SCCM Resource Library-Drug Shortage Alert: Parenteral Corticosteroids

Pdf Summary

This Drug Shortage Alert provides recommendations and information regarding the shortage of intravenous (IV) hydrocortisone and methylprednisolone in the acute care setting. The alert suggests management strategies, pharmacotherapeutic considerations, and safety implications for adult patients in the event of a shortage.<br /><br />The alert recommends reserving IV hydrocortisone for adrenal crises or patients with adrenal insufficiency who cannot take hydrocortisone orally. It also suggests using dexamethasone or methylprednisolone plus fludrocortisone for relative adrenal insufficiency in patients with sepsis/septic shock. The alert advises using enteral formulations of steroids when clinically allowable, due to their high bioavailability.<br /><br />The alert provides potential management strategies for selected indications in critically ill patients, such as acute bacterial meningitis, ARDS, anaphylaxis/hypersensitivity reactions, asthma exacerbation, COPD exacerbation, severe community-acquired pneumonia, COVID-19 pneumonia, and contrast allergy prevention in high-risk patients.<br /><br />Pharmacotherapeutic considerations discussed in the alert include the use of corticosteroids in different indications, transitioning from one steroid to another, and the route of administration. The alert also compares different glucocorticoid agents in terms of dosing, anti-inflammatory potency, mineralocorticoid potency, duration of activity, half-life, and bioavailability.<br /><br />Safety implications mentioned in the alert include the possibility of medication dosing errors and the need for clear communication and education to avoid adverse drug events or delays in care. The alert emphasizes the importance of implementing institution-specific guidelines and conservation strategies, as well as optimizing dose and compounding preparations to preserve alternative agent supply.<br /><br />Overall, this Drug Shortage Alert provides comprehensive recommendations and considerations for managing the shortage of parenteral corticosteroids in the acute care setting, with a focus on adult patients.

Asset Subtitle

Pharmacology, Crisis Management, 2023, 0:02:00

Meta Tag

Content Type Article

Knowledge Area Crisis Management

Knowledge Area Pharmacology

Membership Level Nonmember

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Resource Allocation

Year 2023

Keywords

Drug Shortage Alert

intravenous hydrocortisone

methylprednisolone

acute care setting

management strategies

pharmacotherapeutic considerations

safety implications

adrenal crises

relative adrenal insufficiency

enteral formulations

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.