The current medication shortage affects life-threatening conditions, including cancer, with 15 cancer drugs in short supply.

Medication shortages reached a record 323 in 2024, affecting all drug classes, particularly sterile injectable generics.

Shortages are due to manufacturing issues, supply chain gaps, and lack of transparency.

High demand for medications like amoxicillin and Adderall is contributing to the shortages.

Healthcare providers are mitigating the current shortage by switching medications and altering regimens.

The FDA plans to increase production and allow imports to address the shortages.

Patients and families can prepare by staying informed about shortages and discussing alternative treatments with their healthcare providers.

The shortages significantly impact patients, especially the elderly and disabled, causing delays and dangers.

Medication shortages are a complex issue requiring a multifaceted approach to ensure patient access.

Discussing care goals with elderly patients early on is essential to develop a personalized contingency plan for potential medication shortages.

A personalized contingency plan can include advance care planning and advance directives like a Healthcare Power of Attorney and a Living Will.

To address potential medication shortages, identifying affected medications like Adderall, which is experiencing a nationwide shortage due to manufacturing delays, is essential.

Developing a plan with a healthcare provider can help prepare for medication shortages, including contact information, medication lists, and symptom management strategies.

Caregivers should share information with healthcare providers to discuss medication shortages and alternative treatment options.

The American Society of Health System Pharmacists and the FDA provide updates on medication availability and shortage status.

Hospital pharmacists report widespread drug shortages, including chemotherapy, with 99% experiencing some supply issues.

The current medication shortage affects life-threatening conditions, including cancer, with 15 cancer drugs in short supply.

Title:

Content: NORTHAMPTON, Mass. (WWLP) – While this shortage of chemotherapy drugs stretches across the country, 22News looks at how the limited amounts of potentially life-saving drugs are impacting cancer care in our area.

It’s a problem, so acute it was recognized by the Biden Administration just last month. The White House noted there’s a shortage of 15 cancer drugs due to manufacturing and supply chain issues.

22News asked Pharmacy Director Michelle Kososki at Mass General Brigham Cooley Dickinson Hospital, to rate the shortage experienced locally on a scale, 5 being a critical shortage and 1 being no shortage at all, “right now I would probably say it is a four. We only have a very small supply of one particular drug.”

Pharmacy Director Michelle Kososki said drug shortages are not uncommon in the healthcare industry however, when faced with potentially life-saving drugs it can get complicated, “Anytime there is a shortage, there’s a risk of not being able to treat patients. Obviously, that is something we want to avoid and we work to the best of our ability with creative solutions to make sure that doesn’t happen.”

Nurse Manager Lisa Martensson at Mass General Care Center at Cooley Dickinson Hospital told 22News, “There’s always the ethical issues of who gets the drug that’s available. It’s supply and demand as you said and looking at what folks had for their disease which ones needed to be treated faster than others based on the aggressiveness of their disease. Those things played in but it was a really difficult decision to sit down and try and decide who would get the drug. We were never in a position where we had to deny anybody.”

Cancer patient Norman Uzdavinis of Whately said he was very concerned when he first heard of the shortage, “I had wondered where in the chemotherapy I would be at, would it have to be delayed for months or years if possible.”

Uzdavinis has not had his medical care compromised but feels for those who have, “I feel for them. I know what I’m going through and that everything is here so it’s perfect for me, but there’s a lot out there that are not as fortunate. I know that.”

“Healthcare providers here were able to mitigate the shortage by using a couple of different tactics. For example, they could switch up a patient’s medication regimen,” Nurse Manager Lisa Martensson said.

“What we did do was use drugs that were in the same classification but not necessarily that specific drug. There are also drug regimens where we could switch around the order to which we gave the drugs so if there was a drug that wasn’t available we are able to do one of the drugs that was available first and do that second drug second. That was able to work out so people didn’t do without and they were able to get what they needed,” Martensson continued.

According to the FDA, the shortage started when one of the major manufacturers of the chemo drug, Accord Healthcare, a company based in India, had to shut down after problems complying with good manufacturing practices were found during an inspection. Now, there is an increased demand from other companies that make these kinds of drugs.

22News contacted some other of the manufacturers of these drugs. Pfizer said they are increasing production by about 40 percent to meet this increased demand.

Local News

Alanna Flood is a reporter who has been a part of the 22News team since 2022. Follow Alanna on X @alannafloodnews and view her bio to see more of her work.

Medication shortages reached a record 323 in 2024, affecting all drug classes, particularly sterile injectable generics.

Title:

Content: General Supervision
Elham Aboul Fath
Editor-in-Chief
Thank you for your patience.
General Supervision
Elham Aboul Fath
Editor-in-Chief
Thank you for your patience.
An Unexpected Catastrophe in the World ’ s Largest Country: The Complete Story of U.S. Drug Shortages
The deficit is at a record level.
According to data from the American Society of Health System Pharmacists and the University of Utah Drug Information Service, organizations began tracking drug shortages for the first time in 2001. Steady since 2021 – now reaching a record high of 323 drugs in the first three months of 2024.
Paul Abramowitz, CEO of the American Society of Health System Pharmacists, wrote in a blog post on Thursday: “It ’ s been a long time to end drug shortages, ” and wrote:“ All drug classes are vulnerable to shortages, some of the most worrisome shortages include sterile injectable generic drugs, including cancer chemotherapy drugs and emergency drugs stored in hospital vans and procedural areas. It is dangerous for doctors and patients. ”
In addition to the 32 chemotherapy drugs that are deficient, the five categories of drugs with the greatest deficiency include central nervous system stimulants, antimicrobials, hormonal agents, and intravenous fluids. [1] The Drug Deficiency Database maintained by the American Society of Health System Pharmacists and the University of Utah is based on voluntary reports from practitioners, patients, and others that have been confirmed by manufacturers. The U.S. drug is in short supply, because it captures broader effects on service providers and patients.
The crisis has lasted a year and a half.
More than half of the treatment shortages have lasted for more than two years, according to an analysis by health consultancy IQVIA, and the average shortage affects at least half a million patients, many of them elderly, according to the US Office of Health and Human Services under the Assistant Secretary for Planning and Evaluation, which shared its analysis with Congress in May.
Growing demand can play a role in drug shortages, as with the recent shortage of weight-loss drugs, but often manufacturing and quality problems, such as supply chain gaps and downtime, are the root cause. And varied.
But the American Society of Health System Pharmacists has “serious concerns ” about parts of this proposal, especially financial sanctions imposed on hospitals that lack the resources to comply with the recommendations, Abramowitz wrote:“ We all know that managing shortages is not enough and is not a sustainable solution to the worsening crisis, and there is still a lot of work to be done at the federal level to fix the root causes of drug shortages. ”
Why Shortage Occurs
Shortages can be caused by high demand, as with the recent shortage of weight-loss drugs, but this is not usually the main problem.
The FDA also blames manufacturing and quality problems, supply chain gaps, and downtime, and Dr. Emily Tucker, a drug shortage expert and an assistant professor of industrial engineering at Clemson University, says that when there is an indication of shortages, large health systems often also proactively place large orders, adding to the system ’ s stress.
“I don ’ t blame anyone.
“When I talk to all the stakeholders – whether it ’ s wholesalers, manufacturers, or the government – everyone wants this problem to end, ” she said.
Lack of transparency
Dr. Julie Grallo, chief medical officer and executive vice president of the American Society of Clinical Oncology, told the House Committee earlier that the shortage puts providers in a terrible position: “The drug shortage crisis is forcing providers to make impossible choices, and it is also hindering the development of new drugs. Health drugs are purchased only on a price basis, and manufacturers do not have to disclose the source of their acquisition of the ingredients.
The shortage of this generic chemical drug came due to the closure of one factory in India that manufactures the active ingredient after a surprise FDA inspection found “significant quality issues, ” says Jarallo:“ We didn ’ t know, and there was no transparency regarding the company ’ s supply of the majority of active pharmaceutical ingredients to all manufacturers across the board.
Knowing this in advance, we could have responded much faster, ” Dr. Steven Schundlemeyer, director of the PRIME Institute of the University of Minnesota School of Pharmacy, which focuses on economic and management issues, told the committee that as with defense contractors in the United States, New Zealand requires manufacturers to disclose their suppliers, and that information is required.
Easily accessible in the database.
Related Topics

Shortages are due to manufacturing issues, supply chain gaps, and lack of transparency.

High demand for medications like amoxicillin and Adderall is contributing to the shortages.

Title:

Content: Spokane, Washington  Est. May 19, 1883
19° Partly Cloudy
News >  Nation/World

Parents looking for children’s Tylenol, ibuprofen find empty shelves

Dec. 1, 2022 Updated Thu., Dec. 1, 2022 at 9:17 p.m.

By Jenna Portnoy, Daniel Gilbert, Ellie Silverman and Katie Shepherd Washington Post

People seeking over-the-counter medication for their sick children are often finding sparse or empty shelves, as a spike in respiratory illnesses pushes pediatricians and emergency rooms to the limit.

