NAPLEX Quiz
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MEDICATION USE PROCESS
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In an outpatient specialty pharmacy, a 45-year-old man (92 kg) with rheumatoid arthritis receives adalimumab (Humira) 40 mg/0.4 mL prefilled pens shipped to his home. He reports the delivery was delayed and the package sat on his porch in direct sun with an outdoor temperature around 35°C (95°F) for approximately 8 hours before he brought it inside. Adalimumab should be refrigerated at 2°C to 8°C (36°F to 46°F), protected from light, and should not be frozen; excursions to room temperature may be allowed only within labeled limits, but exposure to high heat can denature the biologic and reduce efficacy. Which stability concern is most relevant given the storage situation?
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