Med Shortages

[Lunah]

The ENA NewsLine lead story is interesting:

Drug Shortages Compromise Emergency Medical Care

I know we've discussed it here before. We're running short on ativan these days ... I had a guy teetering on the edge of DTs, it was not the time to worry about where to find more benzos!

We're also short on IV Zofran, and we've nearly run out of Toradol a few times in the last month. What about the rest of you?

[caroladybelle, BSN, RN]

Perhaps only when Dennis Quaid's kids can't get morphine ... I don't know, I guess it takes a celebrity. Haha.

Unfortunately, until someone famous dies from lack of a cheap generic IV drug, I don't think anyone will care.

So much for the much vaunted "World's Best Healthcare is USA" hype.

[Footballnut]

These are all the same things we have been out of recently. Looks like good opportunity for drug counterfeiters abounds in today's market.

[Roy Fokker, BSN, RN]

Slowly getting some stock of IV Zofran (yay!). Also had a fresh batch of Propofol delivered!

Still critically short/out-stock of IV: Valium, Versed, Compazine, Ativan, Reglan, Levophed, Neo, Vecc and Etomidate.

Totally forgot ... we also ran out of the acetone reagent, of course right when I have a new onset diabetes guy.

We're back to "old skool" for figuring out DKA Vs HONK (don't forget about Urinalysis! )

Frankly, if you think about it - the treatment for both isn't very dissimilar: insulin drip and an assload of fluids (the difference between the two is fluid loading - risk of cerebral edema etc.).

cheers,

[brillohead, ADN, RN]

Im not the biggest fan of reglan (tends to wig out my pts)

Oh thank goodness, I thought I was the only one! Took Reglan back in the day for its off-label use of increasing breastmilk production, and I was a zombie.... I actually had my husband take over care of my baby for a day because I was afraid I wasn't competent enough to provide safe care! You couldn't pay me a million dollars to take that evil drug again!

[katsanchezRN]

In NM there is also a shortage of vit k Im...hope we don't have a critical inr cause all we have is PO....

[Pudnluv, ASN, RN]

We are out of IV compazine, told to use zofran or phenergan first. We do IV reglan available only from the pharmacist and practically takes an act of congress to give it up. We have also had shortages of fentanyl and morphine. Really, morphine?? How do we have a shortage of morphine?? A friend of mine who orders meds for his surgical office was told that there was a shortage of valium and versed and only to order these drugs as needed. I truly don't get it. These are thousand dollar chemotherapy drugs. These are basic generic drugs. What I have heard is that many of these drugs are manufactured over seas due to cheap labor and they are not passing FDA requirements, so they are not able to be distributed in this country. not sure if that is true, but I wonder if any other countries are having this problem with drug shortages.

[BelgianRN]

Trust me we have intermittent drug shortages in Belgium as well. It seems a lot of the benzodiazepines are in short supply, so our approach to treating seizures changes based on what the house has to offer. Kinda similar to the specialty of the day in a restaurant.

I read in another thread somewhere (Drug Shortages) that the problem is a change in FDA regulations for non-USA production. As a result many companies no longer meet the regulations so they cut back on production and have started working on getting back on track with FDA regulations. Maybe the simplest thing is for the FDA to change back their regulations as they were :)