Usual supplies of fever- and pain-reducing medicines, such as liquid acetaminophen and ibuprofen recommended for children with RSV, flu or the coronavirus, have not kept up with demand in recent weeks in pockets of the country hit hardest by surging illnesses.

Unlike in Canada where the government has issued emergency orders to address a shortage of acetaminophen and ibuprofen, commonly known by the name brands Tylenol and Advil, and similar products, U.S. manufacturers and retailers emphasized that supplies should rebound within weeks. On the prescription side, increased demand for the antibiotic amoxicillin has caused shortages in the United States, Canada and parts of Europe.

In the meantime, pediatricians say they worry limited access to medicines could result in more urgent-care and emergency visits as parents struggle to keep sick children comfortable.

“It’s a huge problem,” said Kristina Powell, a pediatrician in Williamsburg, Virgina, and president of the Virginia chapter of the American Academy of Pediatrics. “This is a result of the ‘triple-demic.’ Parents run to Walmart or Target, the shelves are empty. … This is going to be a long fall and winter of viral infections.”

A crop of influenza-like illnesses, which includes RSV, hit the South and Southeast hard a month ago, federal data show, and those illnesses have slowly progressed westward. By mid-November, Texas, New Mexico and Tennessee reported the highest incidence of illness, while levels remained very high in Virginia and D.C., followed closely by Maryland, according to data tracked by the Centers for Disease Control and Prevention.

Kylie Moriarty, 30, of Buffalo, Misssouri, searched her local Walmart for Tylenol or ibuprofen to treat her sick 9-year-old daughter and found nothing but empty shelves. That seemed odd, she said, because just last week she had no trouble buying the same products for her 2-year-old son in a merry-go-round of illnesses affecting families with young children.

“I was very frustrated that it’s 2022 and we can’t keep something in stock for parents to help their children get better,” she said in a phone interview. “It makes me want to cry, almost, because these are my kids.”

She and her husband called other pharmacies looking for medicines to soothe the girl and couldn’t find any guaranteed availability.

“When they’re sick, there’s only so much that loving on them and cuddling with them you can do. So when there’s no medicine or something that you can give them … it’s hard,” Moriarty said.

Feeling powerless, the couple gave up and cautiously shared their younger child’s more concentrated medicine with the older one, which seemed to help. Just as they began to relax, their little boy came home from day care with a fever. Moriarty plans to schedule an appointment with his pediatrician for treatment – and samples to take home.

The ordeal reminded her of the height of the pandemic when supply chain problems left consumers scrambling for toilet paper and other basics.

Generic varieties play a large role in the market for over-the-counter comfort drugs, and that industry runs on profit margins so lean that companies typically lack capacity to boost production on short notice, according to supply chain experts. That left shelves bare during the early days of the pandemic.

The same dynamic is playing out now as RSV, flu and the coronavirus hit simultaneously, prompting sporadic shortages of commonly used ibuprofen and Tylenol at some hospitals and retail stores.

The extent of those shortages isn’t clear. The Food and Drug Administration hasn’t reported any shortages of fever or pain medications. Drugmakers, pharmacists and industry organizations say there aren’t any constraints to manufacturing and expect supplies to rebound within weeks.

The University of Utah’s Drug Information Service, which tracks drug shortages, received its first report of a shortage of liquid ibuprofen – generally for children – on Monday, and quickly confirmed it with several manufacturers. Most of the drugs tracked by the service are purchased in large quantities by hospitals, but some formulations had over-the-counter labels. Erin Fox, the service’s director, said it was impossible to know how widespread retail shortages were given the variety of store-branded versions.

“There are definitely distribution and supply chain problems that still exist,” she said, such as a company not being able to hire enough drivers. “These shortages seem to be mostly a demand spike and should resolve relatively quickly,” she added.

Until then, both chain stores and independent pharmacies are dealing with the unpredictability of high demand and uncertain supplies.

Martin McCarthy struck out at 5 p.m. Wednesday when he stopped by Brookville Pharmacy in Chevy Chase, Maryland, looking for liquid Motrin for his 10-year-old son, who probably picked up a bug at school.

The pharmacy’s stock of children’s fever reducers was depleted after two busy weeks of parents and grandparents stopping in to buy Tylenol or Motrin for little ones suffering from colds, RSV, flu and other viruses.

By Wednesday evening, only three boxes of generic ibuprofen chewables, two boxes of generic acetaminophen chewables and six boxes of suppository acetaminophen remained. Other parents peeked down the aisle looking for liquid fever reducer and fever reducer for children younger than 3, only to leave empty-handed.

McCarthy scanned the cold-medicine aisle for a few minutes and called home to confirm that his son would tolerate grape-flavored chewable tablets instead of the liquid Motrin he was used to.

“It is surprising because it’s basically completely out,” he said. “And it’s just generic.”

A spokeswoman for Walgreens said McCarthy’s experience is typical. Even if their usual choice of medication is unavailable because of high demand, parents can usually find an alternative.

“Although demand for pediatric OTC medications have increased, Walgreens is prepared and able to continue meeting the needs of our customers and patients. We are working with our diverse set of suppliers and distributors to ensure our patients have the products they need most,” Walgreen spokeswoman Zoe Krey said in a statement.

Martha Welman, a pediatrician and medical director at Neighborhood Health, a primary care provider serving low-income and underinsured patients in Alexandria, Arlington and Fairfax, said staff will sometimes call pharmacies to find medicines for patients – a time-consuming process at a busy time.

“If it’s between helping someone find a medicine or seeing a sick child, we have to make that choice. We’re all kind of compromising right now,” she said.

Perrigo, an Ireland-based manufacturer of over-the-counter products, said “shortages are occurring in a number of markets we supply” because of high demand. The company has increased production of medications for fever and pain by 46% through October compared with a year ago, and increased shipments by a similar rate.

The Consumer Healthcare Products Association, which represents companies making over-the-counter drugs, said parts of the country are seeing a rise in pediatric illnesses but that there aren’t “overall widespread shortages here in the United States” of children’s pain relievers.

“We understand it might be frustrating for some parents who are unable to quickly locate these products from their usual pharmacy or retailer due to limited out-of-stocks in some stores,” the association said in a statement, but it emphasized the importance of calling around for medications and not hoarding, which could lead to widespread shortages.

Elizabeth Murray, a pediatric emergency medicine physician at Golisano Children’s Hospital in Rochester, New York, said from the bed shortage to overflowing emergency rooms, the last thing parents need is another hurdle. But until the early and aggressive onset of respiratory illness abates, health care providers and parents have no choice but to ride it out together.

“Everyone would like to have one thing to blame and there isn’t one thing to blame,” she said. “This is happening for a variety of reasons and we’re going to move through it and we’re going to be OK.”

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Title:

Content:
The Shortages Are Coming

by Tyler Durden
Tuesday, Nov 08, 2022 - 09:20 PM

Authored by Michael Snyder via The End of The American Dream blog,

Do you remember in early 2020 when they told us that the shortages that we were experiencing would just be temporary?  Of course some of them were, but then more shortages just kept on erupting.  That wasn’t supposed to happen, and now it appears that our supply chain problems could potentially get a whole lot worse.  In just a few short months, we will be three years away from the beginning of the pandemic in the United States.  But instead of a “return to normal”, more shortages are on the way.  And in some cases, they could even be life threatening.

Let me give you an example.  We need Amoxicillin to treat some of the most common infections that our children experience.  Unfortunately, the FDA is warning us that we are now facing a very serious shortage of Amoxicillin…

Ear infections and strep throat.

Both are common childhood illnesses, for which the go-to prescription is in short supply, according to a recent nationwide alert from the U.S. Food and Drug Administration.

The warning specifically involves the powder, which pharmacists use to mix liquid Amoxicillin for childhood infections.

This is a really big deal.

According to one recent survey, close to two-thirds of all pharmacies in the nation are having difficulty getting Amoxicillin right now, and the national shortage of Adderall is even worse…

Nearly 66% of pharmacies are having challenges obtaining amoxicillin, according to a new National Community Pharmacists Association (NCPA) survey of 8000 pharmacy owners and managers, whereas 89% are realizing a shortage of Adderall.

Of course we are dealing with lots of other drug shortages at this moment as well.

In fact, according to the official FDA drug shortage list there are nationwide shortages of a whopping 183 different drugs in the United States right now.

We truly are in unprecedented territory.

Up in Canada, things are even worse.

If you can believe it, at this point the Canadians are facing “an acute shortage of basic painkillers”

The Canadian healthcare system is experiencing an acute shortage of basic painkillers, particularly acetaminophen and ibuprofen, which are commonly used to relieve pain and fever in children during flu season.

Canada’s Association of Medical Assistance in Dying Assessors and Providers (CAMAP) chose this perhaps awkward moment to roll out a webinar for healthcare professionals that advised them to offer assisted suicide to their suffering patients.

So why don’t the Canadians have enough Acetaminophen and Ibuprofen right now?

Well, we are being told that the primary reason is “a lack of raw ingredients to make the drugs”

CBC News quoted health officials who blamed “a lack of raw ingredients to make the drugs,” “an uptick in respiratory viruses fueled by the relaxed [Chinese coronavirus] measures,” and “panic buying” for the shortage of painkillers for children.

