Availability of antidotes for the treatment of acute poisoning in Queensland public hospitals

Nissen, Lisa; Wong, K; Jones, A. T.; Roberts, Darren M.

doi:10.1111/j.1440-1584.2010.01129.x

Cited by 26 publications

(33 citation statements)

References 18 publications

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“…This situation is similar to that described in the literature, in which larger hospitals generally have larger, more diversified antidote stocks. 2,5,6 Since no Brazilian recommendations for antidote supply are available, the diagnosis provided by the present study was based on international guidelines. Although the US and UK guidelines for antidote stockpiles can provide a useful starting point, the recommendations may not be realistic from a clinical or economic perspective within our context.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9] Various factors have been correlated with antidote unavailability, including product shelf-life, the high cost of certain antidotes, the classification of some antidotes as orphan drugs (i.e. drugs of low commercial interest that qualify for incentives such as tax relief, depending on each country's policy) and difficulty in importing antidotes from certain countries.…”

Section: Introductionmentioning

confidence: 99%

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Antidote availability in the municipality of Campinas, São Paulo, Brazil

et al. 2017

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CONTEXT AND OBJECTIVE: The lack of availability of antidotes in emergency services is a worldwide concern. The aim of the present study was to evaluate the availability of antidotes used for treating poisoning in Campinas (SP). DESIGN AND SETTING: This was a cross-sectional study of emergency services in Campinas, conducted in 2010-2012. METHODS:The availability, amount in stock, place of storage and access time for 26 antidotal treatments was investigated. In the hospitals, the availability of at least one complete treatment for a 70 kg adult over the first 24 hours of admission was evaluated based on stock and access recommendations contained in two international guidelines. RESULTS: 14 out of 17 functioning emergency services participated in the study, comprising pre-hospital services such as the public emergency ambulance service (SAMU; n = 1) and public emergency rooms for admissions lasting ≤ 24 hours (UPAs; n = 3), and 10 hospitals with emergency services. Six antidotes (atropine, sodium bicarbonate, diazepam, phytomenadione, flumazenil and calcium gluconate) were stocked in all the services, followed by 13 units that also stocked activated charcoal, naloxone and diphenhydramine or biperiden. No service stocked all of the recommended antidotes; only the regional Poison Control Center had stocks close to recommended (22/26 antidotal treatments). The 10 hospitals had almost half of the antidotes for starting treatments, but only one quarter of the antidotes was present with stocks sufficient for providing treatment for 24 hours. CONCLUSION: The stock of antidotes for attending poisoning emergencies in the municipality of Campinas is incomplete and needs to be improved. RESUMO

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antidote availability in the municipality of Campinas, São Paulo, Brazil

et al. 2017

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“…A despeito da importância dos antídotos e medicamentos usados em intoxicações, diagnós-ticos anteriores apontam para falhas no abastecimento desses em diferentes contextos 4,5,6,7,8,9 . Vários fatores estão associados a esse cenário, incluindo o custo e a necessidade de manutenção de estoques mínimos, que frequentemente vêm a perder validade e precisam ser repostos 8 .…”

Section: Introductionunclassified

Antídotos e medicamentos utilizados para tratar intoxicações no Brasil: necessidades, disponibilidade e oportunidades

et al. 2013

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Antídotos e determinados medicamentos são essenciais ao tratamento de algumas intoxicações e não podem sofrer falhas no abastecimento, sob o risco de prejudicar a saúde e a segurança da população. O objetivo deste trabalho foi avaliar a disponibilidade de antídotos e medicamentos recomendados para o tratamento de intoxicações no Brasil. A partir de consensos internacionais, foram selecionados 41 antídotos para análise, todos sem patente em vigência. Desses, 27 são registrados, porém 11 estão disponíveis em formas inadequadas ao tratamento de intoxicações, restando 16 medicamentos comercialmente disponíveis. Somente um terço dos medicamentos necessários para o tratamento de intoxicações está incluído na relação de medicamentos essenciais do país. Em adição, é apresentada proposta de suprimento das demandas a um dos antídotos, anticorpo antidigoxina, considerando a capacidade de produção nacional de imunobiológicos. Os resultados demonstram limitação da assistência adequada aos pacientes intoxicados no país e reforçam a necessidade urgente de políticas públicas na área.

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“…1 Several studies have reported that hospital pharmacies have inadequate stocks of antidotes available. [2][3][4][5][6] Administration and dosing errors have also been reported in the literature. 7,8 With new dosing strategies being introduced, use in special populations, expanded indications for established antidotes, and the reassessment and expansion of off-label indications for other medications, knowledge of antidotes remains paramount.…”

mentioning

confidence: 99%

Before and after Study of Pharmacists' and Students' Knowledge of Two Novel Antidotes: High-Dose Insulin Euglycemia and Intravenous Fatty Acid Emulsion 20%

2015

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Purpose: To assess pharmacists' and students' knowledge of high-dose insulin euglycemia (HIE) and intravenous fatty acid emulsion 20% (IFE) and to see whether it improved after an educational intervention. Methods: A survey to assess the knowledge about the use of HIE and IFE as antidotes was e-mailed to practicing pharmacists, pharmacy residents, and students prior to and following an educational intervention. Fact sheets on the antidotes were developed in conjunction with the New York City Poison Control Center and were used as the educational intervention in this study. The impact of exposure to the intervention was measured by comparing the number of correct responses per question on the pre-and posttests and the mean pre-and posttest scores using chi-square and t tests, respectively. Results: Most respondents felt either not at all or only somewhat comfortable with managing a toxicologic emergency. There was a statistically significant difference in mean scores on the pretest and posttest (2.9 vs 5.45; P = .001) and for the number of participants giving correct responses for each question before and after education: 52.4% of respondents answered "I don't know" to the questions prior to education versus 21.2% after education (P < .001). Fewer respondents felt not at all comfortable managing a toxicologic emergency after the educational intervention (42.4 vs 50.3%; P < .001). Conclusion: Pharmacists and students reported little comfort in managing toxicological emergencies in general and have limited baseline knowledge about these agents. Educational interventions can significantly improve knowledge. Prior familiarity with these newer antidotes should reduce delays in their administration in an emergency.

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Availability of antidotes for the treatment of acute poisoning in Queensland public hospitals

Cited by 26 publications

References 18 publications

Antidote availability in the municipality of Campinas, São Paulo, Brazil

Antidote availability in the municipality of Campinas, São Paulo, Brazil

Antídotos e medicamentos utilizados para tratar intoxicações no Brasil: necessidades, disponibilidade e oportunidades

Before and after Study of Pharmacists' and Students' Knowledge of Two Novel Antidotes: High-Dose Insulin Euglycemia and Intravenous Fatty Acid Emulsion 20%

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