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Published in: International Journal of Clinical Pharmacy 1/2015

01-02-2015 | Research Article

An analysis of unused and expired medications in Mexican households

Authors: Sandra Leticia Gracia-Vásquez, Evangelina Ramírez-Lara, Ivonne Antonieta Camacho-Mora, Lucía G. Cantú-Cárdenas, Yolanda Araceli Gracia-Vásquez, Patricia C. Esquivel-Ferriño, Mónica Azucena Ramírez-Cabrera, Patricia Gonzalez-Barranco

Published in: International Journal of Clinical Pharmacy | Issue 1/2015

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Abstract

Background Unsafe storage of unused medications at home leads to an increased risk of toxicity, accidental childhood poisoning or risk for suicide, whereas an improper disposal of unwanted/expired medications from household raises concern about environmental pollution. Objective The aim of the study was to characterize expired medications collected according to the types of therapeutic groups, pharmaceutical dosage forms, expiration dates and were prescribed or over the counter drugs, and whether they came from Mexican health system or purchased by patients themselves. Setting The study was conducted in the metropolitan area of Monterrey during a 12-month period from March 2012 to February 2013. Method Unused/expired drugs were collected according to the collection and disposal of expired medication program instituted by the Department of Health of the State of Nuevo León. Pharmacists and students from The Autonomous University of Nuevo León recorded types of therapeutic groups, total of medicines in each group, among other classification criteria. Main outcome measure The proportion of every collected therapeutic group, type of dosage forms, and expiration date. Results The amount of medications classified was 22,140 items corresponding to a 30 % of the total collected medications in that period of time; most of them belonged to the non-steroidal anti-inflammatory drugs (16.11 %). According to the pharmaceutical dosage forms, results showed that a high percentage were solid dosage forms (73.39 %), of the total unused/expired medications, most of them were prescription drugs (91 %) which were purchased at private pharmacies. Expiration date of medications ranges from 1995 to 2016, being 2011 the outstanding year (36.66 %). Conclusion Addressing the aspect of unused drug disposition constitutes a challenge for Mexican government, due to health implications related to inadequate disposition. No matter how efficient the programs of collection and disposal of expired drugs are, none of them can collect all unused or expired drugs, that is the reason why the best approach might be to prevent this need.
Literature
1.
go back to reference Ruhoy IS, Daughton CG. Beyond the medicine cabinet: an analysis of where and why medications accumulate. Environ Int. 2008;34:1157–69.PubMedCrossRef Ruhoy IS, Daughton CG. Beyond the medicine cabinet: an analysis of where and why medications accumulate. Environ Int. 2008;34:1157–69.PubMedCrossRef
2.
go back to reference Corcoran J, Winter MJ, Tyler CR. Pharmaceuticals in the aquatic environment: a critical review of the evidence for health effects in fish. Crit Rev Toxicol. 2010;40(4):287–304.PubMedCrossRef Corcoran J, Winter MJ, Tyler CR. Pharmaceuticals in the aquatic environment: a critical review of the evidence for health effects in fish. Crit Rev Toxicol. 2010;40(4):287–304.PubMedCrossRef
5.
go back to reference Kusturica MP, Sabo A, Tomic Z, Horvat O, Solak Z. Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people. Int J Clin Pharm. 2012;34:604–10.PubMedCrossRef Kusturica MP, Sabo A, Tomic Z, Horvat O, Solak Z. Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people. Int J Clin Pharm. 2012;34:604–10.PubMedCrossRef
6.
go back to reference Annear B, Sinclair K. Response to ‘returned medicines: waste or a wasted opportunity?’. J Public Health. 2008;30(2):209–10.CrossRef Annear B, Sinclair K. Response to ‘returned medicines: waste or a wasted opportunity?’. J Public Health. 2008;30(2):209–10.CrossRef
7.
go back to reference Guirguis K. Medications collected for disposal by outreach pharmacists in Australia. Pharm World Sci. 2010;32:52–8.PubMedCrossRef Guirguis K. Medications collected for disposal by outreach pharmacists in Australia. Pharm World Sci. 2010;32:52–8.PubMedCrossRef