As I have covered in previous articles, most of the basic ingredients that go into our pharmaceutical drugs come from China.

So if you think that things are bad now, just wait until war with China erupts.

Once that happens, our pharmacies will get really empty and our entire healthcare system will experience a historic meltdown.

Switching gears, with Thanksgiving coming up I wanted to talk about the fact that we are now facing a nationwide shortage of turkeys

As CNBC reports, the price of turkey is up 73% from last year, a pretty astonishing figure. Experts attribute it to the bird flu, which has devastated turkey stocks this year. Apparently, the disease normally doesn’t flourish during the summer as farmers get their holiday flocks together. But, you know, the 2020s haven’t been easy so naturally, the flu hit hard right in the middle of the year when it could do the most damage.

The good news, if you want to call it that, is that you will still probably be able to get a turkey if you are willing to pay enough.

The bad news is that supplies of turkey just keep getting tighter and tighter.

One business owner in San Francisco recently stated that it is “like pulling teeth trying to get turkeys from the companies” at this stage…

But it’s not just the Thanksgiving bird that’s at risk — it’s your lunchtime turkey sandwich, too. San Francisco delis and butchers are already feeling the effects of the shortage.

“It’s like pulling teeth trying to get turkeys from the companies,” said Sal Qaqundah, owner of Arguello Market, a San Francisco cult favorite for its “world famous” turkey sandwich.

Unfortunately, we are also facing a shortage of butter in the weeks ahead.

The USDA is urging consumers not to “panic buy” butter so that there will be enough to go around for everyone…

Butter is another area where the war and cost of dairy products has affected supply, as the price of the condiment and baking ingredient has gone up a dollar per pound since January of this year, per Eater. Fearing a full-blown butter shortage, the USDA has asked consumers not to rush or panic buy, but simply secure what they need at a given time, per Best Life.

Did you ever imagine that we would be talking about a butter shortage in late 2022?

Things just keep getting crazier and crazier.

And if the diesel fuel shortages eventually get as bad as some are projecting, we could soon be facing severe shortages of countless products.

Our ships, our trains and our trucks run on diesel fuel.

So if there is not enough diesel fuel, we are going to have a real problem trying to fill up our stores with enough stuff for everybody.

Even now, supplies of diesel fuel are so tight that one big player in the industry just issued a major alert

A major fuel supply and logistics company is raising a red flag on upcoming diesel fuel shortages.

Mansfield Energy issued the alert Friday stating there was a developing diesel fuel shortage in the southeastern region of the United States. The company speculated that the shortage could be generated from “poor pipeline shipping economies” and a historically low supply of diesel reserves.

“Poor pipeline shipping economics and historically low diesel inventories are combining to cause shortages in various markets throughout the Southeast,” the company said. “These have been occurring sporadically, with areas like Tennessee seeing particularly acute challenges.”

There are a number of reasons why supplies of diesel fuel have gotten so tight.

But the biggest is the fact that imports from Russia have been totally cut off

But the primary reason is the cutoff of Russian imports. Prior to Russia’s invasion of Ukraine, the U.S. was importing nearly 700,000 barrels per day (BPD) of petroleum and petroleum products. Most of those imports were finished products and refinery inputs that boosted distillate supplies in the U.S.

The loss of those Russian imports have caused problems for refineries as they struggle to fill holes in their product slates. Refineries do have a small amount of flexibility in shifting gasoline production to diesel production. But it’s a relatively small amount (e.g., ~5% in a refinery I once worked in). That also means that if refiners do shift production, that also potentially creates shortages in the gasoline market.

So why don’t we just produce more ourselves?

Well, thanks to our politicians, the number of refineries in the United States has actually been declining in recent years even as our population has grown.

At this point we simply do not have enough refineries, and this is a problem that is not going away any time soon.

In the months ahead, we aren’t going to completely run out of diesel fuel as some people out there are suggesting.

But supplies may get so tight that it could potentially create widespread supply chain nightmares that are quite severe.

Let us hope that such a scenario does not materialize.

Because the American people are already angry enough about the economy.  In fact, a brand new survey has found that it is the number one issue for U.S. voters at this moment…

The Washington Post and ABC gave Americans eight top issues they will be considering when making their decision in a poll that showed likely voters split between the Democrats and Republicans.

The economy was cited by 26 percent of likely voters as one of the most important factors, followed by abortion with 22 percent and inflation and threats to democracy each by 21 percent.

For decades, we have been able to rely on our supply chains to continuously fill our stores with mountains of cheap goods.

But now our supply chains are breaking down.

In fact, our entire economic system is breaking down and most people are completely and utterly unprepared for the difficult times that are coming.

I know that many of you have been patiently waiting for a long time for life to “return to normal”.

Sadly, that isn’t going to happen.  The incredibly bad decisions that our leaders have been making are now catching up with us in a major way, and a great deal of pain is ahead.

*  *  *

It is finally here! Michael’s new book entitled “End Times” is now available in paperback and for the Kindle on Amazon.

0

Healthcare providers are mitigating the current shortage by switching medications and altering regimens.

The FDA plans to increase production and allow imports to address the shortages.

Title:

Content: As drug shortage list grows, many hospitals face tough decisions on rationing care

More than half of hospital pharmacists are reporting a critical shortage of chemotherapy drugs and nearly all are reporting overall medicine supply gaps as prescription drug shortages near an all time high, according to a new survey.

Hospital pharmacists said drug shortages have forced 1 in 3 health systems to delay, cancel or ration care or switch to alternate drugs to continue to treat patients. And 99% are reporting some drug supply shortages, an American Society of Health-System Pharmacists survey of more than 1,000 pharmacists released Thursday found.

The organization reported shortages of 309 drugs, near the all-time high of 320 shortages in 2014. The scarcity of key drugs is prompting hospitals to find or substitute drugs and change treatment plans as needed.

“In some cases, there are no alternatives to the affected drugs, which puts patients at risk," ASHP Chief Executive Officer Paul W. Abramowitz said in a statement. "This issue requires quick action from Congress to address the underlying causes of shortages and ensure patients have the medications they need.”

Cancer drug shortages

In June, the Food and Drug Administration said it will temporarily allow overseas drug manufacturers to import some chemotherapy drugs.

The FDA allowed Qilu Pharmaceutical, a drug manufacturer in China, to import the injectable chemotherapy drug cisplatin in 50-milligram vials. Toronto pharmaceutical company Apotex Corp. will distribute the medication in the United States.

More than a dozen cancer drugs have been in shortage in recent months, including cisplatin and carboplatin, used to treat lung, breast, prostate and gynecologic cancers. The National Cancer Institute said cisplatin and similar drugs are prescribed for 10% to 20% of all cancer patients.

In June, the National Comprehensive Cancer Network released a survey of 27 academic cancer centers that found 93% reported shortages of carboplatin and 70% faced shortages of cisplatin.

When cancer hospitals face such shortages, they attempt to make sure there's enough medication for patients to finish the course of treatment, said Mike Ganio, ASHP's senior director of pharmacy practice and quality.

Cancer hospitals facing such shortages might change medications for new patients starting on chemotherapy, said Ganio, a former pharmacy manager at an academic cancer center.

"You try to keep that patient on the same regimen as much as you can, unless they're failing it for some reason, and then you would switch," Ganio said.

Steroids, hormonal drugs also in short supply

More than 1 in 5 hospital pharmacists also reported shortages for steroids, hormonal drugs and oral liquids such as lidocaine, ibuprofen and amoxicillin.

A smaller number of pharmacists said heart medications, emergency prefilled syringes and drugs used for intensive care unit patients were in short supply. Others reported shortages of attention deficit hyperactivity disorder medicines, antimicrobial drugs and injectable opioids.

In all, about two-thirds of pharmacists said the shortages were "moderately impactful," which means they are managing shortages but patients are affected.

Pharmacists are managing the shortages by offering therapeutic alternatives, buying different vial sizes or concentrations and rationing medicines.

This article originally appeared on USA TODAY: Survey: Drug shortages are widespread, hospitals ration care

Patients and families can prepare by staying informed about shortages and discussing alternative treatments with their healthcare providers.

Title:

Content: Sunday, 17 March 2024 10: 18 GMT
Medicines for the elderly and the disabled
(MENAFN- Al-Anbaa)
Many elderly people and people with disabilities with special needs suffer from some of the problems they face in many aspects of daily life, including the lack of availability or access to appropriate treatment prescribed for them in some medical centers and hospitals, especially those with severe diseases such as diabetes, heart, kidneys, eyes, etc., because they are not available in the mentioned pharmacies, and their prices are high. Civil society mechanisms and private hospitals, which cause them to multiply their pain and poor conditions and expose them to dangers resulting from that delay, and such “should not happen in the prosperous state of our beloved Kuwait. ”
It is necessary to have a system to deliver them through modern means, as was the case during the Corona disaster, and to have a system to deliver them according to the title and accurately work through the contributions of our cooperative societies, and to prevent the manipulation of some of this important medical issue and the health of the declining bodies to search for the source of medicine suitable for each performance, especially for the elderly and cases of disability....
From a humanitarian point of view, expatriates must be included in general according to a specific mechanism and based on the health insurance they pay when renewing their residency.
Our wishes for safety for all on the land of safety and giving, Kuwait Humanity.
MENAFN17032024000130011022ID1107987532
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The shortages significantly impact patients, especially the elderly and disabled, causing delays and dangers.

