Lidocaine shortage

[Tobra]

Tried to order local anesthetic today. We had a list of stuff to order, really, gal is going down her list, gets to lidocaine and it is too bad, out of stock. Looks like the primary producer quit making it, and other companies have not picked up the slack yet. I could see this causing a lot of problems

FDA Drug Shortage

[LEAKYSEALS951]

Just Wonderful.

Can you use septocaine (or something else) in your neck of the medical woods?

[legion]

How about benzocaine?

(I seriously have no idea how compatible these drugs are.)

[speeder]

Time to bring back pharmaceutical cocaine!!

If nothing else, I'm sure that it made for some interesting office parties back in the day.

[Rick Lee]

Damn! I'm having a biopsy done in my left cheek (facial) in a few weeks and was really hoping they'd have more than laughing gas for me.

[ckelly78z]

Bite the bullet like they did in the spaghetti Westerns.

[pavulon]

The medication back-order problem has been ongoing for years now. The core of the issue is that, like every business, companies don't want to make low profit products when they could be making high profit products. Local anesthetics and many opiates are low cost cost meds with low profit margins and are regularly unavailable. Intermittent but repetitive propofol, ketamine, lactated ringers, rocuronium and succinylcholine (all now well off patent too) and several other medications are facts of life in my work. Oddly, bullshiz medication and hospital marketing never goes on back order. Nor do obtuse regulations. Health care is about benjamins.

[NY65912]

I need my epidurals! Maybe they can use Bourbon instead, no opposition here.

[GH85Carrera]

Originally Posted by ckelly78z

Bite the bullet like they did in the spaghetti Westerns.

My brother was and still is an avid bow hunter, mostly deer. Years ago he had one guy with him that figured hunting in general and camping in particular required liberal doses of whiskey taken internally. One evening sitting around the campfire he started showing how his Indian heritage would come out and he wanted to have a good hunting dance for the group. He held his bow and the quiver with razor sharp hunting tips on it and danced. It was not long before the whiskey induced a fall and he fell right on the arrow tips and one arrow sliced up under his right pectoral muscle about an inch deep. He just yanked it out and was bleeding like a stuck pig so he held pressure on it. Everyone was worried but he said he was OK. The bleeding stopped and he figured he needed to sterilize the wound.

He said in the John Wayne movies they just pour whiskey on it and then just grit their teeth and might wince or make a sucking sound through their teeth. It can't be that bad he figured. So he took a pull on his whiskey bottle for internal application and then leaned back and poured whiskey right on the wound.

My brother said they all knew he was OK when he jumped straight up screaming in pain and started running around the campsite screaming in pain. Everyone was laughing so hard no one talk. He finally calmed down and said the movies ain't real!

The next morning he was so sore he just drove out to a hospital and got several stitches and recovered with no issues. My brother distanced himself from that group of drinkers, not hunters.

[Tobra]

also fairly infuriating is the problem getting antibiotics sometimes.

You get a WTF? I never heard of that bug, get the infectious disease guy on the phone deal and the answer is something something out of production we can get it for you in two months. Makes me want to give someone a kick in the belly, maybe I will run into the ex wife at the grand kid's birthday.

[GH85Carrera]

It is just weird that a product that has been in use for years, and still used all the time would go out of production. If they were not making enough, raise the price a little. Especially if they were the only supplier of it. I don't get it.

[Noah930]

There's also a shortage of IV fluids. Can only buy a couple boxes of it at a time.

[Tobra]

My understanding is that the factory that produces the lion's share of the stuff was inspected and found to be not sterile enough. They shut it down to be refurbished, and the other manufacturers don't have enough excess capacity.

I like keeping a few IV start kits and a few bags of fluid around, just in case.

[Noah930]

In the surgery center, we go through 5-15 bags of IVF per day. I took a look last week, and I could only find 2 bags of LR in the whole place. The rest were Normal Saline. Fortunately, we don't do much fluid resuscitation in a surgery center--just fluid maintenance--so NS is all that's really needed.

Have also noticed the shortage of lidocaine, which is another product we use like proverbial water.

[tabs]

Originally Posted by Noah930

There's also a shortage of IV fluids. Can only buy a couple boxes of it at a time.

Maybe they should start to check under used car seats....

[flatbutt]

Originally Posted by Tobra

My understanding is that the factory that produces the lion's share of the stuff was inspected and found to be not sterile enough. They shut it down to be refurbished, and the other manufacturers don't have enough excess capacity.

I like keeping a few IV start kits and a few bags of fluid around, just in case.

If you're thinking Hospira yes they had huge issues including not responding properly to an FDA 483 citation. A good friend of mine was hired by them after the fact to take charge of their validation program. He gave up after two years.

[flatbutt]

Originally Posted by Tobra

Tried to order local anesthetic today. We had a list of stuff to order, really, gal is going down her list, gets to lidocaine and it is too bad, out of stock. Looks like the primary producer quit making it, and other companies have not picked up the slack yet. I could see this causing a lot of problems

FDA Drug Shortage

Checking the status of the NDA on this it looks like only one manufacturer holds a license. Usually FDA will work with a sole manufacturer to keep the pipeline flowing. If the primary has called it quits someone else will need to file an ANDA and that takes time and money...a lot of both.

[aap1966]

In Australia we have an isoprenaline shortage....crank up the joules on the temporary pads!

[flatbutt]

I love my TENS unit.

[sammyg2]

Ringer's lactate. .. if anyone mentions D5W I'm going into total flashback mode.