8.
go back to reference Runnalls TJ, Margiotta-Casaluci L, Kugathas S, Sumpter P. Pharmaceuticals in the aquatic environment: steroids and anti-steroids as high priorities for research. Hum Ecol Risk Assess. 2010;16:1318–38.CrossRef Runnalls TJ, Margiotta-Casaluci L, Kugathas S, Sumpter P. Pharmaceuticals in the aquatic environment: steroids and anti-steroids as high priorities for research. Hum Ecol Risk Assess. 2010;16:1318–38.CrossRef
9.
go back to reference Bound JP, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environ Health Perspect. 2005;113:1705–11.PubMedCentralPubMedCrossRef Bound JP, Voulvoulis N. Household disposal of pharmaceuticals as a pathway for aquatic contamination in the United Kingdom. Environ Health Perspect. 2005;113:1705–11.PubMedCentralPubMedCrossRef
10.
go back to reference Braund R, Peake BM, Shieffelbien L. Disposal practices for unused medications in New Zealand. Environ Int. 2009;35:952–5.PubMedCrossRef Braund R, Peake BM, Shieffelbien L. Disposal practices for unused medications in New Zealand. Environ Int. 2009;35:952–5.PubMedCrossRef
11.
go back to reference Prescott JD, Estler K. Waste not want not: drug disposal and the role of the pharmacist. Pharm Times. 2010;76:107–113. Prescott JD, Estler K. Waste not want not: drug disposal and the role of the pharmacist. Pharm Times. 2010;76:107–113.
13.
go back to reference Tong AYC, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int. 2011;37:292–8.PubMedCrossRef Tong AYC, Peake BM, Braund R. Disposal practices for unused medications around the world. Environ Int. 2011;37:292–8.PubMedCrossRef
14.
go back to reference Butler CC, Rollnick S, Pill R, Maggs-Rapport F, Stott N. Understanding the culture of prescribing: qualitative study of general practitioners’ and patients’ perceptions of antibiotics for sore throats. BMJ. 1998;317:637–42.PubMedCentralPubMedCrossRef Butler CC, Rollnick S, Pill R, Maggs-Rapport F, Stott N. Understanding the culture of prescribing: qualitative study of general practitioners’ and patients’ perceptions of antibiotics for sore throats. BMJ. 1998;317:637–42.PubMedCentralPubMedCrossRef
15.
go back to reference Sorensen L, Stokes JA, Purdie DM, Woodward M, Roberts MS. Medication management at home: medication-related risk factors associated with poor health outcomes. Age Ageing. 2005;34:626–32. Sorensen L, Stokes JA, Purdie DM, Woodward M, Roberts MS. Medication management at home: medication-related risk factors associated with poor health outcomes. Age Ageing. 2005;34:626–32.
16.
go back to reference Jassim AM. In-home drug storage and self-medication with antimicrobial drugs in Basrah, Iraq. Oman Med J. 2010;25(2):79–87. Jassim AM. In-home drug storage and self-medication with antimicrobial drugs in Basrah, Iraq. Oman Med J. 2010;25(2):79–87.
17.
go back to reference Daughton CG, Ruhoy IS. Green pharmacy and pharmEcovigilance: prescribing and the planet. Expert Rev Clin Pharmacol. 2011;4(2):211–32.PubMedCrossRef Daughton CG, Ruhoy IS. Green pharmacy and pharmEcovigilance: prescribing and the planet. Expert Rev Clin Pharmacol. 2011;4(2):211–32.PubMedCrossRef
18.
go back to reference Garey KW, Johle ML, Behrman K, Neuhauser MM. Economic consequences of unused medications in Houston, Texas. Ann Pharmacother. 2004;38:1165–1168. Garey KW, Johle ML, Behrman K, Neuhauser MM. Economic consequences of unused medications in Houston, Texas. Ann Pharmacother. 2004;38:1165–1168.
19.
go back to reference Ley General de Salud, México, Editorial SISTA, S.A. de C.V., 2008. Ley General de Salud, México, Editorial SISTA, S.A. de C.V., 2008.
20.
go back to reference Wieczorkiewicz SM, Kassamali Z, Danziger LH. Behind closed doors: medication storage and disposal in the home. Ann Pharmacother. 2013;47:82–489.CrossRef Wieczorkiewicz SM, Kassamali Z, Danziger LH. Behind closed doors: medication storage and disposal in the home. Ann Pharmacother. 2013;47:82–489.CrossRef
21.
go back to reference Budnitz DS, Salis S. Preventing medication overdosing in young children: an opportunity for harm elimination. Pediatrics. 2011;127(6):1597–9.CrossRef Budnitz DS, Salis S. Preventing medication overdosing in young children: an opportunity for harm elimination. Pediatrics. 2011;127(6):1597–9.CrossRef