Medication shortages are a complex issue requiring a multifaceted approach to ensure patient access.

Title:

Content: Saturday 13 July 2024
Chairman of the Board of Directors and Editors
Abdurrahim Ali
Editor-in-Chief
Dalia Abdul Rahim
Chairman of the Board of Directors and Editorial Board
Abdurrahim Ali
Editor-in-Chief
Dalia Abdul Rahim
Reports & Investigations
A “cure ” for the lack of medicine.
News portal monitors the suffering of health insurance patients..
Health Minister Apologizes to Citizens
Head of the division: Insistence on using the trade name exacerbates the problem
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Hundreds of chronic disease patients from health insurance clinics suffer from a lack of treatments and medicines, especially diabetics; because of the lack of insulin and many other medicines that are not available, where the journey of great suffering begins after the patient leaves the examination room and the doctor writes the necessary treatment in the prescription, to surprise patients that the treatment does not exist and he has to look for it himself.
In this report, "Al-Bawaba News" monitors the suffering of patients looking for medicine in light of the lack of the market of local and imported medicines in health insurance pharmacies and free market pharmacies, where « Al-Bawaba » met "Amina", a 50-year-old woman suffering from diabetes, went to health insurance in the city of Al-Mahalla Al-Kubra, in an attempt to get her treatment to clash with reality. The health insurance deducts a fixed monthly subscription for her treatment, but the head of the pharmacy inside Ibn Sina Clinic in Mahalla Al-Kubra confirmed that the treatment is not currently available, and that the patient must go to three pharmacies affiliated with the Health Insurance Authority, and three pharmacies outside it affiliated with the Health Insurance also, to get the medicine.
"Amina" did not despair of attempts and despite her illness, she went to 6 pharmacies affiliated with health insurance inside and outside the headquarters and did not find sugar medicines available, even she did not find it in the free market in various pharmacies.
The suffering continues.
Amina ’ s condition is not unique in the midst of a hustle of medication shortages, as Menna Magdy from Giza also complained about the lack of insulin and tapes needed for a glucose meter, which has become rare.
“Mina ”, the mother of a diabetic child, said:“ I am a son diagnosed from 1 year and 4 months with diabetes type I take Novo Rapid and sediment, of course we are supposed to take insulin from insurance and imposed according to measurements, but they do not need enough insulin in the middle of the lack of drugs, and when Benji I spend the treatment every two months..
We have to take medicine from other patients. ”
She pointed out that there is a clear suffering that appears in the patient groups and we are trying together to find solutions to the shortage of drugs, insulin and tapes, even in pharmacies in free markets we do not find.
She added in desperation: "We kept reducing the quantities of medicine against our will and from how many days of insulin ended up on the pharmacies of October all so that I find one Novo pen but not you."
In the governorate of Ismailia, despite the application of comprehensive health insurance in the governorate, but she has seen a shortage of medicines inside pharmacies, "Rawda", a mother of two diabetics, says that she suffers from the provision of medicines to her children with immune diabetes, where for the past 3 months she was unable to provide medicine from health insurance.
She added that after suffering a few doses were dispensed and without sugar measurement strips, and added that some substitutes of drugs for diabetes led to double pathological symptoms, where one of her children suffered from a high cumulative rate of up to 15 and enter the intensive care.
She pointed out that the shortage of medicines is not only in health insurance pharmacies and the public sector, but in free pharmacies, where she is looking for medicines in her province and neighboring provinces in order to obtain the prescribed doses of sugar for her sons.
Lack of medicines
Dr. Mahmoud Fouad, Executive Director of the Right to Medicine Association, stressed that there is a shortage of many medicines for many diseases such as immunological diseases, Mediterranean anemia, SLE, Duchenne diseases, muscular dystrophy, neurologic and psychological drugs, in addition to some hormone drugs.
Fouad explained in a statement to "Al-Bawaba News", that diabetics suffer from the lack of availability of some diabetes drugs, especially popular insulin, although there is an increase in the recent drug varieties to more than 30% of the drugs.
Fouad pointed out that there are some traders who store medicines in stores to offer them in the market at new prices, in addition to many problems related to imported medicines, which have also increased their price significantly.
Fouad pointed out that there is a new increase in a large number of items in the coming days by up to 50% and up to 80% for imported medicines.
In the same context, Dr. Ali Auf, head of the medicine division of the Federation of Chambers of Commerce, said that the problem of medicine shortage is not only related to the provision of medicine from the state or pharmaceutical factories, but also related to the culture of the citizen in dealing with these medicines.
The head of the medicine division said in statements to "Al-Bawaba News" that the citizen deals badly with drugs in two cases, the first of which is to store a large amount in the case of a shortage and then provide it in pharmacies; for fear of suffering in obtaining it if shortage, and thus causes this behavior to deprive other patients to get their doses on time.
He added that the other wrong behavior is the use of essential drugs to treat some diseases such as diabetes in the treatment of another disease such as obesity, and therefore drugs are consumed at a higher rate than the production of companies, which makes the period of the end of the crisis longer than necessary.
He pointed out that most sugar medicines (pills) are available under the scientific name and not the commercial name, and that local insulin is manufactured internally and 85% of the insulin available in Egypt is local production, but the production covers the needs of health insurance and hospitals of the Ministry of Health and the government sector.
He added that there is a crisis in imported insulin, where it is available only by 15%, and international factories adhere to a production plan, and therefore in the case of increased consumption of drugs is not increased production in the actual time for the shortage of medicine, and thus patients in the local market resort to Egyptian insulin shows demand for medicine, which is a pressure and shows cases of drug shortage.
He pointed out that there is a near breakthrough to provide medicine, and that it is easy for Egyptians to deal with the scientific name and not commercial, and in case of any drug shortage, call the ambulance pharmacies available in Greater Cairo and the governorates through the hotline 16682 or call the Drug Authority on the hot number 15301; to find out where any medicines are missing and the scientific alternative to it.
For its part, the Drug Authority explained through its official page on Facebook that there are many alternatives to authentic medicines and all of them are safe and have the same effect and effectiveness as the original medicine; pointing out that the alternative medicine, is a medicine composed of an active substance different from the original medicine, but it is used to treat the same disease.
The Egyptian Medicines Authority advised that you should consult your doctor or pharmacist before using an alternative medicine as they can help you ensure that the alternative medicine is suitable for you and that it will not interact with any other medicines you are taking.
In the same context, the Authority said in a press release that Dr. Ali Al-Ghamrawi, President of the Egyptian Drug Authority, received a delegation of representatives of local companies and the Chamber of Pharmaceutical Industry to discuss ways of cooperation between the Authority, companies and the Chamber to provide medicines and necessary supplies in the Egyptian market.
Promises of the new government
In his first remarks to the new government on the crises of medicine, Prime Minister Mostafa Madbouly said today in a press conference that the pharmaceutical sector in Egypt follows the private sector, and that the state is coordinating with the private sector to reduce the prices of medicine, stressing that the state is keen to stabilize the prices of medicine, especially that the Egyptian medicine is cheaper than most countries in the world.
He explained that the state is procuring the dollar to provide raw materials for manufacturing, and that the import of raw material at the daily price of the dollar caused great losses to the state.
Timeline
On the lack of medicine, the Prime Minister said that the drug prices were coordinated by the Drug Authority after developing a plan with the companies for the absence of any shortage of medicines in the coming period, and explained that the drug productivity takes a great time in manufacturing and therefore there is a shortage of medicines in the markets, pointing out that the coming period will witness a great abundance of medicines.
For his part, Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, revealed that the drug file is important and has a dimension in the Egyptian national security, and affected like any commodity with dollar components during the last year and a half in light of the existence of global crises.
He explained that since the beginning of the crisis and the perception of the lack of currency to cover the needs, priorities have been set so that the citizen does not feel a shortage, stressing that the guests from Gaza and Sudan are all additions that affected the requirements of production and the basics of the pharmaceutical industry of raw materials.
He added that there were deficiencies in some types of medicines, but there are alternative or similar medicines and this culture is not approved by many, in the absence of the medicine written by the doctor they say it is incomplete.
Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, continued that Egypt is the cheapest country in the world in medicine, and the unable is not affected by the high prices of medicine, adding that the state provides it and the Egyptian pharmaceutical industry covers 95% of the needs.
He added that there are 69 million citizens who are insured in the health insurance system that has existed since the 1960s, in addition to the beneficiaries of treatment decisions at the expense of the state.
Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, said that the drug pricing procedures are the prerogatives of the Egyptian Drug Authority, pointing out that the increase in drug prices will be in the range of 30 to 35%.
The minister apologized.
The Minister of Health apologized to the citizens for the shortage of some medicines in the markets during the recent period, stressing that during the next few months there will be no shortage of imported or local medicines, as the import of raw materials began to restart production and will be in cooperation with the entire minister to take care of the pharmaceutical industry.
He added that the state is keen to provide all the necessary capabilities for the treatment of patients and the provision of medicines, and that there is an upcoming international cooperation with the international institution "Gustav" for the treatment of tumors in France, which does not have a presence outside France.
It receives patients from all over the world, which is the center of excellence for the treatment of tumors in the world, and the efforts of the Egyptian government have been successful in persuading it to receive the center with all its competencies and expertise to participate the Ministry of Health in the work of a hospital in Egypt.
He explained that Egyptian doctors will be trained abroad to transfer international experiences and expertise to Egypt, stressing that the citizen will be treated at the highest international level without incurring any dime, but paid instead by the state through health insurance.
He stressed the completion of 24 projects to develop hospitals at a cost of 7.34 billion pounds, adding that there are 20 new projects in 11 governorates and these hospitals will operate with a capacity of 2,747 beds.
Dr. Khaled Abdel Ghaffar, Deputy Prime Minister and Minister of Health, said that the presidential initiatives launched by President Sisi led to an increase in the average age of the Egyptian human being.
Dr. Abdul Ghaffar explained that the national projects plan from 2025 to 2026, stressing that it includes 54 projects in 24 governorates in the Republic and will operate with a capacity of 9588 beds.
Dr. Abdel Ghaffar added that the comprehensive health insurance project will end in 2030 and will cover all governorates of the Republic, stressing that Egypt has received thousands of sick and injured cases coming from the Gaza Strip, and will be assisted in rebuilding the health system in the Gaza Strip within the framework of Egyptian assistance to the brothers.

