Managing the risk of shortages and medication errors with curares during the COVID-19 pandemic: a hospital pharmacy experience.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has spread rapidly around the world. Like many clinical teams, hospital pharmacies have widely contributed in preventing and containing the COVID-19 pandemic. Pharmacies were thus involved in the management of overuse of specific drugs, medication shortages and risk of medication errors.
OBJECTIVES: To assess the use of curares during the COVID-19 crisis and to highlight the lessons to be learnt from this overuse.
METHODS: The use of curares (Atracurium, Cisatracurium and Rocuronium) was compared with the usual use levels in our hospital. Supply issues have been identified and investigated. The risk of medication errors was clearly established and considered.
RESULTS: Despite an increased demand, our hospital has not experienced any disruption in the supply of curare medications. But the risk of curare shortages has led to the registration of new pharmaceutical forms and dosages never used before. We also observed necessary switches between different curares. All of this has contributed to an increased risk of medication errors.
CONCLUSIONS: During the COVID-19 pandemic, the pharmaceutical management of curare medications has been particularly critical. The risk of medication errors and unsafe medication practices was high. This analysis must lead to a high level of vigilance in the next few months. © European Association of Hospital Pharmacists 2021. No commercial re-use. See rights and permissions. Published by BMJ.