22.
go back to reference Norma Oficial Mexicana NOM-073-SSA1-2005, Estabilidad de fármacos y medicamentos. 2005. Norma Oficial Mexicana NOM-073-SSA1-2005, Estabilidad de fármacos y medicamentos. 2005.
23.
go back to reference Therapeutic Research Center. Proper disposal of expired or unwanted drugs. Pharm Lett. 2007;23(230401):1–9. Therapeutic Research Center. Proper disposal of expired or unwanted drugs. Pharm Lett. 2007;23(230401):1–9.
25.
go back to reference Thompson CA. Return-and-disposal programs commence at health systems. Am J Health Syst Pharm. 2007;64:1254–5.PubMedCrossRef Thompson CA. Return-and-disposal programs commence at health systems. Am J Health Syst Pharm. 2007;64:1254–5.PubMedCrossRef
27.
go back to reference Thach AV, Brown CM, Pope N. Consumer perceptions about a community pharmacy-based medication take back program. J Environ Manag. 2013;127:23–7.CrossRef Thach AV, Brown CM, Pope N. Consumer perceptions about a community pharmacy-based medication take back program. J Environ Manag. 2013;127:23–7.CrossRef
28.
go back to reference Kotchen M, Kallaos J, Wheeler K, Wong C, Zahller M. Pharmaceuticals in wastewater: behavior, preferences, and willingness to pay for a disposal program. J Environ Manag. 2009;90:1476–82.CrossRef Kotchen M, Kallaos J, Wheeler K, Wong C, Zahller M. Pharmaceuticals in wastewater: behavior, preferences, and willingness to pay for a disposal program. J Environ Manag. 2009;90:1476–82.CrossRef
29.
go back to reference De Bolle L, Mehuys E, Adriaens E, Remon JP, Van Bortel L, Christiaens T. Home medication cabinets and self-medication: a source of potential health threats? Ann Pharmacother. 2008;42(4):572–9.PubMedCrossRef De Bolle L, Mehuys E, Adriaens E, Remon JP, Van Bortel L, Christiaens T. Home medication cabinets and self-medication: a source of potential health threats? Ann Pharmacother. 2008;42(4):572–9.PubMedCrossRef
30.
go back to reference Kiyingi KS, Lauwo JAK. Drugs in the home: danger and waste. World Health Forum. 1993;14:381–4.PubMed Kiyingi KS, Lauwo JAK. Drugs in the home: danger and waste. World Health Forum. 1993;14:381–4.PubMed
32.
33.
go back to reference Zavaleta BM. Evaluación de la prescripción de medicamentos en los Servicios Médicos de la Universidad de las Áméricas Puebla. Tesis Licenciatura Ciencias Farmacéuticas. Departamento de Ciencias Químico-Biológicas, Escuela de Ingeniería y Ciencias, Universidad de las Américas Puebla. Mayo 2006;1:54–58. Zavaleta BM. Evaluación de la prescripción de medicamentos en los Servicios Médicos de la Universidad de las Áméricas Puebla. Tesis Licenciatura Ciencias Farmacéuticas. Departamento de Ciencias Químico-Biológicas, Escuela de Ingeniería y Ciencias, Universidad de las Américas Puebla. Mayo 2006;1:54–58.
34.
go back to reference Allen L, Ansel H, Popovich N. Pharmaceutical dosage forms and drug delivery systems. 9th ed. EUA: Ed Lippincott Williams and Wilkins; 2009. Allen L, Ansel H, Popovich N. Pharmaceutical dosage forms and drug delivery systems. 9th ed. EUA: Ed Lippincott Williams and Wilkins; 2009.
35.
go back to reference Gómez LM, Galar M, Téllez AM, Carmona FC, Amaya A. Estudio de automedicación en una farmacia comunitaria de la Ciudad de Toluca. Rev Mex Cienc Farm. 2009;40(1):5–11. Gómez LM, Galar M, Téllez AM, Carmona FC, Amaya A. Estudio de automedicación en una farmacia comunitaria de la Ciudad de Toluca. Rev Mex Cienc Farm. 2009;40(1):5–11.
37.
go back to reference Evans KL, Brown SR. Many sample closet medications are expired. J Am Board Fam Med. 2012;25(3):394–5.PubMedCrossRef Evans KL, Brown SR. Many sample closet medications are expired. J Am Board Fam Med. 2012;25(3):394–5.PubMedCrossRef
Metadata
Title
An analysis of unused and expired medications in Mexican households
Authors
Sandra Leticia Gracia-Vásquez
Evangelina Ramírez-Lara
Ivonne Antonieta Camacho-Mora
Lucía G. Cantú-Cárdenas
Yolanda Araceli Gracia-Vásquez
Patricia C. Esquivel-Ferriño
Mónica Azucena Ramírez-Cabrera
Patricia Gonzalez-Barranco
Publication date
01-02-2015
Publisher
Springer Netherlands
Published in
International Journal of Clinical Pharmacy / Issue 1/2015
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-014-0048-1

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