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Content: Meitu
The first quarter of the United States serious drug shortage 323 drugs urgent cancer patients also have to be diverted and rationed!
CHU HENG NETWORK NEWS CENTER 2024-04-16 10: 42
According to the latest data from the American Society of Health System Pharmacists (ASHP) and the Utah Center for Drug Information Services, a total of 323 drugs in the United States were in severe shortages in the first quarter of this year, surpassing the record of 320 in 2014.
Among the drugs affected are the widely used diabetes drugs Ozempic and Mounjaro, the allergy treatment drug adrenaline, the common antibiotic amoxicillin for children, chemotherapy drugs and injections commonly used in hospitals in intensive care.
ASHP CEO Paul Abramowitz said in a statement that almost all categories of drugs are facing shortages, with non-patented sterile injectable drugs, including cancer chemotherapy drugs, and emergency drugs stored in hospital emergency vans and operating areas, the shortage of such drugs is the most worrying.
According to the American Cancer Society, chemotherapy is one of the top five drugs most affected by the shortage, which threatens to have a devastating impact on patients, and some hospitals and clinics say doctors have had to divert patients to ration their medications because of a shortage of some chemotherapy drugs.
In addition, ASHP noted that the continued nationwide shortage of ADHD drugs is “a problem for clinicians and patients. ”
The shortage of popular drugs is even more acute, with Mounjaro, the diabetes drug known as the “slimming pill ”, already in dire straits.
In response, Lilly said that the “unprecedented surge in demand ” for Mounjaro and its similar drug Zepbound has led to a shortage in the market, which the company is struggling to cope with.
Lilly is ramping up investments to boost production at Mounjaro and Zepbound in the second half of 2024.
The company said it expects intermittent supply disruptions in the near term due to unprecedented demand.
How to cure the drug shortage
The last major “drug shortage ” in U.S. history occurred in 2014, and it has only been alleviated in the years since.
Since 2021, the drug shortage situation seems to be increasing, and scholars in the field of medical health and economics in the United States believe that the reason for most drug shortages in the United States is the fragmentation of the drug supply chain.
The White House this month proposed spending between $3.26 billion and $5.11 billion over the next decade to help address the nation ’ s drug shortage.
The bill requires approval and funding from the U.S. Congress.
U.S. researchers and policymakers believe that a complete solution to the “drug shortage ” may require changes to the business model of the U.S. pharmaceutical industry, including measures to increase the price of generic drugs to attract more drug manufacturers.
Policymakers recommend giving the FDA more power to access more information about drug shortages and impending shortages.
Currently, the FDA relies primarily on phone calls to manufacturers asking if they can increase their supply to understand the situation.
The American Society of Health System Pharmacists said it is working with the federal government to advise the government on measures to address the drug shortage, including that Congress should require manufacturers to be more transparent on any supply chain issues and encourage more diversity in supply chains.
According to Abramowitz, “The federal government still has a lot of work to do to fundamentally address drug shortages, and the American Society of Health System Pharmacists will continue to engage regularly with policymakers to guide them in drafting and passing new legislation to address drug shortages and continue to advocate vigorously for proven solutions on behalf of our members. ”

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Content: Widely used medicines on list of those unavailable for Irish consumers at present

Cough syrups and effervescent painkillers that are staples of family medicine cabinets are out of stock

Demand for medicines to treat colds and flu has doubled or trebled in some cases in recent weeks compared to the norm at this time of year, according to the Irish medicines regulator.

The Heath Products Regulatory Authority (HPRA) says this is due to a combination of factors, including the level of respiratory illness in the community, and says it understands similar trends have been observed in other European countries from conversations it has with suppliers and regulators in other countries.

The comments come after a new analysis of medicine shortages in the Irish market showed that 216 medicines are now unavailable to doctors and pharmacists, up 15 per cent on the numbers just a month ago.

Painkillers

Among the products unavailable, according to an analysis by Azure Pharmaceuticals’ Sandra Gannon, are most antibiotics in liquid form which are typically relied on for dosing children and older people who have problems swallowing tablets. The same is true of dissolvable disprin, regularly used as a first-line painkiller in children and adults for the same reason, and other effervescent painkillers.

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A range of cough mixtures, such as Benilyn, Actifed and Sudafed as well as Night Nurse have also been reported by pharmacists across the State as low or out of stock.

Lack of such common medicines generally used by parents as first-line self-medication for families in cases of colds and other respiratory illnesses seem certain to increase pressure on GPs and emergency departments where they will have to turn for advice and alternative treatments. That inevitably adds to pressure on a health service that is already considered to be operating under crisis conditions.

A look ahead to 2023

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A number of antibiotic eye drops and more general ones such as Artificial Tears are also unavailable according to Ms Gannon, whose company specialises in manufacturing long-standing essential medicines that are no longer on patent.

Other medicines on the HPRA medicines shortage list include Epanutin, a drug widely used to prevent seizures in people with epilepsy, as well as treatments like Dermovate, which is used by people suffering from psoriasis and eczema.

Only one supplier

Ms Gannon also said a particular brand of nebules, used by patients with chronic obstructive pulmonary disease and for which there is only one supplier in the Irish market, are also out of stock and not expected to return until sometime next month.

“We need to see meaningful engagement from the Department of Health in relation to current reimbursement policies for essential mainstream medicines,” said Ms Gannon. “New medicines are reimbursed using the average of a basket of EU countries and if the same policy was applied to essential medicines, it would make the environment here more conducive to retaining these medicines and go some significant way to safeguarding supply.”

Dominic Coyle

Dominic Coyle is Deputy Business Editor of The Irish Times

Discussing care goals with elderly patients early on is essential to develop a personalized contingency plan for potential medication shortages.

