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The parenteral opioid shortage: Causes and solutions

Hanna Hollingsworth, PharmD, Chris Herndon, PharmD, CPE




Opioids, shortage, protocol, ketamine, nalbuphine, butorphanol

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FDA: FDA Drug Shortages. Available at Accessed February 7, 2018.

Section 826 of Title 21 United States Code Controlled Substances Act. Available at: Accessed February 7, 2018.

Office USGA. GAO-15-202, DRUG SHORTAGES: Better Management of the Quota Process for Controlled Substances Needed; Coordination between DEA and FDA Should Be Improved. 2015. Available at Accessed February 7, 2018.

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FDA: 2017-Hospira Inc 2/14/17. Available at: Accessed February 7, 2018.

Galinski M, Dolveck F, Combes X, et al.: Management of severe acute pain in emergency settings: Ketamine reduces morphine consumption. Am J Emerg Med. 2007; 25(4): 385-390. doi:10.1016/j.ajem.2006.11.016

Barash PG: Clinical Anesthesia. Available at:,+7e+barash+butorphanol&source=gbs_navlinks_s. Accessed February 7, 2018.

Beaudoin FL, Lin C, Guan W, et al.: Low-dose Ketamine Improves Pain Relief in Patients Receiving Intravenous Opioids for Acute Pain in the Emergency Department: Results of a Randomized, Double-blind, Clinical Trial. Acad Emerg Med. 2014; 21(11): 1194-1202. doi:10.1111/acem.12510

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