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1/17/24 Temporary Shortages
January 17, 2024

From: "David Collette" <david.collette@hhsys.org>
To: "Pharmacists" <grp_allpharm@hhsys.org>
Cc: "Pharmacy Buyers" <pharmbuyers@hhsys.org>
Sent: Tuesday, January 16, 2024 5:13:26 PM
Subject: temporary shortages

 

As you all know, we have several temporary shortages (and work-arounds) due to the weather's impact on our McKesson delivery. We are hopeful that we will receive a delivery Wednesday, but we need to plan through the end of the week just in case I-65 remains impassable. I have been in contact with various people regarding several of these issues and here is an update:
  • Inhalers (I spoke to Wayne Byford and Lawanda Burgess in RT as well as Dr. White; all are OK with making these changes automatically if we run out of Symbicort, Spiriva, or Advair. Please work closely with RT when switching regimens - they work with these drugs daily and have a lot of insight into practical alternatives to the ordered regimen). We are critically short on the underlined drugs and will need to switch to an alternate product when we run out...
    • Symbicort
      • Can use Pulmicort BID or
      • Asmanex (daily to BID)
    • Spiriva
      • Can use Atrovent (usually QID)
    • Advair
      • May also use Pulmicort
  • Daptomycin (spoke to Jonathan Edwards and Dr. White)
    • Jonathan has contacted all ID physicians
      • New starts needing MRSA coverage will be placed on Zyvox, Teflaro, or Vanco (as appropriate)
      • Existing patients will continue on dapto unless the delivery is further delayed and we run out - AMT will closely monitor
  • Nimbex (Kate, Nellie, and Jerry contacted)
    • Very small supply remaining
    • CV will swap their current patient over to another NMB
    • Vecuronium is a possible alternative if new orders are received
  • Cleviprex (Kate, Nellie, and Jerry contacted)
    • NICU patient receiving the largest dose has been stopped at this time and clonidine patch applied
    • Nicadipine is a reasonable alternative if new orders are received
We will watch this (and other) shortages closely and provide updates as needed. DAVID






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