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Content: Most elderly people do not want to use medical technology to maintain their lives!
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Most elderly people do not want to use medical technology to maintain their lives!
Respect for end-of-life care choices is a gift of love
2021-10-30 10: 30
Research shows that in the face of serious illness and subsequent life-support treatment options, most elderly people do not want to use medical technology to maintain their lives, but prefer to maintain personal independence and comfort, and can get along with their loved ones.
Graphic / Pixabay
Taiwan enters a society of old and dying
Taiwan ’ s population is aging rapidly. According to the 2018 estimate of the National Development Council of the Executive Yuan, it will be more than 20% in 2026, making it one of the fastest aging countries in the world.
In February 2018, for the first time, the number of deaths in Taiwan exceeded the number of births, and the proportion of elderly people over the age of 65 in the total number of deaths has reached 72%.
Older people have a higher proportion of multiple co-morbidities and functional degeneration than younger people, resulting in complex care issues, shorter life expectancy, more difficult diagnosis and prediction of end-stage disease in older non-cancer patients, longer impact on family care and social burden, and different causes of death from the middle-aged population.
Due to the reduction of physiological health retention due to aging, the elderly are more vulnerable to various diseases and even death; at the same time, when the elderly receive a variety of invasive and non-invasive treatments, it is easy to cause adverse reactions or medical injuries, even if the active treatment of diseases, to maintain a good quality of life is also very difficult.
In addition, after the introduction of life-saving medical treatment and life-prolonging measures, the long-term inability to rely on the accompanying care burden will not only reduce the quality of life of elderly patients, but also increase the pressure of family care, anxiety and depression.
Most older people do not want to live with medical technology.
Although research has pointed out that when faced with serious illness and subsequent life-support treatment options, most elderly people do not want to use medical technology to maintain their lives, but prefer to maintain personal independence and comfort, and can get along with their loved ones.
However, under the current clinical environment in which medical technology is concerned, elderly patients are often directly introduced into various life-saving medical and lifesaving measures when they encounter serious illness, and the process lacks sufficient discussion of care choices and goals. Medical personnel also rarely actively invite elderly patients and their families to participate in discussions on care goals and care plans, resulting in the care of elderly people at the end of their lives, often unable to meet their actual needs and preferences.
Elderly preferences, disease trajectories, and life expectancy need to be taken into account when formulating care plans and goals.
The elderly with debilitating disability and multiple co-morbidity face considerable challenges in formulating care goals and care plans due to the difficult prediction of the future, and the long course of illness, and the difference between good and bad performance of each person.
Therefore, geriatric medicine emphasizes that every time a care plan is formulated, care goals should be discussed with the elderly as early as possible, and the most important thing in the discussion process is to consider the elderly ’ s own life “values ” and“ care preferences ” to make decisions.
The main points that need to be considered in the discussion process are: First, is there currently clinical guidance for elderly people with this disease?
2. What is the life expectancy of this elderly person? 3. What is the severity of multiple co-morbidity?
4. What are the physical activity and cognitive functions of this elderly person?
After assessing the above points, communicate with the elderly and their families to plan care goals that meet the needs and preferences of the case, and then develop a care plan tailored to the elderly.
Communicate and discuss the choice of eating nutrition measures with the shared decision-making model of doctors and patients
Professor Lai taught his father ’ s story on the medical platform in August 110, conveying that he was a doctor and a son. Because of cultural taboo about discussing end-of-life care choices in advance, he could not know his father ’ s life values and preferences for managing diet and life-saving medical care. The 100-year-old record is so important that he asks himself, "If time goes back, will I insist on putting it back into my father's nasal tube?"
The literature points out that weight loss and poor appetite in patients with advanced debilitating diseases are inevitable at the end of the disease course. At the same time, the body's need for nutrition and water will decrease, and even if the intake is reduced, it will not feel uncomfortable.
In a 2006 study, Chernoff found that when elderly debilitating patients had reduced dietary intake and performed percutaneous endoscopic gastrostomy (PEG) to provide tube irrigation, the mortality rate was 54% for patients with terminal dementia one month after surgery. 28% of patients without dementia; the mortality rate after one year of surgery, 90% of patients with terminal dementia, and 63% of patients without dementia.
According to Cochrane ’ s latest systematic review of 2021, compared to other mouth-promoting diets, the administration of terminal dementia cases with oral tube feeding has not only failed to increase survival rates, improve quality of life, nutritional indicators, and reduce pain, but also failed to reduce the depression and anxiety of caregivers.
Therefore, medical professionals should discuss the pros and cons of different nutritional intake methods with patients and their families. If elderly patients are unwilling to accept tube feeding, they can encourage their families to choose the food that the patients like through careful hand feeding, and to express their concern for the patients by focusing on different ways other than eating.
Of course, at the end of life, when the intake of nutrients is slowly reduced, death will gradually come, but this is the process of natural death of life, not starvation, nor killing.
Advance discussion of end-of-life treatment goals and options to help improve care
Advance care planning is a process that allows patients to communicate with their relatives, friends, and medical teams to understand various treatments and outcomes, and then express their wishes based on their own values, establish care goals, and make decisions about the future of care they want or don ’ t want.
Evidence shows that pre-established health care plans can effectively promote medical communication, help patients get the medical care they want, improve the quality of end-of-life care, reduce stress, anxiety, depression, and increase satisfaction, and reduce the cost of care at the end of life.
Elderly patients with debilitating disability and multiple co-morbidities rarely have the opportunity to communicate with a pre-established healthcare plan.
According to foreign research, only about 2 to 29% of frail elderly people have discussed with health care personnel about the end of life, discussed too late or not at all, which will cause the patient's quality of life to decline, family anxiety, unnecessary hospitalization, unnecessary prolongation of the death process, patients' distrust of the medical system, doctors' overwork and increased medical costs.
Respect for end-of-life care choices for the elderly is a precious and loving gift
The author was fortunate to respond to the issue of "how to do a proper stop at the end of the life of the elderly, so that the living do not regret, and the dead are peaceful" from the perspective of geriatric medicine.
Past research by the NTU team has led us to understand that nephrologists, nephrologists, the general public, and the medical team all believe that hospice refers to the absence of physical pain and the ability to die naturally.
Palliative medicine treats the end of good as part of a full life, and therefore advocates that every clinical professional should make use of every opportunity for clinical contact with the elderly to discuss end-of-life care goals and care preferences early.
It is hoped that this article will encourage the elderly themselves, their families, and clinical staff to take the initiative to discuss the pre-established medical care plan and sign the relevant pre-established medical decisions so that they can obtain the care and treatment that meets their wishes, and have the opportunity to provide the elderly with this precious and loving gift.
※ This article is reproduced from: Yuanqi Network Medical Platform
Article belongs to the author 's personal opinion, the responsibility belongs to the author, this paper provides a platform for exchange of views, does not represent the position of this newspaper.
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A personalized contingency plan can include advance care planning and advance directives like a Healthcare Power of Attorney and a Living Will.

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AGEWISE

AGEWISE: Learning about Advance Care Planning

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Q: What is Advance Care Planning and how do I go about it? —AF

Answer: Advance Care Planning is a topic that some people avoid but that is an important thing for most of us to consider. Our friends at Trellis Supportive Care provide weekly workshops on Advance Care Planning. We reached out to them to provide insight on the subject, and this is what they had to say:

It has been said that Advance Care Planning boils down to having conversations today, to avoid a crisis tomorrow. In other words, it is a smart step to ensure that you are ready for whatever comes your way as it relates to potential care you may need in the future.

Although no one likes to think about what they would do if they became suddenly ill, or unable to speak for themselves, there is tremendous peace of mind when you have a plan in place for these scenarios. It is also a gift to anyone who may be your caregiver one day. That is why in April, we’re proud to support National Health Care Decisions Day as a time to complete your Advance Directives.

So, what exactly is an Advance Care Plan? It is the process of documenting your wishes by creating your Advance Directives, which include a Healthcare Power of Attorney and a Living Will. Your Healthcare Power of Attorney is someone you trust, and appoint, to make decisions and speak on your behalf if you are unable to speak for yourself. The Living Will is a document that communicates your goals and preferences for future care.

Making your wishes known, and having them documented, may not seem important in our everyday lives; but if the day comes that you are unable to speak or make decisions for yourself, your family and your healthcare providers will be thankful for your thoughtfulness in providing your wishes in advance.

Trellis Supportive Care staff knows how important, and beneficial, it is for families and health-care providers to have these important conversations — especially before a healthcare crisis arises. Trellis Supportive Care offers weekly Advance Care Planning workshops, both in-person and virtually, with free resources available to all who participate.

This ongoing initiative called, Got Plans?, is offered to anyone in the community free of charge. Facilitators make the process simple and understandable. To register or learn more call 336-331-1314 or email KLawler@TrellisSupport.org.

Q: Will the Shepherd’s Center resume having their used book sale this year? —FH

Answer: Great news for local book lovers — the Shepherd’s Center of Greater Winston-Salem’s Used Book Sale Event is back!

The Shepherd’s Center will hold its 35th Annual Used Book Fundraiser Sale on Thursday, May 5 and Friday, May 6 from 9 a.m. to 9 p.m., and on Saturday, May 7 from 8 a.m. to 2 p.m. in the Education Building at the Winston-Salem Fairgrounds. Entrance for parking is through Gate 5 from Deacon Blvd. There will be thousands of used books and other media on hand at exceptional prices. As a special treat, Saturday sales will be half-price.

The Shepherd’s Center’s mission is to promote and support successful aging through direct services, educational, volunteer and support programs for older adults. Throughout the year, they accept book donations from individuals, schools, libraries, nurse/health ministry congregations and retirement communities. Dedicated book center volunteers gather most days throughout the year to sort and price books, which go into the annual sale, and all proceeds of the sale benefit the programs and services provided for older adults in our community. Some of the programs include Faith In Action, The Vital Living Senior Center and The Congregational Nurse and Health Ministry partnership with Novant Health. During 2021, the Shepherd’s Center provided services for over 6,800 aging adults throughout the greater Winston-Salem/Forsyth community. Over 300 Shepherd Center associated volunteers provided more than 30,000 hours of service in our community.

For more information about The Shepherd’s Center of Greater Winston-Salem or the Annual Used Book Sale, visit their website at shepherdscenter.org/used-book-sale-.

AgeWise is a weekly column compiled by staff of Senior Services Inc., a nonprofit organization in Winston-Salem. If you have a question, email agewise@seniorservicesinc.org or mail to Senior Services, 2895 Shorefair Drive, Winston-Salem, NC 27105.

