A medication exposed to the environment may become degraded with loss of potency. This is especially important if the drug is used in life-threatening situations. It is important to examine a medication that has had an environmental exposure prior to its use.


Medications at risk:

(1) physician's medical bag

(2) emergency squad medication kits

(3) first aid kit

(4) medication carried by a backpacker or traveller


Significant exposures:

(1) excessive heat (storage in vehicle during summer, next to heater or furnace)

(2) excessive cold, with freezing (storage in vehicle during winter)

(3) excessive moisture (humidity, rain, immersion)

(4) excessive vibration or pressure (crush)

(5) chemical reaction when formulations mix


Signs of a problem when examining the carrying case:

(1) break in seal or loose cap

(2) visible moisture

(3) crushed or damaged container

(4) change in a temperature indicator or use of a maximum temperature thermometer

(5) change in a thawing indicator or use of a minimum temperature thermometer

(6) leakage or debris in the bottom of the carrying case

(7) degradation of paper or cardboard boxes


Possible signs of problems with a medication:

(1) tablets sticking together

(2) tablets or capsules crumbling or disintegrating

(3) discoloration

(4) unusual odor

(5) presence of a precipitate


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