A scarcity of a critical medication used to sustain patients at risk of respiratory failure due to inability to breathe without medical assistance has affected hospitals across the UK.
Medical professionals have received instructions to limit their utilization of the liquid version of salbutamol, an important treatment for individuals experiencing intense asthma episodes or COPD, which typically includes emphysema or chronic bronchitis.
A national patient safety alert classified as “critical for safety” was released by the Department of Health and Social Care (DHSC) and NHS England, cautioning about a limited availability of 2.5mg and 5mg vials of salbutamol liquid. The 5mg vials are not expected to be in stock again until mid-April 2024.
Due to severe shortage, hospitals were instructed to immediately request for authorized imports of salbutamol nebuliser liquid instead of waiting until supplies are depleted.
The medication is given using a nebulizer, which forces air through the solution to generate a mist that relaxes the muscles and opens up the airways for the patient.
In January, The Guardian reported that there were record levels of drug shortages in the UK. This caused concern among doctors that it could potentially jeopardize the lives of their patients.
A lung doctor who frequently administers medication through nebules to assist patients with breathing difficulties expressed concern about the supply shortage. This drug is crucial for managing severe respiratory issues and is typically a first-line treatment for patients in critical condition.
“We have been instructed to limit our use of it and seek alternative options when available. It is recommended that we use it sparingly, only in cases of absolute necessity. Although not currently a crisis, the fact that a life-saving medication is facing rationing is concerning.”
According to the patient safety alert, hospital administrators were advised that in order to save resources for critical situations, physicians should:
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Discontinue the use of nebulizers once the patient’s condition has become stable.
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It is advisable to switch from using nebuliser liquid to a salbutamol pressurised metered-dose inhaler (pMDI) for patients facing a mild to moderate asthma attack or COPD flare-up.
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If a patient requires nebulizer liquids, they should only be used on an as-needed basis instead of on a regular schedule.
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Supplies need to be used as far as possible only with “acute, severe exacerbations of COPD and asthma”, people who cannot breathe due to an attack of anaphylaxis – a life-threatening allergic reaction to eating something – and those who cannot use a pMDI.
The scarcity is not impacting the accessibility of salbutamol inhalers, the blue-hued “reliever” inhalers utilized by individuals with pulmonary diseases like asthma to alleviate breathlessness.
The lack of availability pertains solely to nebulized salbutamol, also known as Ventolin, in the form of vials or liquid. Patients who have been unable to independently resume normal breathing after repeated inhalation of the medication may be prescribed a salbutamol nebulizer.
Physicians expressed worry about the state of affairs. Dr. Tim Cooksley, the former president of the Society for Acute Medicine, stated: “Salbutamol is frequently utilized to manage urgent health issues in patients with respiratory difficulties and there is no readily available substitute. It is a crucial element of daily medical practice and there is a significant danger of harm to these patients if supply problems are not swiftly remedied.”
A message from the organization Asthma and Lung UK has been published on their website, informing patients that there is currently a shortage of salbutamol nebulizer solution in the UK.
Alternative options will be offered for prescription by healthcare professionals. Furthermore, nebulizer liquid from other countries with comparable licensing standards as the UK will also be accessible.
The DHSC stated that the scarcity had been resolved by securing alternative sources.
A representative from the National Health Service stated that the recent temporary shortage of salbutamol nebuliser liquid has been resolved. The issue was caused by a manufacturing problem with one supplier. The department promptly worked with suppliers and others in the supply chain to guarantee that patients in the UK had access to the necessary supplies.
Source: theguardian.com
