You may have read that there’s an acute shortage of life-saving ventilators to help patients with Covid-19 breathe and possibly save their lives.
There’s now a new threat emerging. Medications that are needed to help patients on ventilators are quickly becoming scarce. The American Society of Health-Systems Pharmacists (ASHP) has reported that as of mid-March, five drugs associated with ventilator use were officially in short supply.
What Drugs Are Affected?
Various drugs to help manage patients’ pain and keep them comfortable are becoming harder and harder to come by. These include:
- Sedatives – Dexmedetomidine, ketamine, lorazepam, and others
- Anesthetics – Propofol, etomidate, and others
- Analgesics – hydromorphone, fentanyl, and morphine
- Neuromuscular blockers – cisatracurium, rocuronium, succinylcholine chloride, and vecuronium
There’s a shortage of these drugs for several reasons, one obvious one is the rising need to put patients affected with Covid-19 on ventilators, the other reason is that manufacturing cannot meet the high demand and new products will not be ready in the immediate future.
Companies such as Sagent and Teva Pharmaceuticals have stopped producing some of these drugs in the past.
Why Are These Drugs Needed?
These drugs are needed when a patient is put on a ventilator because being awake and aware while on a ventilator is very painful and uncomfortable.
First, there’s the tube insertion down the throat that sets off the gag reflex and causes the urge to panic and fight it off.
Secondly, the ventilator tube is inflated to block off the rest of the patient’s throat to allow full airflow from the ventilator for optimal functioning. If a patient is not sedated, given a paralytic, or pain medication – this is a painful and frightening time.
Lastly, severe cases of Covid-19 cause the lungs to fill with fluid and patients need to be paralyzed and sedated in order to heal.
Are There Any Alternatives?
While there’s a shortage, there’s been discussions about using alternatives to these drugs and ventilators.
Pharmacists are working with hospitals to come up with alternative drugs that work almost as well as those in demand. Such alternative drugs could be morphine or codeine instead of the requested opioid painkillers. Benzodiazepines are similar to Propofol but are slower acting and harder to adjust.
Using Noninvasive Positive-Pressure Ventilation (NPPV) machines. These are machines that apply positive pressure to the chest and abdomen to deliver a mixture of air and oxygen without invasive procedures. You may recall these machines used during the Polio epidemic in the 1940s.
The best fight against Covid-19 is to self-quarantine and wash your hands often.
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