THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 488.5 Guest: Angelo Voxakis, P.D. Topic: Prescription Storage Host: Richard Roeder Producer: Ed Graham

NEMA: This is a conversation on the proper storage of medications to protect their potency and avoid accidents. My guest is pharmacist Dr. Angelo Voxakis from the Hereford Pharmacy in Parkton, Maryland.

NEMA: Dr. Voxakis, most medications that come in pill form are in bottles that are dark in color. Why?

VOXAKIS: The reason why is they found through the years that it's easier to put them in amber because of light sensitivity. Sometimes direct sunlight can really alter the medication. It can either decompose it a lot faster or it can even alter completely the medication that's there.

NEMA: What are the best conditions under which to store the average medication? I recognize there will be special differences for certain special medications but in general, what are the best conditions for that?

VOXAKIS: The best conditions are a cool dry place, probably anywhere from 40 to 75 degrees and a tightly closed container.

NEMA: Okay now, is it true or false that medications store well in a refrigerator?

VOXAKIS: It's not necessary but again if it's in your refrigerator, not in a tightly sealed container, you have other problems - absorbing odors, just like anything else.

NEMA: Many people who take multiple prescriptions carry pill boxes with them as they travel throughout the day. Are any medications susceptible to damage from heat in somebody's pocket even if it's only for a day?

VOXAKIS: Pretty much for one day, it's not going to matter with the exception of, off the top of my head, nitroglycerin tablets. Nitroglycerin tablets should never be removed from their original container which should also be tightly closed. The reason why is humidity. The outside can really start disintegrating the actual medicament. Therefore when the person needs it, it would have no effect on them.

NEMA: I assume you would recommend against people leaving medications in an automobile glove compartment.

VOXAKIS: Most definitely. The heat there is very intense.

NEMA: What do you recommend that your customers do who may have poor eyesight to keep their medications organized and avoid a dangerous accident?

VOXAKIS: Basically, if someone approaches us and says that they're having a problem reading the labels, what we can do basically - your medication is basically given once a day whether it be in the morning or the evening, twice a day, three times or four times a day. On something like that, what I would do is I'd color code the label for the patient where they wouldn't have to actually physically read if it's a once a day or twice or whatever. All they would see is the color and in turn I would tell them - the yellow would be every morning, the blue would be morning and the evening and that would be the simplest way of doing it for a patient.

NEMA: Now one of the issues of storage is safety and something we talked about recently on another program I'd like to touch on again - the childproof cap we touched on but how common are mishaps where medications that belong to adults find their ways into the stomachs of children?

VOXAKIS: Statistically nationally, it's come down through the years and basically it's because of the childproof container. The containers we have in our store are a little bit more expensive than the average container which is either childproof or non-childproof. We prefer to go to the one that's either/or and our reasoning behind this is we're finding a lot of our elderly customers cannot open up a childproof container but at the same time as grandchildren visit them, they want a precaution.