Destroying the ecology and affecting the food chain. How to throw away expired medicine?


Many people throw away expired medicines carelessly or do not know how to dispose of them. Because of this, community pharmacies with many branches have also implemented drug recycling programs in recent years, allowing people to place expired, spoiled or redundant medicines nearby. Save a lot of trouble in the branch’s safe drug disposal box.

How different types of medicines are stored, how long they are useful and how to properly discard them are among the most common questions pharmacists are asked. Basically, the shelf life of medicines can be known from the packaging, box or aluminum foil (strip). The problem is that many people receive medicines in white medicine bags when they go to clinics, and the expiry date of the medicines is often not marked on them.

In fact, international regulations stipulate that whether you are receiving medicine in a large hospital or a small clinic, the medicine bag must be marked with the generic name of the medicine (generic name), dosage, method of taking, frequency, time, and expiry date (exp. date).

However, what we often see is just the opposite. Not only do some drugs not have the expiration date written on the medicine bag, but sometimes they don’t even have the name of the medicine, but only label it for fever, cold or cough. In fact, the public should have the obligation to know the information about the drugs they take. If they find that it is not stated, they can make a complaint to the clinic.

Drugs flushed down the toilet contaminate water sources

Registered pharmacist Chan Chiew Ying pointed out that this may be because medical staff believe that after prescribing medication to patients, they will take the medication regularly according to the doctor’s instructions and finish it within a certain number of days without leaving any medication behind. However, a more common phenomenon is that patients feel their condition improves after taking it for one or two days, so they stop taking the medicine, and maintain a “frugal” mentality to save the remaining medicine so that they can take it again next time. In fact, this is inappropriate.

“If you understand the manufacturing process of pharmaceuticals, you will find that they are very sensitive substances. Oral tablets (pills) are basically powders that are mixed evenly and pressed into tablets. The pharmaceutical process requires more than just The ingredients of the drug will also be added to maintain the stability of the active ingredient.”

“Many factors can affect the stability of drugs, including air, sunlight, humidity and temperature. Because of this, we often see some drugs packaged individually in aluminum foil to avoid too much contact with the air. And cause oxidation. After all, it is a substance that people take into their mouths and control their disease. Therefore, it is very important not to let external factors affect the stability of the drug.”

He said that it is conceivable that when people receive medicine, if it is put into the medicine bag, it means that it has been exposed to the air. Therefore, it is not recommended to store the remaining medicine for next time. In addition, if the appearance of the medicine is discolored, broken, hydrated or deteriorated, it is even more inappropriate to take it.

“As for how to dispose of excess and expired drugs? Many people flush the drugs directly down the toilet or throw them in the trash. In fact, these are incorrect practices.”

Anticancer drugs contain cytotoxicity

“Different drugs will have different effects, and the most direct one is environmental pollution. Flushing drugs directly into the toilet will pollute water sources and damage the ecology; throwing them into the trash can will affect the food chain, and burying them in the soil will also pollute the soil and cause widespread damage. Natural environment. If antibiotics are thrown away carelessly, bacteria may develop resistance. Antibiotics are used to treat bacterial infections. If the bacteria successfully escape, they will evolve and eventually transform into superbugs, which will no longer be eradicated by antibiotics. .”

“Especially when patients don’t follow the doctor’s instructions and finish taking antibiotics, they often end up with a few pills left. If these pills are thrown into the environment, not only will they not kill the bacteria, but they will also have the opportunity to evolve.”

He reminded that arbitrary discarding of hormonal drugs may interfere with the endocrine systems of plants and animals. What is even more serious is the cytotoxicity contained in anti-cancer drugs, which can cause harm to humans and the environment.

“Therefore, it is very important to properly dispose and recycle expired or surplus medications.”

Discard non-controlled drugs plus tea leaves

Pills, capsules or potions that are generally used to treat coughs, fevers, analgesics or diarrhea, that is, non-chemotherapy and controlled drugs, can be poured into a sealable plastic bag, and then mixed with tea or coffee grounds to neutralize the properties of the medicine. After sealing, just throw it into the trash can like ordinary garbage.

As for controlled drugs, they usually require a doctor’s prescription, such as antihypertensive drugs, hypoglycemic drugs, and anticancer drugs. It is recommended to take them directly to drug recycling bins, such as those set up in government clinics or community pharmacies. .

