When should CSTDs be used in hazardous drug handling?

• A. Only after administration
• B. During drug transfer and compounding where feasible to minimize exposure
• C. Never; CSTDs are optional
• D. Only for non-hazardous drugs

Answer: (B)

Closed system transfer devices reduce exposure to hazardous drugs by preventing the escape of aerosols and splashes during handling. The riskiest moments are when you transfer the drug from vials or containers into syringes, bags, or infusion systems, and during compounding when the drug is being mixed or repackaged. Using CSTDs during drug transfer and compounding minimizes exposure for the staff involved in these activities, so they should be used whenever feasible to protect workers. They aren’t limited to administration or to non-hazardous drugs, and if a specific step can’t use a CSTD, other protective measures (PPE, engineering controls) should be used, but CSTDs are preferred whenever possible.