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William Bodziak, an expert on shoe impressions, testified that a pair of Air Force 1s found at the home of two of the five teenagers convicted of murdering NBA star Chris Paul's grandfather, Nathaniel Jones, could have made the shoe impressions found on Jones' Lincoln Town Car the night Jones was found dead in 2002. But it is not a definitive match. The shoe impressions are the only piece of physical evidence that police used to tie the five teenagers to the crime scene. The four men (one of the men died before filing a claim with the N.C. Innocence Inquiry Commission) are seeking exoneration from a panel of three superior court judges in a hearing that started Monday in Forsyth Superior Court.

Jessicah Black was 16 when she told Winston-Salem police that five teenagers were involved in the death of Nathaniel Jones, NBA star Chris Paul's grandfather. But nearly 20 years later, she told a panel of three superior court judges that she lied after hours of interrogation from Winston-Salem police detectives. She said she just wanted to go home and detectives told her that the five boys had already confessed. They told her, Black said, she was lying when she tried to tell the truth.

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To address potential medication shortages, identifying affected medications like Adderall, which is experiencing a nationwide shortage due to manufacturing delays, is essential.

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Content: Nationwide Adderall shortage impacting area pharmacies in the Panhandle

Published: Oct. 19, 2022 at 5:07 PM CDT|Updated: 19 minutes ago

AMARILLO, Texas (KFDA) - The Food and Drug Administration has declared a nationwide Adderall shortage and the Panhandle is feeling the affects.

The FDA blames the shortage on manufacturing delays.

Health experts say a shortage in stimulant medications is actually not a rare occurrence.

“The amount of medication that is produced is limited and regulated by the government, so there have been other years where towards the end of the year in particular, we start to struggle with supply issues. In this case, however, while that does seem to be probably one of the contributing factors, the other issue we’re facing, at least what we’re hearing about it right now, is that the manufacturing delays have been an issue and some of that has been secondary to the labor shortages,” said Dr. Carolyn Lentsch-Parcells, pediatrician and assistant professor at Burnett School of Medicine at TCU.

Martin Tipton Pharmacy is being impacted by this shortage.

“We’re having to order from various manufacturers right now, not our normal manufactures just because we cannot get them from our normal ones,” said Mark Vogler, Martin Tipton Pharmacy.

Fortunately its patients have been able to get their needed medication, just a different brand.

Amarillo Pharmacy is also being impacted, saying the drug has been back ordered for the past two months.

The Amarillo Pharmaceutical Care Center at Texas Tech Physicians is also seeing a back order on one of the strengths of the drug.

“The drug company manufacturers short-acting and extended-release, for example. So, a pharmacist, in this situation, will work collaboratively with the patient’s provider to find an available strength and dosage to meet the patient’s needs until the original strength becomes available again,” said Amarillo Pharmaceutical Care Center at Texas Tech Physicians.

Dr. Lentsch-Parcells acknowledged this may be an uneasy time for those depending on Adderall, especially with the end of the semester and holidays approaching. She encourages you to reach out to your providers.

“There are various strategies that we will sometimes use to help our patients get the best care possible, while we are trying to ride out the shortage, so that might be changing dosage or using dosage forms that are available to replace their typical medication,” said Dr. Lentsch-Parcells

She emphasizes not to make any changes to your medications without speaking to your providers first.

Pharmacy chains, like CVS and Walgreens, both confirm they are seeing intermittent supply issues with the generic form of the drug.

Developing a plan with a healthcare provider can help prepare for medication shortages, including contact information, medication lists, and symptom management strategies.

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Dr. Nirushan Thiruchelfam stressed that developing a plan to deal with asthma cases in consultation and coordination with the specialist doctor is a very important step for patients to avoid unexpected asthma attacks, pointing out that it is important for patients as well as the people who care for them to have an adequate level of understanding and awareness about the mechanism of developing and following up an asthma plan.
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(Before proceeding, we emphasize that the information here is general and for guidance only.
If you have asthma or have a child or someone with asthma consult your doctor first and last).
The pulmonologist at Cleveland Clinic stressed the importance of asthma patients and those who care for them understanding what symptoms are related to asthma attacks and what steps they should take when the condition worsens, noting the importance of coordination between patients and health care providers to deal with the symptoms and not allow them to worsen.
Asthma sufferers are more sensitive to the presence of dust, what are the most important tips that reduce their symptoms? Asthma sufferers are more sensitive to the presence of dust, what are the most important tips that reduce their symptoms?
Asthma Management Plan
The asthma management plan helps to enhance patients ’ preparedness in case of seizures, as well as improve their daily lifestyles.
This plan can serve as an important tool for patients as well as caregivers and doctors to deal with the condition and its symptoms.
For parents and guardians, such plans are an important resource for nurses and teachers to deal with children with asthma.
Asthma management plans typically include contact information and a list of medications that are broken down into colors or "zones," and are usually coded in green, yellow, and red.
These areas help determine what steps to take depending on the severity of symptoms.
The plan should also include information and other elements such as a patient ’ s vaccination record, including dates of receipt of the flu and COVID-19 vaccines.
Dr. Thiruchelfam pointed out that the different stages of an asthma management plan should clarify which medications to use and what additional steps to take based on the symptoms.
The action plan should also take into account everything a patient can experience during asthma attacks and what needs to be done to deal with the condition and treat the symptoms.
Asthma sufferers are more sensitive with dust, what are the most important tips to reduce their symptoms?
Avoiding causes
Dr. Thiruchelfam pointed out that individual care is the basis for dealing with asthma cases, saying, “When it comes to dealing with asthma cases in particular, the patient must be careful to avoid the causes and have a sufficient level of awareness to address the symptoms that may arise during a seizure. ”
“Of course, the treatment plan will vary according to each patient ’ s condition, and patients will need to coordinate with their doctors on what plans are best for their condition.
"The plan should be discussed with the doctor during visits and updated to monitor any developments in symptoms, as the doctor may need to change the medications the patient is taking to control the asthma attack."
Dr. Thiruchelfam outlined below the elements of a typical asthma management plan, as well as the additional steps to take if a child has an asthma attack.
CONTACT INFORMATION
An asthma management plan should contain important contact information, including the patient ’ s name, doctor ’ s information, and the name and phone number of the emergency contact.
It should also include the date of creation of the action plan, so that anyone reviewing it can see how recent it is.
Symptoms and medications by region
A section of the action plan should include a list of symptoms that need to be identified.
Based on this, the doctor writes down the appropriate steps that the patient should follow.
Depending on the etiology, symptoms and steps previously taken, each area in the action plan identifies medications and actions to take.
The green “go ” zone determines the medications the patient takes daily to control asthma attacks.
The patient in the green area can get a good night ’ s sleep, breathe at a good rate without any coughing or whistling sound, as well as work and play during the day.
The Green Zone also lists medications to be taken in case of exercise-induced asthma.
The yellow "caution" zone specifies the additional steps that the patient should take, along with the need to continue taking all the medications specified in the green zone.
Patients follow these steps if they show initial signs of a cold, experience unknown triggers, or experience symptoms such as coughing, mild wheezing, chest tightness, or coughing at night.
In addition to taking the medications indicated in the yellow area, the patient should contact the doctor to update him about the condition.
The role of the red “danger ” zone comes, if the asthma attack continues to worsen even after the patient has taken the drugs described in the green and yellow areas.
This section identifies additional medications, which the patient must take when the usual medications do not help control the condition and breathing is difficult and fast or the patient has difficulty speaking or expansion of the nostrils.
In addition to taking medications listed in the red zone, the patient or person taking care of them should contact the doctor immediately and, if this is not possible, go directly to the emergency room.
The best rate of exhalation flow.
The exhalation flow rate refers to the speed at which a patient can push air out of the lungs when he or she inflates strongly and as quickly as possible.
The exhalation flow rate varies between people and is determined by the exhalation flow meter.
The best exhalation flow rate for the patient should be recorded in the action plan, as well as the exhalation flow rates for each area within the plan.
Causes / Catalysts
Everyone has different triggers that can trigger an asthma attack, whether it ’ s a change in weather or seasons, certain foods, dust, exercise, or even emotional triggers or triggers, all of which should be mentioned in the plan.
"4-4-4" rule for kids.
In addition to the steps in the action plan, the "4 4 4" rule is important to learn how to act in times when children have an active asthma attack.
This shortcut will help the parent, nanny or teacher remember the details to help the child use the inhaler during a seizure.
When a child has symptoms such as shortness of breath, chest tightness, wheezing, or any other asthma-related symptoms, the "4 4 4" rule is as follows:
By developing an asthma management plan and knowing the ‘ 4 4 4 ′ ′ rule, patients and their caregivers can be confident that they are prepared to deal with potential asthma attacks.
Copies of the work plan must be available at home, doctor ’ s office, school and child care center.
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Caregivers should share information with healthcare providers to discuss medication shortages and alternative treatment options.

