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Drug Shortage Alert: Parenteral Corticosteroids
Drug Shortage Alert: Parenteral Corticosteroids
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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
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Content Type
Article
Knowledge Area
Crisis Management
Knowledge Area
Pharmacology
Membership Level
Nonmember
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Associate
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Professional
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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
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