Hospitals have to start looking for alternatives that work almost as well as the current standard treatments.
“Many places are already shifting to using medications that we tried to avoid,” said Dr. Lewis J. Kaplan, president of the Society of Critical Care Medicine, a nonprofit involved in research and advocacy for patients. “We had cut down tremendously on the amount of benzodiazepines, which you may be familiar with as Ativan or Valium, because they may induce delirium, especially in people who are having trouble sleeping. But we’re now using those medications where our standard sedatives are running low.”
Some hospitals are purchasing alternative antibiotics, crushing up pills instead of using IV fluids, and reducing nonessential surgeries and treatments to prioritize patients with coronavirus infections, Dr. Kaplan said.
“There isn’t a hard and fast rule,” he said. “It is, what do I have? Can this work for this patient? And do I need to ask someone about whether or not the drugs that are mixing are reasonably safe?”
One change that has further strained drug supplies is a switch to buying albuterol inhalers for individual patients rather than using nebulizers, a shift that doctors hope will decrease the spread of the virus through the air. But that move heightens the problem of depleting supplies for people with asthma and chronic obstructive pulmonary disease, who routinely rely on the inhalers and have been encouraged to buy 90-day supplies of their medicine.
“In general, that’s good advice up front,” Mr. Schondelmeyer said. “But with drugs like albuterol, we’re not going to be able to sustain that because we’re already on short supply.”
Kelley Dougherty, a spokeswoman for Teva Pharmaceuticals, one of the drugmakers that manufactures albuterol inhalers, said the company was facing unprecedented demand but did not have any supply chain issues at the moment. “Over all, our supply chain supporting our key products, brand and generics and API remains largely uninterrupted,” she said, referring to active pharmaceutical ingredients. She added that the company was “producing as much albuterol as possible as quickly as possible.”