Tag Archives: drug shortage

Drug Shortage 0.45% NS Liter Bags 11.27.18

To:            Nursing, Pharmacy, Physician Staff

From:     Maryna Shayuk, Chair Pharmacy and Therapeutics

Alan Mader, Pharmacy Clinical Coordinator

Date:        11/27/18

Re:            Drug Shortage:  0.45% NS liter bags

S

Situation

0.45% NS in liter bags have been placed on shortage at this time.
B

Background

This shortage was unexpected and was announced today.
A

Assessment

Substitution during this shortage will be necessary
R

Recommendation

Pharmacy will utilize the following plan to substitute orders written for 0.45% NS:

0.45% NaCl to 0.9% NaCl – for pre & post-surgery.

If patient is hypernatremic, substitute with Lactated Ringers.

All other orders call MD.

Pharmacy services will place “Substituted for ________” in the comment section of the Paragon order so that nursing is aware of the change.

Morphine Injection Shortage

Morphine Injection Shortage 10.18.2017

There is a nationwide shortage of morphine injection that expected to last until early to mid-November. The Pharmacy Department is running very low on supply and expects that the drug will become unavailable.  Please consider ordering an alternate injection product for pain management.  An opioid dose conversion chart is included below for your convenience.

A

Analgesic

B

Oral

C

Parenteral

D

Oral: Parenteral Ratio

E

Oral Morphine: Analgesic Ratio

F

Analgesic Duration

G

Half Life

Morphine 30 mg 10 mg 3 : 1 1 : 1 4 – 6 hrs 3 hrs
Oxycodone 20 mg 1.5 : 1 3 – 5 hrs 4 – 5 hrs
Hydromorphone 7.5 mg 2 mg  4: 1 4: 1 3 – 4 hrs 2 – 3 hrs
Fentanyl 100 mcg See Table B on page 2 1 hr 3 – 12 hrs
Methadone 20 mg 10 mg 2 : 1 See Table C on page 2 4 – 12 hrs 15 – 50 hrs
Codeine 200 mg 130 mg 1.5 : 1 1 : 7 4 – 6 hrs 3 hrs
Hydrocodone 30 mg 1 : 1 3 – 6 hrs 3 – 4 hrs
Meperidine 300 mg 75 mg 4 : 1 1 : 10 2 – 4 hrs 2 – 3 hrs
Nalbuphine 10 mg 1 : 1 3 – 6 hrs 5 hrs