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Content: Photo Credit: Courtesy

Quantifying Change

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The medical profession is very dedicated to measuring our demise. Once a person begins to show signs of memory loss, the process begins. There are standard tests given by one’s family doctor. Imperfect scores indicating the beginning of memory loss, may lead to visits with a psychologist, a psychiatrist and/or social worker. Ultimately all roads for the elderly will lead to a Gerontologist. The Gerontologist may recommend further tests be administered by a Neurologist in an attempt to discover the root causes of the memory loss. There are dozens of conditions which can affect the brain and cause dementia. Some of these have other specific physical manifestations and it is important to assess the situation in order to direct the physician’s decisions regarding anticipated care and medications. For younger patients with memory loss, the investigation will probably rest with a Neurologist who will assess why this unusual condition is occurring.

Gerontology is a truly honorable profession. Wanting to help us to ease into our golden years with as much assistance as possible is a far cry from the days of yore when people were hidden away in embarrassment.

Still, there are limitations as to what even a professional can assess in short appointment with someone like Hubby, once every six or eight months. Once a test is administered, statistics and graphs are moderately helpful to the professional, but what really matters is that the specialist knows what occurs on a day-to-day basis over the many months in between appointments. Standardized tests only reveal a small segment of the daily changes. To get the most out of these meetings, the caregiver needs to participate by sharing information. This applies, not only to the care of a person with memory loss. Anyone caring for the elderly really should consider the same course of action.

The necessity to advise your loved one’s doctor of the changing realities, may present itself as an awkward situation to navigate. This problem does not only apply with family of those with memory loss or dementia. The situation can be similar with a cancer patient or someone with another serious disease. How much does a spouse want to reveal in front of the patient being discussed? There are sometimes very embarrassing topics. Sometimes, the patient will deny the veracity of the spouse’s statements, or try to minimize them when they feel humiliated. There is sometimes a conflict that people feel when torn between trying to help their loved one and thinking that they are entitled to their “privacy.” When one is very ill or mentally compromised, they need you more than ever, to accompany them to doctor appointments. They will likely forget much of the information imparted, and without your assistance- much would be lost.

I recall when my mother had lung cancer. A good friend suggested that we tape record all meetings with doctors because frightened patients mishear what the doctor is saying, and become quite confused about the information imparted. My parents did this. They BOTH needed to be able to review the meetings.

There is a limited amount of time any doctor will assign to each appointment. With experience, I devised a solution for my need to communicate with the doctor both in confidence and while Hubby was still in the room with us. The night before an appointment, I would sit at my trusty computer and write a list of observed changes in behavior – those about which I felt the doctor needed to be appraised. A handwritten note would have been fine, but much harder on the doctor trying to decipher my penmanship. By taking time the evening before to think about the issues which needed his attention, I was able to write a cohesive letter delineating each issue. Handing the papers to the doctor upon entry to the appointment gave him/her a chance to focus on our immediate concerns. It essentially presented the doctor with the questions needed to be discussed with the patient. Without this introduction the expert would not have been able to focus on the degree of severity of a particular problem and /or its possible remedy. One cannot analyze what one is not aware is happening!

Upon entering any doctor’s office, they would always ask Hubby “How are you feeling?” “Great” was often his response. “Then why are you here?” inquired his doctors. Hubby looked at me for help as he had no clue why we were seeing this particular physician. Sensing that the doctor was indeed interested in his health, Hubby would go into a monologue about one physical issue or another, not realizing which specialist was asking the question. The cardiologist was not really interested in his ear ache, or weight loss (always exaggerated for affect!). Nor was the hematologist fascinated by his concern about a possible hernia or a skin condition. Inevitably, I had to remind Hubby to focus on the specialty of the doctor of that moment. These are all attendant problems with memory loss.

On occasion, I have written an email to the family doctor expressing a specific concern which needed consultation. This is a last resort, only to be used if one has a very close relationship with the doctor. They have so much paperwork and bureaucracy to deal with, that additional communications from us can be a bit of an irritant. A healthy respect for their overwhelming caseload is certainly appreciated by the doctors we deal with regularly. It is a bit of an imposition to expect the doctor to remember the details of the email when you finally are in his office.

There appears to be a widely accepted scale which certain doctors use to explain the seven stages of dementia. I was not familiar with it as we live in Israel where it is not used widely. However, it is prevalent in many countries and caregivers often refer to their loved one being in a stage 2,3,4 etc. The explanations for each stage are described in detail online. Google can help you with the specifics if you are interested. I am not personally fond of this form of categorizing, as patients vary enormously, but I do understand that it has its purpose.

On another occasion we were referred to Memory specialists at a local hospital. In my naivete, I had the audacity to think that they would want to help Hubby. After waiting months for the treasured private appointment, and paying a high fee for the honor, the esteemed doctor actually brought me to tears. When he was interviewing Hubby, it seemed that he was intentionally confusing him. The question went something like this “When you went for your CT scan last month, what did your brain scan reveal?” I knew Hubby would not know how to respond so I answered – that Hubby did not actually have a brain scan last month. The specialist was furious with me. It had been a trick question, intended to see if Hubby would catch the error. I was banned from the room with a lecture about how I needed to have respect for the patient and allow him to respond. After I was ejected, holding back the tears, I was furious that the doctor had been so insulting, especially in front of my husband. It was not acceptable that I was being denigrated for the way I was caring for Hubby. When he called me back into the room, I was still fuming. He made a weak apology/explanation which was totally insufficient. Medically, nothing of value was offered, and yet I was told that we should return in three months. Another private bill from this specialist – to pay to be insulted? Not my style. Later I discovered that we had unwittingly been roped into a study on dementia by that same doctor. Unbeknownst to me, I was paying to be studied so that he could write a paper to advance his career. I was livid. Needless to say, we did not return.

Families are often confused as to whether they should be going to a Neurologist or a Geriatrician to monitor the care of their loved one. It really depends on what is causing the dementia. I prefer the attention of a specialist who looks at the whole patient who presumably has age-related issues along with the memory loss. This is the specialty of a Geriatrician. My observation in general is that Neurologists are far more specialized in more complex issues relating to the brain, and are not the first port of call in the caregiving process. One visit to a Neurologist may be required to determine the cause of the dementia, but in most cases, I have found a geriatrician is best for day-to-day issues and dementia medications. The chapter that I have published called Beware of Ologists – Chapter 6, shares more of my thoughts on this subject – another chapter that I hope you will enjoy.

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Barbara Diamond is a journalist living in Jerusalem, Israel. She has been a political activist on behalf of Israel and the Jewish people for over fifty years, having participated in political and humanitarian missions to Ethiopia, the former Soviet Union, China, and Europe to meet with world leaders on matters of concern. She has written over 100 articles for the Jerusalem Post and on her blog at The Times of Israel, hosted an English radio talk show in Jerusalem and continues mentoring others to pass on the torch of responsibility. You can reach her at barbara@thedementiadiary.com and visit her site at thedementiadiary.com.

The American Society of Health System Pharmacists and the FDA provide updates on medication availability and shortage status.

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Content: The first two weeks of the drug shortage platform announced 22 new lung cancer drugs "Rothko Capsules" will be imported into the project
▲ It is recommended to use 12 substitutes for the missing drug items, a total of 10 drug licenses.
(Photo / taken from the website of the Food and Drug Department)
Journalist Yen Yun-chen / reporting from Taipei
The Ministry of Health and Welfare announced today (12) the shortage of 22 drugs in the first two weeks of the list, including the lung cancer new drug "Rosick 200 mg capsule" due to the shortage of foreign raw materials, has coordinated the original company to send foreign packaged drugs to Taiwan, and will be imported by project.
The Food and Drug Administration of the Ministry of Health and Welfare has set up a "Drug Supply Notification Processing Center" to integrate six types of drug platforms, including Western medicine, Chinese medicine, rare disease drugs, children 's difficult to obtain drugs, public vaccines and infectious diseases drugs.
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Before the opening of the platform, the Food and Drug Administration of the Ministry of Health and Welfare issued a letter to medical institutions and pharmacies on March 24, re-statistics on the shortage of various brands, and announced the status of processing every two weeks, and released the first survey results today (12).
▲ A new lung cancer drug, Roseke Capsules, has been launched for public consultation.
(Photo / taken from the website of the Food and Drug Department)
From the public information of the platform, it can be seen that from March 24 to April 4, a total of 22 reports of shortage of Western medicines were received, of which 7 were investigated without shortage, 12 had alternative medicines, 1 had been restored to supply, 1 had no alternative medicines to start the open request, and 1 was under processing.
In an interview with the media, the director of the Food and Drug Department, Yang Po-wen, pointed out that half of the 22 items were reported by the manufacturer, and the other by the hospital or pharmacy, and the reason for the notification was that the normal supply of the products was not expected.
Yang Po-wen points out that in terms of the shortage of drugs, the main reason for the shortage of drugs is the increase in demand for drugs, which has led to a shortage of drugs on the supply side, or the shortage of drugs caused by production problems.
The Food and Drug Administration (FDA) will look for alternative medicines according to the shortage of drugs. For example, Taiyu Pharmaceuticals “Lok Shin Ping Capsules 30mg ” is recommended to replace with the same ingredient. However, the lung cancer drug“ Rossik 200mg Capsules ” is a new drug. Project input.
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