Who is responsible in this situation?

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I work at a longterm care home and have been working with cytotoxic medications and crushing them while possibly inhaling them while pregnant. I had a miscarriage in October. The medication on the strip pack was not labeled as cytotoxic and did not state cytotoxic on the package. Our home did not train staff until after I had my miscarriage. The pharmacy just recently started labeling the packaging now and stating not to crush. Is this my fault for not knowing as a nurse not to crush these medications even though our MAR stated to do so, or is this the home and pharmacies mistake. What should I do? Cytotoxins are very very dangerous for pregnant women, and anyone for that matter.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Out of curiosity, what were the meds?

We cannot offer medical or legal advice here.

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Ok just wondering if I could get any advice which may be helpful. Thought some other nurses could offer me some help. The medication is called Finasteride or Proscar. This is just one of the several we have been handling. Thanks!

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Specializes in Complex pedi to LTC/SA & now a manager.

Assigning fault is a legal question. Do the nurses not look up drugs not familiar with? While the pharmacy must label appropriately, nurses must know the medication they are administering including risks, precautions, potential interactions & side effects.

From the drug abstract in Micromedix for Proscar:

cutaneous absorption may occur; broken or crushed capsules should not be handled by women of childbearing potential or who are pregnant due to potential risk to male fetus

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Specializes in Medical Surgical.

I think that as a nurse its our responsibility to look up all meds we are giving. If you would have looked it up, you would have seen that it was toxic to pregnant women. In long term care, there are base meds that we give often, that we should know inside and out, this is one of them.

Also, this is a med that can be crushed, as long as your not pregnant.It is not usually a scored tablet, which if your ordered to crush a scored tablet, you should look it up immediately and also call the md to make sure its ok.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

it has to do with the male genitalia in utero and had nothing to do with miscarriage. Laying blame is asking for legal advice I would seek the advice of your OB/GYN

We as nurses handle many products that should not be used by women who are pregnant or seeking to be pregnant....wear gloves.

Finasteride is contraindicated for use in women who are or may become pregnant. Finasteride is a Type II 5α-reductase inhibitor that prevents conversion of testosterone to 5α-dihydrotestosterone (DHT), a hormone necessary for normal development of male genitalia. In animal studies, Finasteride caused abnormal development of external genitalia in male fetuses. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the male fetus.
a nurse is responsible for looking up drugs she is giving and not wait for pharmacy.
[h=3]Exposure of Women — Risk to Male Fetus[/h] Women should not handle crushed or broken Finasteride tablets when they are pregnant or may potentially be pregnant because of the possibility of absorption of Finasteride and the subsequent potential risk to a male fetus. Finasteride tablets are coated and will prevent contact with the active ingredient during normal handling, provided that the tablets have not been broken or crushed [see Contraindications (4), Use in Specific Populations (8.1), Clinical Pharmacology (12.3), How Supplied/Storage and Handling (16) and Patient Counseling Information (17.2)].

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Specializes in HH, Peds, Rehab, Clinical.

I believe I remember thate when commercials aired for this drug, that was one of the warnings, that women who are, or may become pregnant should not handle this drug". I don't want to sound harsh, but YOU are your own advocate for everything pertaining to you. If you were unfamiliar with this drug, it would be up to you to flip the the pages covering it in a drug guide and spending the 5 minutes required to read up on it.

I also never understand how anyone inhales drugs that they are crushing. How close do people put their noses to the plastic envelope?!

Ok just wondering if I could get any advice which may be helpful. Thought some other nurses could offer me some help. The medication is called Finasteride or Proscar. This is just one of the several we have been handling. Thanks!
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I just wanted to say I am so very sorry for your loss.

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Specializes in CDI Supervisor; Formerly NICU.

It disappoints me a little that it took 7 posts for any condolences on the loss of her baby, but 3/4 of the posts quoted a rulebook. I'm sorry for your loss, OP.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I am usually good about this....:facepalm:I am very embarrassed. :shy:

Op I am very sincerely sorry about your loss.small_beating_heart_bullet_by_stamped_in_black-d6rqgnh.gif ((BIG HUGS))

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I am sorry for your loss. Praying you find comfort.

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Specializes in Medical Surgical.

I am also very sorry.

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