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Search results for "Drug shortages"
- Drug shortages
Journal Article > Commentary
Banerjee R, Thurm CW, Fox ER, Hersh AL. Pediatrics. 2018;142:e20180858.
Drug shortages can disrupt care processes and diminish medication safety. This commentary highlights distinct concerns associated with disruptions in access to appropriate antibiotics for pediatric patients and the lack of evidence exploring this common problem. The authors suggest strategies to address these shortages, including antibiotic stewardship and government oversight. A WebM&M commentary discussed challenges associated with medication shortages.
Cases & Commentaries
- Web M&M
Steven Plogsted, PharmD; October 2018
A 1-month-old preterm infant in the NICU receiving the standard 500 mL bag of 0.45% sodium chloride (NaCl) with heparin at low rates developed hyponatremia. Clinicians recognized the need to deliver a more concentrated sodium solution and ordered that the IV fluid be changed to a 500 mL bag of 0.9% NaCl with heparin. However, due to a natural disaster affecting the supply chain for IV fluids, 0.9% NaCl 500 mL bags were in short supply, and the order was modified to use 100 mL 0.9% NaCl bags, which were available. Since the total volume was much smaller, a lower concentration formulation of heparin was required. However, the verifying pharmacist discovered that an 10-fold higher concentration had been used to compound the fluids, and further investigation revealed this same error had occurred on five other occasions.
Addressing the Global Shortages of Medicines, and the Safety and Accessibility of Children's Medication.
Geneva, Switzerland: World Health Organization; 2015.
Drug shortages have the ability to affect the patient safety in emergency departments, oncology services, and pediatrics. This report discusses the consequences of drug shortages, approaches different countries are taking to reduce their occurrence, and strategies such as proactive identification of potential supply limitations and collective agreements to manage shortages.
Journal Article > Study
Impact of a drug shortage on medication errors and clinical outcomes in the pediatric intensive care unit.
Hughes KM, Goswami ES, Morris JL. J Pediatr Pharmacol Ther. 2015;20:453-461.
Drug shortages can result in safety consequences, as studies have shown a higher rate of treatment failure and increased adverse events associated with unavailability of first-line therapies. However, this study did not find any change in adverse events in pediatric intensive care unit patients during a shortage of commonly used sedatives and injectable opioid pain medications. The authors note that advance warning of the shortage and development of standardized algorithms for drug substitution may have mitigated the potential safety hazards.
Legislation/Regulation > Organizational Policy/Guidelines
DeCamp M, Joffe S, Fernandez CV, Faden RR, Unguru Y; Working Group on Chemotherapy Drug Shortages in Pediatric Oncology. Pediatrics. 2014;133:e716-e724.
Journal Article > Study
Metzger ML, Billett A, Link MP. N Engl J Med. 2012;367:2461-2463.
The nationwide unavailability of certain prescription medications has posed a potential patient safety problem, as these shortages have been increasingly common over the past few years. This study shows clear evidence that drug shortages can result in patient harm. In 2009, a shortage of mechlorethamine (a standard component of chemotherapy regimens for childhood leukemia) forced oncologists to treat patients with an alternative agent, cyclophosphamide (which was thought to be equally effective). This article demonstrates that children who received cyclophosphamide clearly had a higher rate of treatment failure, resulting in the need for further chemotherapy and bone marrow transplantation. This finding adds to other recent studies documenting clinical consequences directly related to drug shortages.