Parveen arrives at the pharmacy one Monday morning to find technician Lucy frantic with worry about the dispensary fridge

“I just went to check the fridge temperature and it was too high. I think it must have broken down over the weekend. Are we going to have to throw away all the drugs that are in the fridge? It’s so much money!”

Answer

Discovering that a fridge has gone outside the recommended minimum or maximum temperature is a ‘heart sink’ moment. Not only could a lot of money be wasted in stock that has to be dumped and a new fridge ordered if the breakdown proves terminal, but it can also take a lot of time and effort to sort out.

To make life easier, UK Medicines Information (UKMi) has developed a database of published and unpublished information from manufacturers for many medicines and vaccines that require refrigeration.

This information helps pharmacists to make decisions about which products are likely to have been affected by a breakdown in the cold chain – not just a fridge failure, but also products that have accidentally become frozen – depending on the product in question and how long the temperature may have been outside the accepted range. The UKMi fridge database is password protected, but login details can be obtained from regional NHS MI centres.

Use of some products that require refrigeration but for which the cold chain has been broken may be appropriate in certain circumstances, but such situations are usually outside the terms of the product licence. When dealing with a fridge breakdown, all products should be quarantined and assessed on an individual basis before disposing of any that may be unsafe. The incident should be logged along with any actions and outcomes.

The bigger picture

Maintaining the cold chain for medicines that require storage between 20C and 80C is essential to guarantee their stability and effectiveness. For this reason, it is a requirement under the GPhC standards that the maximum and minimum temperatures of fridges are monitored regularly and recorded.

The fridge itself must be purpose-built for the cold chain products, as opposed to being a standard domestic refrigerator. Pharmaceutical refrigerators include a fan to circulate air inside, which helps maintain a uniform temperature throughout the fridge and also compensates for the rise in temperature when the door is opened.

A common feature of pharmaceutical fridges is a calibrated temperature gauge, which can be read from the outside and is accurate to 0.50C. Many fridges can be locked and are fitted with an audio or visual alarm that alerts staff if the temperature deviates from the normal range, and some have a clear door so stock can be checked without having to open the door.

Extend your learning

Make sure you have the details of your regional MI centre handy (look it up at here)so you can get in touch to arrange access to the database quickly if needed.