Touching Pills

[Captain_k]

I have gotten myself all worked up.

I recently started trying to conceive. I haven't been working much lately, so I wasn't thinking about my pill handling practices.

However, I was giving finasteride and methotrexate last night, so I was being extra careful.

two things struck me. When I opened the Po methotrexate, I could really smell it! Does that mean I might have inhaled some?

also, I realized I have gotten a bit sloppy at work lately. Our pill splitter is tricky to use with some meds, so often lately I have been snapping some tablets in half with bare hands (clean hands). Or occasionally if a patient drops their pills in bed, I will pick them up for them ungloved. This isn't for cytotoxic drugs of course. I know now how stupid this is, and of course I will stop doing it.

i am so overtired, and now I've gotten my self all worked up.

do you guys think I'm at risk of any serious exposure? Could I have damaged anything if I am pregnant? (It's too early to test) Do any of you guys touch pills? Not looking for a lecture. Thanks

[NurseCard, ADN]

Try to relax. :)

Highly doubtful that you inhaled any Methotrexate just by

opening the pills. If you have to CRUSH it, or any other

toxic drug, you would want to wear a mask. Not sure if

it or any drug like it is crushable though.

From now on, make sure you handle any toxic meds

with gloves, but it sounds like you are doing that. Not

really a good idea to handle a patient's meds with

bare hands, but I'm sure we've all done it.

I think you are fine. Welcome to allnurses!

[Captain_k]

Thank you so much for answering! I really appreciate your kind words. And sorry, I did mean to say "pill splitter", not "pill crusher". I've edited that in my post.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

I got into the habit of wearing gloves during med administration a very long time ago, no matter what the medication was. The reason for this is because of patients dropping pills onto the bed, spitting them out, coughing on my hands when trying to assist with hand-to-mouth coordination, etc. The gloves are there; might as well use them. It's a wonderful habit to have.

[KatieMI, BSN, MSN, RN]

I really think that all those "reproductive hazards" and so forth perceived from theoretical possibility of inhaling/touching/being otherwise exposed to medications are overblown way out of the common logic. Patients and their family members are all "exposed" to the very same chemicals (which are quite commonly just thrown about like litter in their houses) for years - and there is no evidence that, say, having someone in the family taking metotrexate might affect risk of inborn anomalities for a child born by a healthy woman living in the same household.

There are rules about chemo drugs and some other selected medications about which there is such evidence. Also, handling pills with naked hands might be seen as unpleasant by both sides (patient as well as nurse) and potentially expose nurses to allergic reactions if they handle drugs they are allergic already (I had it happening). But these ubiquitous instructions of putting Coumadin pill wrappers in a "black biohazard bad" which is always nowhere to be found and putting double gown, goggles and gloves for crushing a Metotrexate pill are from the list of senseless schmolivies poured onto already overworked staff.

[LovingLife123]

You should always wear gloves when administering drugs. Also, you aren't pregnant yet and I would think twice about the smell of drugs. It honestly never even occurred to me pregnant or trying that any med would get into my system unless I was handling a patch or absorbative cream ungloved.

I know nitro paste can be absorbed through the skin, but that's why I always wear gloves.