Drug Shortage Has Medical Community Scrambling

BY MARITA LOWMAN THE SUNDAY TIMES June 03, 2001 A national shortage of vital drugs is forcing hospital pharmacists here and elsewhere to pay close attention to Internet drug updates, search for appropriate substitutes and, when possible, buy in excess before a shortage occurs. In Texas, the shortages have become so severe some elective surgeries and other procedures are being delayed.

In all cases, alternate drugs can be used, Mercy Hospital chief pharmacist Joe Sharon said, but the pharmacists' role in monitoring the products has become more intense.

"We spend a lot of time tracking drug manufacturers' predictions on supplies, coming up with alternative drug recommendations, scrutinizing dosages and communicating with the doctors and nurses," said Scott Jenkins, a clinical pharmacist at Geisinger Medical Center in Danville. "Close communication is key."

To date, patient care has not been compromised, Mr. Sharon said. But some drugs are not being administered as freely as they had been in the past. And new products need careful watch.

Short-acting anesthetics, heart attack medications, antibiotics and seizure-prevention medicine are among the drugs difficult to get.

"New products become available, but some patients have adverse reactions to them. Sometimes we'll start using a new drug approved by the (Food and Drug Administration), then the FDA pulls it off the market," Mr. Jenkins said.

At any given time, six to 12 commonly used drugs are unavailable, experts said. Sometimes, up to 20 drugs have been impossible to find at any one time.

The FDA's short-supply list has included Wydase, which helps circulate anesthesia during surgery; bacitracin, an antibiotic to treat pneumonia in babies; naloxone hydrochloride, which counteracts drug overdoses, and phenobarbital, which combats seizures.

At Geisinger, the tetanus vaccine is being reserved for emergencies. Booster doses have been curtailed.

And at Community Medical Center, phenobarbital is available only in oral doses, not injections.

Multiple factors led to the shortages, which began about two years ago and worsened in recent months, Mr. Jenkins said.

"Sometimes, the FDA regulations cause a product to be taken off the market. Sometimes the raw materials for the drug are in short supply. And sometimes the manufacturer stops making a drug because it's become unprofitable," he said.

Substitute drugs may be less effective and more expensive.

One of the most serious shortages has been fentanyl, a common anesthesia drug. ESI Lederle, a division of American Home Products Corp., suspended production after the FDA ordered it to upgrade certain manufacturing lines.

The other two companies that make the drug couldn't keep up with demand.

But the fentanyl shortage was alleviated when drugmakers increased production, according to an FDA report.

Experts doubt the situation will improve dramatically for at least a year, perhaps longer.

KNIGHT RIDDER NEWS SERVICE contributed to this report.

http://www.scrantontimes.com/site/news.cfm?newsid=1898982&BRD=2185&PAG=461&dept_id=415898&rfi=6

-- Martin Thompson (mthom1927@aol.com), June 03, 2001

Answers

Weren't we reading much the same thing two years ago, warning us about y2k?

-- LillyLP (lillyLP@aol.com), June 03, 2001.

"Sometimes the raw materials are in short supply"... Why is this? Is it a Y2K thing? Are high oil prices a factor? It would be gret to know.

-- John LIttmann (LITTMANNJOHNTL@AOL.COM), June 05, 2001.