“Children are dying,” says Steve Plogsted, a clinical pharmacist who chairs the drug-shortage task force of the American Society for Parenteral and Enteral Nutrition (ASPEN). “They’re not getting any calcium or any zinc. Or they’re not getting any phosphorous, and that can lead to heart standstill. I know of a neonate who had seven days without phosphorous, and her little heart stopped.” Click the quote. This situation of parenteral (administered intravenously) nutrient shortages, described by Alexandra Robbins in the Washingtonian is absolutely true. Your friendly Pharmer has been adjusting physician orders, in response to this situation for years now.
At one time, the U.S. could take drastic measures to enhance the supply of life saving drugs. Breweries were co-opted during war time to bolster supplies of penicillin, halfway through the last century, for example. Mired in the inertia of huge government and its regulations, shortages of relatively easily supplied medications can no longer be managed. Now it takes years to bring up a new production facility when an older one fails or goes out of business. There are only a few manufacturers which provide electrolytes and nutrients for parenteral use, for those patients whose digestive tracts are not able to process food. Very possibly, the new progressive administration, staffed with many who regard humanity as a pestilence upon the earth, is not motivated to address the shortages and mal-distribution of lifesaving drugs.
Most recently Ms. Robbins has exposed the fact that celebrities are using parenteral nutrients for cosmetic reasons, performance enhancement, or hangover treatment while premature babies are dying for lack of vital nutrition. It seems that the clinics which provide these treatments are not put at the back of the line for products which have been on shortage.
Your friendly Pharmer knows directly that there have been shortages of many electrolytes, soluble vitamins, lipids and trace elements which are needed for parenteral nutrition. When some shortages subside, other shortages take their place. There is a constant need to reformulate parenteral nutrition solutions in order to rebalance electrolytes to make up for those which are unavailable. While older patients can usually survive for awhile without some nutrients, the premature babies are out of luck. It’s not good for health care business for providers to advertise that vital supplies are missing from their institutions. It’s not good for the current administration for the media to advertise their incompetence or unwillingness to address this problem.
Please take the time to read Alexandra Robbins two articles linked above. Her style of writing will adequately convey the nature of this problem and its consequences to those without specific medical training. Pharmer recommends either to lower your expectations of health care, or call your legislators and ask them to address this problem, and while they’re thinking about health care, remind them to defund the “Affordable” Health Care Act this September. Links to the Senate and House contacts are on the side bar of this blog ALWAYS. Monitor drug shortages for yourself. There’s an app for that!
