• 4/5/2024.  PCA cartridges
  • Notified Medical Staff.
• 4/15/2024. Ampicillin 125mg vials
  • Monitoring before changing to 250mg vials on unit.
• 3/20/2024.  Prevduo.
  • Notified Anesthesia
• 11/27/2023. Clorotekal 
  • Notified Anesthesia.  Replace with bupivacaine spinal.  
• 11/20/2023 Albuterol 1.25 mg/3mL
  • Notified Dr.Spedale
• 11/1/2023 Sodium Acetate
  
  • Notified Dr.Spedale
• 10/2023. Ketamine 200mg/20mL vials
  • Notified Anesthesia. 
• 10/2023. Sodium Bicarbonate 4.2% prefilled Syringes Unavailable 
  • Notified NICU and Mother/Baby Leadership: In emergency packs, substitute with sodium bicarbonate 4.25% 5mL vials x2 vials (10 mL total)
• 9/2023.  “LIDOCAINE 2% WITH EPI ALT. TEST DOSE 10 mL” (Xylocaine 2% with EPINEPHrine 1:200,000 vials)
  • Notified Anesthesia.  Substitute with lidocaine 1% with EPINEPHrine 1:200,000 30mL poly amps in Pyxis machines
• 8/2023. Bupiviacaine w/ epinephrine
  • Per P&T minutes - estimated release date Mar 2025; lidocaine with epinephrine available in limited quantities
• 8/2023. Ketamine
  • Per Anesthesia, add dexmedetomidine 4mcg/mL. Due to the manufacturer shortage of Ketamine, we have loaded Precedex 20ml vials in the LD OR Pyxis machines (OR1, OR2, OR3, and OR12) and also the LD Core Pyxis.
• 7/2023. Hetastarch.
  • Notified Dr.Cusimano. 
• 5/2023. Lugol's Solution
  • Notified medical staff:  Lugol’s 5% iodine solution (potassium iodide 100mg/mL and 50mg/mL iodine) is on backorder and the pharmacy is not able to obtain any Lugol’s solution from other hospital facilities or through other vendors.  We have been able to obtain acetic acid 5% as an alternative for cervical cancer screening visualization
• 4/2023. Nalbuphine
  • Nubain on backorder.  Notified Nursing Leadership and Anesthesia. 
• 3/2023. Indigo Carmine
  • Notified surgery. 

*RESOLVED (most recent listed first)*

• 4/25/2024. Methergine injection
  • Notified Medical Staff and Nursing.   More supply expected mid-May. 
• 11/14/2023 Erythromycin 1g ointment.   
  • 1/10/2024 - 3 month supply with nursing conservation strategy.   Not been able to order from distributor for the last 2 days
  • 12/20/2023 - 12/21/2023 - Steady supply.
  • 12/18/2023 - Notified Dr.Moore and medical staff of nursing conversation strategy for larger Erythromycin 3.5g ointment tubes.
  • 11/14/2023 - Notified Dr.Spedale, Dr.Sanches, and Nursing Leadership.   Starting 11/15, larger Erythromycin eye ointment tubes (1/8 ounce = 3.5g) will be stocked in Pyxis. 
• 11/27/2023. Beyfortus
  • 3/22/2024.  Notified NICU - out for the 2024 RSV season
  • 1/18/2024 Update - We did have our sales rep reach out and ask if we would be interested in an additional allotment. We asked for an additional 100 doses, but but haven’t received any further information or confirmation they will be sent.  Our distributor still doesn't have any product available to order. 
  • Notified Dr. Spedale.   Allocate for < 35 week EGA
• 12/13/2023.  Sodium phosphate
  • 1/24/2024 - Notified Dr.Spedale and Dr.Voelker - We were able to obtain 400 vials of sodium phosphate.  We will be able to use it for compounding TPNs again beginning 1/24.
  • Notified Dr. Spedale and NICU providers.   Remove from TPNs 12/14/2023.  Consider Phos-Nak packets for oral supplementation. 
• 11/27/2023 Promethazine injections
  • 2/22/2024 - Pharmacy stop automatic substitution.  Promethazine injection will be loaded in all units that previously stocked the drug before the shortage.  Nursing leadership has been notified. 
  • 1/10/2024 - Notified medical staff: Automatic therapeutic substitution for Assessment Center and Operating Rooms
  • Notified medical staff:  Release date 12/25/2023.   Remaining promethazine inventory projected to be depleted mid-December.   Pharmacy will adjust Pyxis inventory to high utilization areas.   Prescribers can consider promethazine oral, promethazine rectal suppository, prochlorperazine IV/IM, prochlorperazine oral, prochlorperazine rectal suppository. 
• 12/20/2023. Phenylephrine 500mcg/5mL syringe.
  • 1/10/2024 - Per Mark, beginning today, we will begin loading them in the OR Pyxis machines again and removing the Phenylephrine 10mg/ml (10,000mcg/ml) vials that had to be diluted.
  • Notified anesthesia of "double dilution" conservation measure
• 3/25/2024. Racepinephrine 2.25% Inhalation
  • Notified NICU