In an article in the New York Times, journalist Walecia Konrad reported a personal story concerning her 10-year-old son’s medication. While vacationing in New Hampshire during a heat wave, the boy’s allergies kicked up. As usual, she gave him a dose of an over-the-counter remedy that usually brings him quick relief. However, this time the drug had no effect—day after day. When she returned home, she asked a pharmacist about it. Was her son becoming immune to this particular medicine? Were his allergies getting worse?
The Culprit? Extreme Heat
At the time, it never dawned on Konrad that there might be something wrong with the medication rather than with her son. The heat wave degraded the allergy medication to the point that it lost its potency.
According to Skye McKennon, clinical assistant professor at the University of Washington School of Pharmacy, extreme temperatures can damage both prescription and over-the-counter drugs. She told Konrad that no drug should be exposed to temperatures higher than 86 degrees. In fact, manufacturers recommend most of their products be stored at a controlled room temperature of 68 to 77 degrees Fahrenheit, because that’s the range in which they guarantee product integrity.
The Consequences of Ambient Heat Damage
During heat waves, the temperature of storage locations can easily rise above this range, causing medicines to physically change, lose potency, or threaten the health of patients. For patients with chronic illnesses like diabetes or heart disease, a damaged dose of a crucial medicine, such as insulin or nitroglycerin, can be life-threatening. Here are just a few more examples of ambient heat damage Dr. McKennon addressed:
When some antibiotics decay, they can cause stomach or kidney damage.
Hydrocortisone cream can separate and become useless in the heat.
Any diagnostic test strip — such as those used to test for blood sugar levels, pregnancy, or ovulation — are extremely sensitive to humidity. If moisture sticks to the strips, it will dilute the test liquid and possibly give a false reading.
Thyroid, birth control, and other medications that contain hormones are especially susceptible to temperature changes. These are often protein-based, and when protein gets hot, it changes properties.
As the New York Times article made clear, even the general public is only now learning about the risks of storing medications in over-heated ambient temperatures. Although most pharmacies monitor temperatures in their cooler and freezer units, too often, room temperature is left up to a “best guess.”
Heat and Humidity: Best Practices for Drug Storage
It’s just as important to place digital data loggers in various parts of each store to monitor temperature. Proper temperature is not only important in the storage rooms, but also on the sales floor. A change in environment such as a heatwave or a power outage can dramatically change “room temperature” and negatively impact pharmaceuticals.
Even in a worst-case scenario in which you don’t have digital data loggers alerting you when there is a temperature excursion or humidity spike, you can still reduce potential damage by following these protocols:
Packaging: Secure all lids. Never open a new container unless necessary.
Ventilation: Open the windows or air vents of the storeroom to allow air circulation. Ensure all windows have screens to keep out insects and birds. Put boxes on pallets and ensure there is space between pallets and the walls of the storeroom.
Circulation: Use a fan to circulate fresh (outside) air. In bigger storerooms, you may need a ceiling fan. Standing fans are more useful in smaller storerooms.
Air conditioners: If possible, use an air conditioner. This solution depends on a constant supply of electricity and requires regular maintenance. Depending on climatic conditions, a dehumidifier may be a less costly option. However, dehumidifiers also need a constant supply of electricity and require regular attention to empty the water containers.
Protecting medications from exposure to humidity and unsafe temperature ranges is critical for patient safety and medication efficacy. Ensure that your pharmacy never distributes unsafe medication by utilizing a continuous monitoring solution in all of your stores.
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