INTRODUCTION
The administration of cytotoxic drugs must be approached with great caution due to risks posed to personnel. Further information regarding cytotoxic drugs can be found in Part I - Pharmacy & Dispensing.

SAMPLE QUESTION
Prepare the equipment necessary for the intravenous administration of Vincristine to a cat suffering from lymphoma.

Equipment

1.  
   • Protective clothing: disposable plastic suit with long sleeves, face mask, goggles and gloves (protective clothing must ALWAYS be used when preparing or administering chemotherapeutic drugs).
   • Electric clippers or curved scissors.
   • Skin disinfectant.
   • Industrial methylated spirit.
   • Suitably sized intravenous catheter - 23g or 25g are suitable depending upon the preference of the veterinary surgeon.
     It is wise to choose zinc oxide tape over some of less adhesive rivals since it is absolutely essential that the catheter does not move from the vein once in place. Elastoplast may cause skin reaction in some dogs.
   • Rubber bung.
   • Sterile water.
   • 2ml Syringe and 21g needle.
   • 1ml Syringe and 23g needle.
   • Vincristine injection contained within a special container labelled "Cytotoxic Drugs".
   • Cytotoxic dispensing box (this is usually a plastic container filled with plenty of absorbent material over which the drug is drawn up for extra safety).
   • DOOP cytotoxic disposal container (yellow with pink writing).
   • Spillage kit (you shouldn't be needing this, but it is vital that the cytotoxic drug prep and admin area has one to hand).

Method

1.  
   1. Ensure that the area in which you are about to work is clearly designated as an area for the preparation and administration of cytotoxic drugs.
   2. Adorn protective plastic suit, gloves, goggles and face mask.
   3. Draw up the correct amount of Vincristine, working carefully over the cytotoxic dispensing box. (1ml insulin syringes are ideal as they are extremely accurate - but remember that Caninsulin syringes are unsuitable since they have their own unit scale). Ensure that the Vincristine is returned to its special container and replaced within the refrigerator after use. Ensure that the needle attached to the syringe containing the drug is covered. The Vincristine syringe must then be labelled and placed in the dispensing box ready for use.
   4. Draw up 2mls of sterile water - this is used to establish that the intravenous catheter is patent within the vein before and after the administration of the Vincristine. Label the syringe and ensure that the needle attached to the syringe is covered.
   5. Lay out the equipment used to place an i/v catheter; ie. clippers, scissors, skin disinfectant, swabs, industrial methylated spirit, 23g or 25g catheter, strips of tape to secure the catheter once in the vein and a rubber bung.