Abstract
Objective: Inadequate availability of essential antidotes is reported in many countries. Information on the availability of antidotes in Kuwait is not available. The aim is to determine whether there are adequate stocks of antidotes in public hospitals in Kuwait and to identify the presence of guidelines for antidote stocking and sharing and to determine the presence of emergency medicine pharmacists in the emergency departments. Methods: A cross-sectional study was carried out using a questionnaire distributed to chief pharmacists of six public hospitals in Kuwait. The questionnaire enquired on the availability of 29 antidotes. Results: All the chief pharmacists responded to the survey. The antidotes that were not available in any of the hospitals were botulinum antitoxin, calcium gluconate gel, dicobaltedetate, fomepizole, sodium calcium edetate, sodium thiosulphate, succimer and unithiol. There was substantial variation in the availability of antidotes, especially for cyanide poisoning, ranging from no hospitals for sodium thiosulphate to one hospital each for sodium nitrite and hydroxocobalamin. Only two hospitals had stocks of the polyvalent snake antivenom. Only three hospitals had sharing agreements. Kuwait does not have guidelines for stocking antidotes. None of the hospitals had emergency medicine pharmacists. Conclusion: The six general hospitals in Kuwait have inadequate availability of certain antidotes. Urgent measures, by creating a national guideline for antidote stocking and enforcing antidote hazard vulnerability assessment and establishing a poison control centre, are needed to reduce morbidity and mortality of poisoned patients in Kuwait.
Highlights
Poisoned patients are managed by supportive measures and/or by the use of specific antidotes
For example following digoxin or cyanide poisoning and must be available at the appropriate time to be effective.it has been reported globally that there is insufficient local availability of essential antidotes, which is of concern as poisoning with certain agents is associated with severe morbidity and mortality [2,3,4,5,6,7,8]
The chief pharmacists were selected for this study as they were considered to be the most appropriate persons who were aware of the types and quantities of antidotes stocked in the hospitals
Summary
Poisoned patients are managed by supportive measures and/or by the use of specific antidotes. Antidotes can offer significant advantages over supportive measures alone in many poisoned patients. For example following digoxin or cyanide poisoning and must be available at the appropriate time to be effective.it has been reported globally that there is insufficient local availability of essential antidotes, which is of concern as poisoning with certain agents is associated with severe morbidity and mortality [2,3,4,5,6,7,8]. In the absence of appropriate guidelines for antidote stocking, recommendations were published for adequate stocking of antidotes in the hospitals of the United States (US) and United Kingdom (UK) [3,9]. Despite the publication of guidelines, a national audit of the acute hospitals in UK revealed that there was significant variation in antidote stocking and that some antidotes for treating poisoning with digoxin, cyanide and toxic alcohols were often not stocked [2]
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