"vials" when ordering online, says Sheldon S. Sones, RPh, FASCP, a
pharmacy consultant in Newington, Conn. A glass ampule will give
you a different dosage form, but it's the same drug, he says. Similarly,
you might try ordering under the trade name, Sublimaze. One adminis-
trator was happy to find 20 cc ampules of Sublimaze ("not too expen-
sive for the waste," she says) as well as 1 ml and 2 ml Sufenta (sufen-
tanil).
4. Caution when using alternative drugs. If you consider using
other formulations such as meperidine and Dilaudid (hydromor-
phone), be aware of the risk of an error or adverse outcome when
using unfamiliar alternative drugs. Not all injectable opioids are inter-
changeable for all indications. During a similar shortage in 2010, 2
patients died when IV hydromorphone was administered at the
intended dose for morphine.
5. Non-opioid multimodal pain management. In some cases, you
can mitigate post-op pain by attacking it before surgery with nerve
blocks or non-opioid analgesics. For example, you can give Celecoxib
with 975 mg of acetaminophen, says Mr. Sones, who cautions that
celecoxib is contraindicated for use in patients allergic to sulfon-
amides.
— Outpatient Surgery editors
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