title: Effect of extreme temperatures on drugs for prehospital ACLS.
abstract: Advanced cardiac life support drugs undergo a wide range of temperature exposures in the prehospital setting. Although manufacturers place temperature restrictions for drug stability on their products, it has been shown that these limits are often exceeded in the prehospital environment. We exposed four different drugs to temperatures of -20 degrees C (-6 degrees F) and 70 degrees C (150 degrees F) and subsequently performed assays to determine their respective chemical stability compared with that of control samples. We determined that no significant difference in chemical structure occurred between the standard sample and the four drugs exposed to extreme temperatures (P > .05). This information has obvious implications in making further recommendations for drug storage. More work to determine bioactivity of temperature-exposed drugs may show results with implications for success in prehospital cardiac resuscitation.
authors.affiliation: Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City.
authors.forename: R B
authors.initials: RB
authors.lastname: Johansen
authors.forename: N C
authors.initials: NC
authors.lastname: Schafer
authors.forename: P I
authors.initials: PI
authors.lastname: Brown
mesh_terms: D000704:Analysis of Variance; D001285:Atropine / Q000737:chemistry*; D002851:Chromatography, High Pressure Liquid; D003080:Cold Temperature / Q000009:adverse effects*; D004355:Drug Stability; D004356:Drug Storage; D004632:Emergency Medical Services / Q000592:standards*; D004837:Epinephrine / Q000737:chemistry*; D005069:Evaluation Studies as Topic; D016231:Fluorescence Polarization Immunoassay; D008401:Gas Chromatography-Mass Spectrometry; D006331:Heart Diseases / Q000188:drug therapy*; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008012:Lidocaine / Q000737:chemistry*; D008020:Life Support Care / Q000592:standards*; D009270:Naloxone / Q000737:chemistry*
chemical_list: D009270:Naloxone; D001285:Atropine; D008012:Lidocaine; D004837:Epinephrine