300 kilograms of medicines recycled every month

“Waste sharp instruments, such as needles or syringes, etc., should be wrapped in yellow bags with yellow logos and thrown into the sharps bin. This is to prevent staff from being injured during the collection process. Usually pharmacists will advise people to wrap needles or syringes in an extra layer of plastic bag before discarding them, but the correct way is to throw them into a specially designed sharps container.”

The COVID-19 antibody rapid screening reagents currently commonly used by the public are actually very well designed and come with sealable bags for disposal. These biohazard bags will then be sorted and cremated by waste management operators, so they can be thrown into general trash cans.

According to a report by the University of Malaya Medical Center, 127 kilograms of drugs were recycled in January 2019, many of which were still unused. As for the pharmacy where Chen Chaoying works, an average of 300 kilograms of drugs can be recycled every month.

In fact, the Ministry of Health has implemented a drug take-back program many years ago, and many government clinic pharmacies are equipped with drug take-back bins. However, some people may find it inconvenient because they need to go to the hospital and find a pharmacy to place it.

It is not difficult to imagine that one of the reasons why many people throw away medicines casually is because of convenience, not to mention specifically looking for coffee grounds to package. For this reason, community pharmacies with multiple branches have recently been implementing a drug recycling program, allowing the public to place expired, spoiled or redundant drugs in the safe medication disposal boxes (Safe Medication Disposal) of nearby branches. Save a lot of trouble.

“In fact, the drug recycling program is not profitable, but rather a thankless task. Because even if the drugs are intact, they cannot be resold. When a certain amount is collected, they have to hire waste management. ) company to pick it up and let professionals dispose of it.

Therefore, they mainly hope to do their part for the community to avoid littering of drugs and causing environmental pollution. In the end, humans will be the victims! “

Discounted effectiveness of expired drugs

Question 1. Will I be poisoned if I take expired medicine?

Answer 1. To be honest, it depends on the drug. Most of them will not cause poisoning. In fact, the danger of taking expired medicines is not poisoning. What we are more worried about is that the medicine does not work after taking it. The stability of the drug will begin to decrease after the expiration date until it becomes ineffective. Take blood pressure-lowering drugs as an example. Originally, a pill could lower excessively high blood pressure to the normal range, but after it expires, it may only lower it a little. When the effectiveness of the medication is compromised and blood pressure does not drop to a safe range, patients may be at risk for complications of high blood pressure, such as heart disease, stroke and kidney problems.

Medications will deteriorate if stored in the refrigerator

Question 2. Is it best to store medicines in the refrigerator?

Answer 2. No, but many people do this. They think that since meat and vegetables can be stored longer in the refrigerator, medicines should also be able to be stored. In fact, food and medicine are different. If we store medicine in the refrigerator, it will easily cause its solubility to change, affecting the stability and efficacy of the medicine. Medicines will also deteriorate if they get damp.

In the process of developing and manufacturing drugs, most must abide by some basic rules. For example, drugs must be able to be stored in a cool, dark, and room-temperature environment. Only certain drugs, such as insulin and certain eye drops, need to be proven by trials and require refrigerated storage. Therefore, general medicines do not need to be placed in the refrigerator, as long as they are protected from light, moisture and heat.

As for cough drops, there is no need to put them in the refrigerator. It should be noted that cough drops should not be taken one month after opening. In addition, insulin itself is also quite special. It needs to be stored in the refrigerator before being opened. After opening, it can be placed in a room temperature environment. It should be discarded if not used within 1 month.

Store medicines away from light, moisture and heat

Question 3. How to store medicines correctly?

Answer 3. If there are elders or children at home, it is recommended not to leave medicine boxes or medicine bags on the table to avoid accidental ingestion. It is best to put them in the medicine box. It will be safer if it can be locked. The location must be protected from light, moisture and heat, and a ventilated dry kitchen is usually a suitable location. Even for medicines that require refrigeration, be careful not to put them in the freezer. They only need to be placed in a refrigerator at 2 to 8 degrees Celsius.

Not recommended for sharing and forwarding with others

Question 4. If there are excess unexpired medicines, can they be transferred to other patients?

Answer 4. In fact, there are two sides to this matter. In the opinion of most professionals, sharing medications with others is not recommended for safety reasons. This is because we cannot ensure that the condition and storage of the medicine are good, and we cannot take a word of advice.

If expired or poor storage affects the stability of the drug and it becomes ineffective after taking it, it may cause serious consequences, and no one can take this responsibility. On the other hand, if the drug is expensive, there may be room for accommodation, considering that even if the drug is less stable it can still be effective. All I can say is that if the financial situation does not allow it, it is another matter, but it is better to get new drugs from the pharmacy.

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