10% Dextrose injection, USP
D2.5W 2.5% Dextrose injection, ...

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