TY - JOUR
T1 - It Takes a Village…
T2 - Contending With Drug Shortages During Disasters
AU - Burry, Lisa D.
AU - Barletta, Jeffrey F.
AU - Williamson, David
AU - Kanji, Salmaan
AU - Maves, Ryan C.
AU - Dichter, Jeffrey
AU - Christian, Michael D.
AU - Geiling, James
AU - Erstad, Brian L.
N1 - Publisher Copyright:
© 2020 American College of Chest Physicians
PY - 2020/12
Y1 - 2020/12
N2 - Critical drug shortages have been widely documented during the coronavirus disease 2019 (COVID-19) pandemic, particularly for IV sedatives used to facilitate mechanical ventilation. Surges in volume of patients requiring mechanical ventilation coupled with prolonged ventilator days and the high sedative dosing requirements observed quickly led to the depletion of “just-in-time” inventories typically maintained by institutions. This manuscript describes drug shortages in the context of global, manufacturing, regional and institutional perspectives in times of a worldwide crisis such as a pandemic. We describe etiologic factors that lead to drug shortages including issues related to supply (eg, manufacturing difficulties, supply chain breakdowns) and variables that influence demand (eg, volatile prescribing practices, anecdotal or low-level data, hoarding). In addition, we describe methods to mitigate drug shortages as well as conservation strategies for sedatives, analgesics and neuromuscular blockers that could readily be applied at the bedside. The COVID-19 pandemic has accentuated the need for a coordinated, multi-pronged approach to optimize medication availability as individual or unilateral efforts are unlikely to be successful.
AB - Critical drug shortages have been widely documented during the coronavirus disease 2019 (COVID-19) pandemic, particularly for IV sedatives used to facilitate mechanical ventilation. Surges in volume of patients requiring mechanical ventilation coupled with prolonged ventilator days and the high sedative dosing requirements observed quickly led to the depletion of “just-in-time” inventories typically maintained by institutions. This manuscript describes drug shortages in the context of global, manufacturing, regional and institutional perspectives in times of a worldwide crisis such as a pandemic. We describe etiologic factors that lead to drug shortages including issues related to supply (eg, manufacturing difficulties, supply chain breakdowns) and variables that influence demand (eg, volatile prescribing practices, anecdotal or low-level data, hoarding). In addition, we describe methods to mitigate drug shortages as well as conservation strategies for sedatives, analgesics and neuromuscular blockers that could readily be applied at the bedside. The COVID-19 pandemic has accentuated the need for a coordinated, multi-pronged approach to optimize medication availability as individual or unilateral efforts are unlikely to be successful.
KW - critical care
KW - disaster
KW - drugs
UR - http://www.scopus.com/inward/record.url?scp=85096651225&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85096651225&partnerID=8YFLogxK
U2 - 10.1016/j.chest.2020.08.015
DO - 10.1016/j.chest.2020.08.015
M3 - Review article
C2 - 32805237
AN - SCOPUS:85096651225
SN - 0012-3692
VL - 158
SP - 2414
EP - 2424
JO - CHEST
JF - CHEST
IS - 6
ER -