Preparative Services, what does it mean?
Preparative Services can be split into three sections, aseptic preparation, Radiopharmacy and non-sterile manufacture.
Aseptic preparation is where products such as pre-filled syringes or infusion bags are made in a Clean Room environment using Isolators and controlled air supply via HEPA filters. HEPA stands for High Efficiency Particulate Air filter. These filters provide a high degree of protection from particle contamination.
Our unit prepares four different types of sterile products.
- Chemotherapy Drugs
- TPN Total Parental Nutrition
- CIVAS Central Intravenous Additive Service
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Within our manufacturing unit we aseptically manipulate, reconstitute and dilute these drugs. There are over 50 different chemotherapy drugs. Some are given on their own but often several drugs may be combined, this is known as combination chemotherapy.
TPN Total Parental Nutrition
Total Parental Nutrition is a nutritional substitute, which is made from a mixture of protein, fat, carbohydrates, vitamins & minerals and trace elements.
TPN is used for patients who are malnourished as a result of their gastrointestinal tract not being fully functional or accessible. Conditions in which TPN is administered include Acute Inflammatory Bowel Disease, General Surgery and Cancer.
Our manufacturing unit works along side the hospitals Nutrition Team to prepare TPN bags for patients prescribed parental nutrition.
(Reference: The Concise Guide to Parenteral Nutrition Pharmacia & Upjohn)
CIVAS Central Intravenous Additive Service
CIVAS can include any preparation of a drug, which needs to be manipulated aseptically e.g. reconstituted, diluted or added to an infusion. Currently we provide a CIVAS service for Ophthalmic Theatres, Renal Unit and Out Patients.
Radiopharmacy is the preparation of products which use small amounts of radioactivity. These products are then injected into patients who require a scan. This is carried out in Nuclear Medicine. There are various different products which target specific areas of the body.
These products are aseptically prepared in a special clean room known as the Technetium Suite located in Nuclear Medicine.
Non-sterile manufacturing produces both one off extemporaneous and batch products. Extemporaneous products are made to an Extemporaneous Dispensing Specification (EDS) and are made for a named patient only. Batch products are made to a Manufacturing Specification (MS) and can be used as stock or supplied to individual patients. Both types of products are manufactured in accordance with the Medicine and Healthcare products Regulatory Agency (MHRA) Specials License and therefore can be used within the trust and sold to outside GP surgeries and Pharmacies both in and outside Norfolk.
Our unit manufactures both internal and external preparations. Internal preparations include liquid suspensions that are not commercially available, for example a suspension may be prescribed for a patient who is unable or unwilling to take tablets. Creams and ointments are made for patients with a variety of skin complaints, such as eczema and psoriasis. Other external liquids include ear drops and lotions.