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Competition among manufacturers is keen, Dr Spivey noted—and cancer centers can make that work to their advantage.  “Don’t believe those sales guys,” she said. “Test it all out yourself. They should be perfectly willing to give you sample supplies to learn the system and test it out yourself. It’s not a bad idea to ask to test the system for a few weeks so your people have time to see what problems emerge as they use them over time.”

Once staff becomes familiar with a system, overall preparation times should drop significantly. “If you don’t have to worry about vial pressures squirting drugs out, or spills—if you take those out of the link—it makes you more confident,” Dr Spivey explained. “Fewer problems occur that can cause contamination.”

Most manufacturers will send on-site trainers to show staff how to use their equipment, she said. The biggest challenge for new users of PhaSeal is mastering equalization pressures when the drug and air are pushed into a vial, Dr Spivey pointed out. “Sometimes it creates negative pressure and the balloon doesn’t work,” she explained. “Where to push air to create positive pressure becomes real obvious, but you have to learn how to do that by trial and error.”

When testing out new equipment, be particularly vigilant for evidence of leaking filters and membranes at interfaces, Dr Spivey advised. Testing equipment in the pharmacy doesn’t have to involve sophisticated simulations with titanium tetrachloride or fluorescent solutions. Lemon juice will do. “Try putting lemon juice in a vial and testing the products, and then touching it to litmus paper to make sure the outside membranes aren’t leaking,” Dr Spivey suggested. She warned, “Most will.” ONA

Bryant Furlow is a medical writer in Albuquerque, New Mexico.


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