We're out of versed and now fentanyl!! A while back we were out of mag sulfate and calcium chloride!!
From what I've read, it is not because the drug companies are trying to jack up the prices, as one would expect . . . many causes . . . raw material shortages, quality issues and in some cases, the drug co's just don't want to produce the drug because it's not profitable.
Soon patients will have to bring their own supply of drugs, if they want to have surgery!
The latest shortage at work is mannitol. So sorry if you've got brain swelling. No have got. You die.
Looking on eBay suggests that bulk mannitol costs about $25/kg (probably much lower in high quantities). If a drug manufacturer supplies a 100g dose, raw material cost alone might be about $2.50 (OK, quadruple it for pharm quality to $10/dose). Even if the selling price is $30, the pharm company incurs significant liability when selling a "cheap, generic" medication. Why should they sell a med for low cost when the potential liability for that same med is very high?
Also saw IV Decadron on the list, and now Mannitol? Crap! What happens when the family member of the big pharm guy gets in a MVA and needs Mannitol? I have a funny feeling it would suddenly become available again....eergh!!!
Also saw IV Decadron on the list, and now Mannitol? Crap! What happens when the family member of the big pharm guy gets in a MVA and needs Mannitol? I have a funny feeling it would suddenly become available again....eergh!!!
Available under the FDA "friends & family" exemption, no doubt. Such a surprise...NOT.
The news today was proclaiming super-duper-neato-keen stuff about the availability of a couple chemo drugs, through the most wondrous efforts of the FDA. Translation: FDA decided to stop interfering with supply/availability of two drugs in short supply. How kind.
Goody for the FDA....idiots. How nice of them to stop meddling with the supply of two drugs.
Now what about the 200+ other drugs in short supply as a direct result of FDA interference & lawsuit hungry product liability lawyers....("Did you stupidly eat 14 Kg of Tylenol and it destroyed your liver??? Such a surprise! Call us - we'll make the poopy-headed generic manufacturers pay through the nose!").
For chemotherapy, methotrexate, cytarabine, daunarubicin, doxorubicin.
For those of you unfamiliar with oncology, cytarabine and methotrexate are used intrathecally (they comprise around 99% of IT chemo - only one other agent used and only very rarely). Cytarabine is used to treat leukemia. Probably >95% of AML cases get cytarabine ... AND THERE IS NO SUBSTITUTE DRUG FOR CYTARABINE!!!!!!
The doses for initial treatment use relatively low doses. However, the follow up consolidation doses are quite high and hospitals have, at times, watch carefully that they have enough.
Imagine, getting the initial round of chemo, clearing the leukemia, just to have it return because your consolidation doses are delayed d/t shortage.
Ok so I was right all along...propofol is not a benzodiazepine! I never thought it was until I saw a doc's progress note that said that we were out of all IV benzos EXCEPT propofol...I pointed it out to my coworker saying, "now that doesn't make sense," and she informed me that propofol was a benzo. I was like ok that's news to me but I'm new to using it so maybe I'm just remembering it wrong. But yup just checked it and I (and you) are right... anyways just wondering because I saw this on here somewhere, is it true that propofol is effective in stopping seizures? It just masks them, doesn't it? Because...what are we going to do when someone comes in in status?
Ok so I was right all along...propofol is not a benzodiazepine! I never thought it was until I saw a doc's progress note that said that we were out of all IV benzos EXCEPT propofol...I pointed it out to my coworker saying, "now that doesn't make sense," and she informed me that propofol was a benzo. I was like ok that's news to me but I'm new to using it so maybe I'm just remembering it wrong. But yup just checked it and I (and you) are right... anyways just wondering because I saw this on here somewhere, is it true that propofol is effective in stopping seizures? It just masks them, doesn't it? Because...what are we going to do when someone comes in in status?
mrr5745
85 Posts
Also saw IV Decadron on the list, and now Mannitol? Crap! What happens when the family member of the big pharm guy gets in a MVA and needs Mannitol? I have a funny feeling it would suddenly become available again....eergh!!!