SCCM Resource Library-Drug Shortage Alert: Electrolyte Medication Shortages

Pdf Summary

The Drug Shortage Alert focuses on the shortage of essential intravenous (IV) electrolytes, including concentrated calcium, magnesium, phosphate, potassium, and sodium, emphasizing the need for careful management and conservation of these resources. Shortages of these electrolytes can have significant clinical consequences, especially for critical patients who rely on them for various physiological functions.<br /><br />The alert stresses the importance of interdisciplinary teams in analyzing institutional usage patterns and adapting protocols to preserve supplies. It recommends considering oral or enteral alternatives when feasible and advises against stockpiling to ensure fair distribution, reserving IV products for patients with critical medical needs.<br /><br />For calcium, it highlights iv use primarily for severe symptoms (e.g., hypocalcemia, cardiac resuscitation, massive transfusion). For magnesium, it's focused on conditions like seizures in preeclampsia, acute asthma, and cardiac arrhythmias. IV phosphate is reserved for severe symptomatic hypophosphatemia, while potassium chloride and acetate are advised for severe hypokalemia or when oral administration is impractical. Sodium acetate is suggested for managing acidotic conditions where it's crucial as a buffering solution.<br /><br />Pharmacotherapeutic considerations include dosage adjustments based on individual patient conditions, potential drug interactions, and alternative treatment approaches. Safety implications addressed entail careful administration and monitoring to prevent adverse effects like phlebitis or tissue necrosis.<br /><br />The document underscores collaboration with pharmacists and adherence to recommendations from bodies like the Institute for Safe Medication Practices (ISMP). It provides detailed tables listing clinical scenarios, suggested management strategies, and pharmacotherapeutic considerations pertinent to each electrolyte, emphasizing patient safety and efficacy. <br /><br />Lastly, it includes resources and guidelines for managing shortages and emphasizes the need for education and communication to avoid elective electrolyte replenishments in mild cases.

Asset Subtitle

Pharmacology, Crisis Management, 2022, 0:15:18

Asset Caption

"Updated September 2022

Lack of availability of any IV electrolyte can have serious consequences. As such, an interdisciplinary team should systematically analyze institutional usage patterns and automatic electrolyte replacement protocols and policies. Depending on current availability, routine usage of these IV electrolytes should be evaluated, and restrictive criteria (e.g., based on indication or severity of laboratory findings) may need to be implemented to conserve existing supply for critical patients and indications. This alert is for the following electrolytes: Concentrated calcium, Concentrated magnesium, Concentrated phosphate, Concentrated potassium, and Concentrated sodium. The recommendations provided within this document are based on current evidence, including a review of available literature by the SCCM Drug Shortages and Medication Safety Committee and the need for conservation during this shortage.

Recommendations and information provided in this Drug Shortage Alert are compiled by experts in the field. Practitioners are advised to consult with their institution’s staff to ensure that response to any drug shortage is in line with internal policies and procedures.
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Meta Tag

Content Type Article

Knowledge Area Pharmacology

Knowledge Area Crisis Management

Knowledge Level Foundational

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Nonmember

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Electrolytes

Tag Resource Allocation

Year 2022

Keywords

drug shortage

IV electrolytes

calcium

magnesium

phosphate

potassium

sodium

patient safety

interdisciplinary teams

pharmacotherapeutic considerations

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