A Comprehensive Review of Intravenous Oncology Drug Preparation in Pharmacy: Safety, Efficiency, Innovations, and Stability
Authors: Zhou Jiangping , Wang Yan , Wang Junping , Sheng Mengyuan 
Published: December 2024

Introduction: Intravenous (IV) administration of oncology drugs is a critical component of cancer treatment, providing rapid and controlled delivery of therapeutic agents. The preparation of these drugs involves intricate processes that require stringent safety protocols, efficient workflows, and innovative technologies to ensure patient safety and therapeutic efficacy. This review aims to provide a comprehensive overview of current practices and advancements in the preparation of intravenous oncology drugs within pharmacy settings, focusing on safety, efficiency, innovation, and drug stability. Safety: Safety is paramount in the preparation of intravenous oncology drugs, given the hazardous nature of chemotherapeutic agents. Adherence to guidelines such as USP <797> and USP <800> is essential to minimize risks of contamination and exposure. Strategies to enhance safety include the use of personal protective equipment (PPE), engineering controls like biological safety cabinets (BSCs) and compounding aseptic containment isolators (CACIs), and rigorous training and education for pharmacy staff. Historical incidents, such as the New England Compounding Center contamination, underscore the critical need for strict safety protocols. Efficiency: Efficiency in drug preparation involves optimizing processes to meet high demand while maintaining safety and quality. Current methodologies include prescription verification, com-pounding, quality control, and dispensing. Technological advancements, such as automated compounding devices (ACDs) and pharmacy management software, have significantly improved efficiency by reducing preparation time and minimizing errors. However, balancing efficiency with safety remains a challenge, requiring careful resource allocation, ongoing staff training, and compliance with safety standards. Innovative Technologies: The integration of cutting-edge technologies, such as robotics, automation, and artificial intelligence (AI), has revolutionized the preparation of intravenous drugs. Robotic systems enhance precision and reduce human error, while advanced aseptic techniques and AI-driven systems optimize dosing and workflow. Future trends include the potential use of 3D printing, nanotechnology, and blockchain to further improve the safety, efficiency, and traceability of drug preparation processes. Stability: Maintaining the stability of compounded drugs is crucial to ensuring their efficacy and safety. Factors such as storage conditions, handling procedures, and compatibility with diluents and containers can significantly impact drug stability. Guidelines like USP <797> provide detailed recommendations for maintaining stability. Research on stabilizing agents, improved packaging, and real-time monitoring systems continues to advance the field, addressing stability challenges and enhancing patient outcomes. Conclusion: This review highlights the critical importance of safety, efficiency, innovation, and stability in the preparation of intravenous oncology drugs. Adhering to stringent safety protocols, optimizing workflows, embracing innovative technologies, and ensuring drug stability are essential for improving patient outcomes and enhancing pharmacy practices. Future research should focus on integrating emerging technologies, standardizing protocols, providing ongoing education, and implementing real-time monitoring systems to further advance the field. By addressing current challenges and embracing new solutions, the preparation of intravenous oncology drugs can achieve greater heights in patient safety and treatment efficacy.