Leaving the party - withdrawal of South African essential medicines
Journal Article
2005
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South African Medical Journal
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University of Cape Town
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Abstract
In August 2004 pharmacies and drug depots were advised
that the sole supplier of parenteral phenobarbitone in South
Africa, essential for the management of status epilepticus in
children, was stopping production at the end of the same year.
Alternative protocols for the management of status epilepticus
resulted in more children requiring intensive care intervention
(N = 9) at the Red Cross Children’s Hospital, over a 2-month
period, than had occurred in any 12-month period since 2000
(2000 N = 3, 2001 N = 1, 2002 N = 1, 2003 N = 2, 2004 N = 7).
Other agents that have suffered or are at risk of the same
fate are sodium nitroprusside, labetalol and esmolol. Sodium
nitroprusside is used extensively in the peri-operative period
in cardiac patients requiring after-load reduction. There
are no other nitrates with equivalent efficacy. Supply was
stopped in 2005 and only reinstated after the pharmaceutical
company was contacted directly. Supply of labetalol and
esmolol was stopped without warning. Without access to
these products it is necessary to resort to agents that are not
appropriate for paediatric use. Acetylcysteine (Parvolex), used
in the management of acetaminophen overdose, also became
unavailable and the supply was re-established only after direct
communication with the pharmaceutical company.
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Reference:
Wilmshurst, J. M., Blockman, M., Argent, A., Gordon-Graham, E., Thomas, J., Whitelaw, A., ... & Ireland, J. (2006). Leaving the party-withdrawal of South African essential medicines: editorial. South African Medical Journal, 96(5), p-419.