Disposal of expired and cytotoxic drugs is by?

WCL Staff Nurse - 2019

Nursing Foundation

Medium

Appeared in: WCL Staff Nurse - 2019

Explanation

Expired and cytotoxic drugs are classified as hazardous pharmaceutical waste under the Yellow Category of the Bio-Medical Waste (BMW) Management Rules, 2016.
The primary and most effective method for destroying these chemical hazards is high-temperature incineration (greater than 1200°C).
When incineration is not available, the alternative is encapsulation (immobilizing the waste in a solid block) followed by disposal in a dedicated, secured hazardous waste landfill, which is separate from municipal landfills.

Option B: This is incorrect because it is illegal and unsafe. It contaminates soil and water, posing a significant risk to public health and the environment.
Option C: This is incorrect as autoclaving uses high-pressure steam to sterilize infectious waste. It does not destroy or neutralize the chemical structure of cytotoxic drugs.
Option D: This is incorrect as this method, using disinfectants like sodium hypochlorite, is meant for liquid infectious waste (e.g., lab cultures, body fluids). It is not effective for solid pharmaceutical waste like cytotoxic drugs.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Biomedical Waste Management (BMW) for cytotoxic drugs as background academic context rather than a clinical decision trigger.
Nurses are legally and ethically responsible for the correct segregation of biomedical waste at the point of generation to prevent harm to healthcare workers, the public, and the environment.
Handling cytotoxic drugs requires specific personal protective equipment (PPE), including chemotherapy-rated gloves, gowns, and eye protection, to prevent exposure.
What if? - If a cytotoxic drug is spilled, the nurse must not clean it with regular supplies. A dedicated cytotoxic spill kit must be used, and all contaminated materials must be disposed of as cytotoxic waste in the yellow container.

How to Approach the Question

First, identify the type of waste mentioned in the question: 'expired and cytotoxic drugs'.
Recall that this type of waste is not just infectious but is a hazardous chemical waste.
Consider the Bio-Medical Waste Management categories. Cytotoxic drugs fall under the Yellow category.
Evaluate the options based on their purpose. Autoclaving and chemical treatment are for disinfection of infectious waste, not chemical destruction.
Eliminate 'Municipal waste disposal' as it's for non-hazardous waste only.
This leaves 'Separate landfill disposal', which refers to a secured, hazardous waste landfill—the correct alternative to incineration for chemical waste.

Concept Tested & Keywords

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E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart B (pp 233-449 of 464) p. 109-111