Kétalar/Célo et plus de 40°C ?

Drugs and drug administration in extreme environments

Kupper TE et AL. J Travel Med. 2006 Jan-Feb;13(1):35-47.

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La question de la stabilité thermique des médicaments se pose dès lors les conditions de stockage sont extrêmes. C'est le cas actuellement dans la BSS. Récemment l'incidence plus élevée d'accidents allergiques à la succinylcholine a été rapportée, avec pour corollaire des recommandations spécifiques émises par l'ANSM. Ces dernières découlent d'une analyse bénéfice/risque au cours d'un exercice métroplitain. Le document qui suit est une revue de l'effet des conditions de stockage sur les médicaments de l'urgence. Dans bien des cas un emploi reste possible, notamment pour la kétamine et la succynilcholine, au prix d'une adaptation posologique. La destruction des ces produits doit rester la règle au delà de 15 j. 

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Emergency medicine must often cope with harsh climates far below freezing point or high temperatures, and sometimes, an alternative to the normal route of drug administration is necessary. Most of this information is not yet published. Therefore, we summarized the information about these topics for most drugs used in medical emergencies by combining literature research with extensive personal communications with the heads of the drug safety departments of the companies producing these drugs. Most drugs can be used after temperature stress of limited duration. Nevertheless, we recommend replacing them at least once per year or after extreme heat. Knowledge about drugs used in extreme environments will be of increasing importance for medical personnel because in an increasingly mobile society, more and more people, and especially elderly — often with individual medical risks — travel to extreme regions such as tropical or arctic regions or to high altitude, and some of them need medical care during these activities. Because of this increasing need to use drugs in harsh climates (tourism, expeditions, peace corps, military, etc) the actual International Congress of Harmonization recommendations should be added with stability tests at +50°C, freezing and oscillating temperatures, and UV exposure to simulate the storage of the drugs at “ outdoor conditions. ”