1. Attire and Protection

Compounding personnel must strictly comply with the requirements of the "Quality Management Standards for Centralized Intravenous Drug Compounding," clean and disinfect hands following the six-step method and dry them, and wear hair caps, masks, and disposable gloves. When compounding hazardous drugs (including cytotoxic drugs), one must first wear a regular mask, then an N95 mask, and also wear goggles and double-layer gloves of polyvinyl chloride and latex. If the outer gloves become contaminated, they must be replaced immediately.

2. Drug Compounding

Operating method for ampoule drugs:

(1) Check and verify.

(2) Disinfect and snap the ampoule. Before opening the ampoule, tap its neck and top to ensure no liquid or powder remains there, preventing the drug from being dispersed into the air when the ampoule is snapped. When opening the ampoule, wrap it with sterile gauze, quickly snap the neck away from the body, and it is forbidden to open it in front of a high-efficiency filter.

(3) Aspirate the drug solution. Select a needle and syringe of appropriate size; after aspirating the drug solution, do not exceed 3/4 of the syringe capacity. When aspirating the drug solution from the ampoule, tilt the ampoule so that the needle bevel is close to the opening. After aspirating the drug solution, immediately point the needle upward to prevent the liquid from flowing out.

(4) Expel air. When expelling air, put on the needle cap first, then wrap it with sterile gauze before expelling air.

Operating method for vial drugs:

(1) Check and verify.

(2) Remove the aluminum cap and disinfect.

(3) Dissolve and aspirate the drug solution. When dissolving the drug, the solvent should be slowly injected along the bottle wall, and the action should be taken only after the drug powder is soaked to prevent leakage. When inserting the needle, the vial should be at a 45-degree angle to the syringe; once the needle passes through the stopper, immediately turn the syringe to a vertical position. If there is still air in the syringe, inject the drug into the bottle in portions to prevent excessive pressure inside the bottle. When the bottle volume is >5mL, a small amount of air should be injected first to prevent difficulty in aspiration. It is best to use a filter needle with a filter membrane and non-wetting properties. When aspirating liquid and oily drug solutions, repeatedly flush the bottle with diluent and then aspirate cleanly, so that no residue remains in the vial and the syringe.

(4) Expel the air in the syringe and check and verify again.