This week, we will look at the 5 NIOSH Tables, their titles, and characteristics.

There are actually 5 tables in the NIOSH document titled NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016. The first 3 tables are also labeled as a group; Table 1 is Group 1, Table 2 is Group 2, Table 3 is Group 3. Note the decreasing number of manufacturer’s safe-handling guidances (MSHGs) going from Groups 1 to 3.

Table 1, Group 1: Antineoplastic drugs, including those with the MSHG

Table 2, Group 2: Non-antineoplastic drugs that meet one or more of the NIOSH criteria for a hazardous drug, including those with the MSHG

Table 3, Group 3: Non-antineoplastic drugs that primarily have adverse reproductive effects

Table 4: List of drugs deleted from the previous update. Currently, there are no deletions to report and this table is empty.

Table 5: Personal protective equipment and engineering controls for working with hazardous drugs in healthcare settings.

Comments:

1. Of these 5 tables, Table 1, Group 1 contains the most serious of the drugs to be handled regarding the adverse effects if they are mishandled. Most drugs in this group also contain MSHGs.
2. Table 2 (Group 2) contains only a few MSHGs (9 of the 52 drugs listed).
3. Table 3 (Group 3) does not contain any MSHGs.
4. The MSHG information is generally contained in Section 16 of the U.S. Food and Drug Administration’s approved product labeling (Drug Product Information [DPI]).

Next week: More detailed discussions on the Tables.

Reference:
https://www.cdc.gov/niosh/docs/2016-161/pdfs/2016-161.pdf?id=10.26616/NIOSHPUB2016161

Loyd V. Allen, Jr., PhD, RPh
Editor-in-Chief
International Journal of Pharmaceutical Compounding
Remington: The Science and Practice of Pharmacy Twenty-second edition

News

EVALI is the New Name for Vaping-related Illness
The vaping-related condition that has sickened hundreds of people has a new name: EVALI, or e-cigarette or vaping product use-associated lung injury. The new name, noted Friday in a newly issued guidance for clinicians from the Centers for Disease Control and Prevention, is a sign of the rapidly evolving investigation into the illness, which has sickened 1,299 people across 49 states, Washington, DC, and the U.S. Virgin Islands. The case count continues to climb weekly. Symptoms include shortness of breath, night sweats, low oxygen levels, and hazy spots on a lung X-ray.

There is a new troubling observation in the outbreak: A few patients who were hospitalized for vaping-related illness and then discharged were later readmitted to the hospital. Those patients were hospitalized anywhere between five and 55 days after they were discharged. “The issue of readmissions is a relatively new consideration in the outbreak,� Schuchat said. It’s not clear yet what’s behind those readmissions.
https://www.statnews.com/2019/10/11/vaping-related-illness-has-a-new-name-evali/

Pfizer Working to Fill Void After Teva Stops Making Vincristine
Pfizer is now trying to fill a serious shortfall after Teva Pharmaceutical discontinued production of a chemo drug used to cure children of serious cancers. It is ramping up production of vincristine — often used with other drugs to treat leukemia, brain tumors, and lymphomas — after Teva in July notified the FDA that it had made the “business decisionâ€� to discontinue production. Its move has left pediatric oncologists scrambling to find supplies.
https://www.fiercepharma.com/manufacturing/pfizer-scrambles-to-fill-void-after-teva-stops-making-chemo-drug-often-children

Merck to Test Software Learning to Prevent Drug Shortages
Germany-based Merck plans to use analytics and machine learning to predict and prevent drug shortages, a move that could also save it money. Merck said its supply-and-demand forecasts are about 85% accurate today. To sharpen its predictions, the company’s health-care division plans to start testing a cloud-based software platform later this year made by North Reading, Massachusetts-based TraceLink Inc. The software can analyze in real time data points from various organizations within Merck’s supply chain, including pharmacies, hospitals, and wholesale distributors.
https://www.wsj.com/articles/drugmaker-to-test-machine-learning-to-prevent-drug-shortages-11571079794

Did You Know ...

…that George Washington said the following?

“Be courteous to all, but intimate with few, and let those few be well tried before you give them your confidence. True friendship is a plant of slow growth, and must undergo and withstand the shocks of adversity before it is entitled to appellation.�

Tip of the Week

I think most of us have been placed in a situation where an individual comes up, and over a short period of time “moves in� and tries to become a “confidant� with us. However, short acquaintances are rarely proven to be so trustworthy that we should share confidential information with them, as it is unknown what that individual may do with it or what that person’s motives are. I’m reminded of two other interesting quotes:

* Every one that flatters thee,
  Is no friend in misery.
  Words are easy, like the wind,
  Faithful friends are hard to find.
          (Richard Barnfield, 1598)

* True friendship is like sound health; the value of it is seldom known until lost.
        (Charles Caleb Colton, 1825)

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Looking Back

Ben met Anna,
Made a hit,
Neglected beard,
Ben-Anna split!
     Burma-Shave