Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF April 15, 2011 Issue | Archived Issues

Acetylcysteine Shortage, Benzocaine Product Risks

Pharmacy Focus

- Update to Fluoroquinolones Boxed Warning

- Shortage of Acetylcysteine 10% 100mg/ml Solution for Nebulization

- Benzocaine Topical Products: Risk of Methemoglobinemia

» Read more


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Women and Ischemic Heart Disease Symposium
April 29

Annual Basketball Game
May 15

Clinical and Translational Research Workshop
Applications due June 1

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Acetylcysteine Shortage, Benzocaine Product Risks

Pharmacy Focus

Update to Fluoroquinolones Boxed Warning

In February 2011, the U.S. Food and Drug Administration approved a revision to the current Boxed Warning labeling for both oral and intravenous fluoroquinolones to include the following statement: "Fluoroquinolone products may exacerbate muscle weakness in persons with myasthenia gravis. Avoid fluoroquinolone products in patients with known history of myasthenia gravis."

Affected fluoroquinolones include: moxifloxacin, ciprofloxacin, norfloxacin, levofloxacin, ofloxacin and gemifloxacin.

Click here for more information.

 

Shortage of Acetylcysteine 10% 100mg/ml Solution for Nebulization

Please note that Cedars-Sinai is currently experiencing an acute shortage of acetylcysteine solution for nebulization. Unfortunately, several of the manufacturers do not have a release date at this time, and acetylcysteine 20% inhalation solution is also on backorder.

Given that our current supply of acetylcysteine nebulization solution is critically low, acetylcysteine 10% has been removed from the Pyxis machines and will only be available for use on a case-by-case basis until Cedars-Sinai can secure adequate supply.

This decision has been approved by the Pharmacy and Therapeutics chair as well as the Pulmonary Division.

 

Benzocaine Topical Products: Risk of Methemoglobinemia

The FDA notified healthcare professionals and patients that the agency continues to receive reports of methemoglobinemia, a serious and potentially fatal adverse effect, associated with benzocaine products.

The adverse effect is seen with use in spray form (used during medical procedures to numb the mucous membranes of the mouth and throat) and in over-the-counter benzocaine gels and liquids (used to relieve pain from a variety of conditions, such as teething, canker sores and irritation of the mouth and gums).

The FDA recommends that:

  • Benzocaine products should not be used on children less than 2 years of age, except under the advice and supervision of a healthcare professional.
  • Adult consumers who use benzocaine gels or liquids to relieve mouth pain should follow the product label recommendations.
  • Consumers should store benzocaine products out of reach of children.

Click here for more information.