NAPLEX Question of the Week: Proper Storage

This week's question gets at an important part of pharmacy practice that ensures patient's receive the intended therapeutic effect from their medication.

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BU is a 68 year old female who asks to speak to the pharmacist at the community pharmacy. She is considering using a pillbox planner in order to help increase adherence with her medications. Upon questioning and according to the pharmacy records, she takes the following medications: telmisartan 80mg daily, atorvastatin 80mg daily, prasugrel 10mg daily, amlodipine 10mg daily, dabigatran 150mg BID, and allopurinol 300mg daily.

Which of the following medications may be safely placed from the original packaging in her pill planner?

A. Prasugrel

B. Dabigatran

C. Telmisartan

D. Allopurinol

Answer with rationale: 

The correct answer is D, allopurinol. The vast majority of medications may be taken from the original "stock" container and placed in an amber prescription vial for dispensing to the patient. However certain medications must be maintained in their original packaging due to light, temperature, moisture, or humidity concerns. The classic example of this is nitroglycerin sublingual tablets. Failure to meet these requirements may affect the integrity of the medication leading to decreased effectiveness. The medications in answers A, B, and C should be retained in their original bottle (often with desiccant) or their foil packaging in order to preserve their integrity and ultimately effectiveness.

Pharmacists are often the only healthcare providers keenly aware of these requirements and should communicate these to patients upon dispensing as part of routine patient counseling. Otherwise a potential loss of potency could occur, especially in longer duration pill planners which may be as much as a month at a time.

Have a great weekend!

Dr. B

Christopher M. Bland

Clinical Professor, University of Georgia College of Pharmacy

Dr. Christopher M. Bland is a Clinical Professor at the University of Georgia College of Pharmacy at the Southeast GA campus in Savannah, GA. Dr. Bland has over 20 years of academic and clinical experience in a number of clinical areas. He is a Fellow of both the Infectious Diseases Society of America as well as the American College of Clinical Pharmacy. He is co-founder of the Southeastern Research Group Endeavor, SERGE-45, with over 80 practitioners across 14 states involved. Dr. Bland serves as Associate Editor for the NAPLEX Review Guide 4th edition as well as Editor-In-Chief for the Question of the Week. He has provided live, interactive reviews for more than 10 Colleges/Schools of Pharmacy over the course of his career.