According to the American Society for Health-System Pharmacists, there are several drug shortages in the United States, with some cardiac drugs being in short supply. Among them are adenosine and lidocaine, which are used to treat arrhythmias, and dofetilide, which is used to treat atrial fibrillation and atrial flutter. Michael Ganio, PharmD, MS, BCPS, FASHP, senior director of pharmacy practice and quality at ASHP, explained that adenosine is used to slow down the heart in life-threatening situations. However, some prefilled syringes of adenosine are in short supply, leading to delays in obtaining the appropriate package size and concentration. If patients cannot get adenosine, physicians must consider other drugs with different or worse side effects. Lidocaine is a second-line treatment for a more life-threatening arrhythmia and is available in prefilled syringes. If lidocaine is not available, amiodarone could be an alternative depending on the patient’s clinical profile. Physicians should be aware of drug shortages and be careful with alternative dosage forms as they may require different administration techniques.

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