The United States faces ongoing shortages of several critical anesthesia medications, with potentially serious effects on patient care and safety, according to a report.
Gildasio S. De Oliveira, MD, of Northwestern University in Evanston, Ill., and colleagues reviewed key issues related to national shortages of important drugs used in the perioperative period. In background information in the article, the authors noted medication shortages have become increasingly frequent over the past decade. In 2010, the American Society of Health-System Pharmacists listed 140 medications in short supply, and shortages also have been reported for alternative drugs in several categories.
Many factors contribute to medication shortages, including product recalls and shortages of raw materials, the authors noted, and surges in demand can cause shortages even when manufacturing and supply are unaffected. Shortages are especially acute for sterile injectable medications because of the many complex steps involved in their manufacture. Inventory management practices, such as short inventories and "just in time" production schedules, also play a role.
Drug shortages can have a "devastating" impact on patient care, according to the study, especially if alternative drugs are not available. Patients might face treatment delays, have procedures canceled or receive alternative drugs that are less effective or have more side effects.
"Drug shortages can therefore increase risks to patients, and can also have a negative impact on institutions," the authors wrote.
Of special concern to anesthesiologists is the shortage of propofol, used widely not only for anesthesia but also as a sedative. Naloxone, essential for managing an overdose of morphine-like drugs, also is in short supply. Shortages have also been reported for medications used to paralyze patients during surgery, as well as the drugs used to reverse muscle paralysis.
The authors urged anesthesiologists to take the lead in dealing with the problem of shortages, stating, "proactive measures must be taken to identify, resolve and possibly prevent a medication shortage before patient care and safety are jeopardized."
Healthcare professions should be aware of American Society of Health-System Pharmacists guidelines for dealing with medication shortages and play an active role in developing and implementing the response at local hospitals. They also can inform the Food and Drug Administration about potential shortages. Depending on the cause, the FDA may take steps to alleviate shortages.
De Oliveira and colleagues believe steps should be taken now to prevent shortages of anesthesia drugs from becoming a public health issue. Steps may include increasing inventories, implementing policies and legislation to increase drug production, and implementing regulatory changes affecting drug manufacturing.
The study appears in the December issue of Anesthesia & Analgesia, the official journal of the Internal Anesthesia Research Society. To read it, visit www.anesthesia-analgesia.org/content/113/6/1429.full.
Gildasio S. De Oliveira, MD, of Northwestern University in Evanston, Ill., and colleagues reviewed key issues related to national shortages of important drugs used in the perioperative period. In background information in the article, the authors noted medication shortages have become increasingly frequent over the past decade. In 2010, the American Society of Health-System Pharmacists listed 140 medications in short supply, and shortages also have been reported for alternative drugs in several categories.
Many factors contribute to medication shortages, including product recalls and shortages of raw materials, the authors noted, and surges in demand can cause shortages even when manufacturing and supply are unaffected. Shortages are especially acute for sterile injectable medications because of the many complex steps involved in their manufacture. Inventory management practices, such as short inventories and "just in time" production schedules, also play a role.
Drug shortages can have a "devastating" impact on patient care, according to the study, especially if alternative drugs are not available. Patients might face treatment delays, have procedures canceled or receive alternative drugs that are less effective or have more side effects.
"Drug shortages can therefore increase risks to patients, and can also have a negative impact on institutions," the authors wrote.
Of special concern to anesthesiologists is the shortage of propofol, used widely not only for anesthesia but also as a sedative. Naloxone, essential for managing an overdose of morphine-like drugs, also is in short supply. Shortages have also been reported for medications used to paralyze patients during surgery, as well as the drugs used to reverse muscle paralysis.
The authors urged anesthesiologists to take the lead in dealing with the problem of shortages, stating, "proactive measures must be taken to identify, resolve and possibly prevent a medication shortage before patient care and safety are jeopardized."
Healthcare professions should be aware of American Society of Health-System Pharmacists guidelines for dealing with medication shortages and play an active role in developing and implementing the response at local hospitals. They also can inform the Food and Drug Administration about potential shortages. Depending on the cause, the FDA may take steps to alleviate shortages.
De Oliveira and colleagues believe steps should be taken now to prevent shortages of anesthesia drugs from becoming a public health issue. Steps may include increasing inventories, implementing policies and legislation to increase drug production, and implementing regulatory changes affecting drug manufacturing.
The study appears in the December issue of Anesthesia & Analgesia, the official journal of the Internal Anesthesia Research Society. To read it, visit www.anesthesia-analgesia.org/content/113/6/1429.full.
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