Availability of antidotes, antivenoms, and antitoxins in New Zealand hospital pharmacies.

Aim: To assess the adequacy of the types and quantities of antidotes, antivenoms and antitoxins held by New Zealand hospital pharmacies.

Methods: A list of 61 antidotes, antivenoms, antitoxins and their various forms was developed following literature review and consideration of national pharmaceutical listings. An Internet-accessible survey was then developed, validated and, during the period 28 February to 7 April 2014, sent to 24 hospital pharmacies nationally for completion. Results were assessed and compared with published guidelines for adequate stocking of antidotes in hospitals that provide emergency care.

Results: The response rate for the survey was 100%. Wide variation in stock levels were reported with only N- acetylcysteine and octreotide held in adequate quantities by all hospitals to manage a single patient for 24 hours. While archaic compounds were still stocked, newer and more effective pharmaceuticals were not. The national replacement cost for expiring drugs was estimated at $171,024, with smaller, more isolated facilities facing the greatest expense and difficulty in achieving timely resupply.

Conclusion: Shortcomings in the types and quantities of antidotes, antivenoms and antitoxins held by New Zealand hospital pharmacies were recognised. This situation may be improved through national rationalisation of pharmaceutical storage and supply, and implementation of a national antidote database.