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10/2/2001

Pharmacy Must Learn From Sept. 11

Cheryl A. Thompson

The horrors of Sept. 11 will not easily be forgotten but, then, perhaps they should remain near the forefront of our thoughts, as the nation seeks to prepare against future acts of terrorism.

Despite the ever-present shortage of personnel, pharmacy directors at hospitals not directly involved in the rescue efforts offered to send pharmacists to help the facilities receiving patients injured in the attacks. The sincere interest in being able to help where urgently needed became the primary concern.

Unfortunately, relatively few of the available pharmacists were needed to treat the thousands of people harmed that day. And, in the end, few of the extra supplies hurriedly delivered to the treatment sites were used.

Pharmacy performed well. But the Sept. 11 disasters did not really challenge the profession.

Personnel in emergency departments did not need to consult pharmacists about the best agents for treating burns or preventing tetanus. Moreover, those agents are routinely stocked in pharmacies, albeit not necessarily in quantities sufficient to treat many patients for several days.

But, if the disasters had involved the release of a nerve toxin or infectious agent, could pharmacists have immediately answered emergency workers’ questions about the best antidotes and treatments?

If someone were to call today for "2-PAM," would pharmacy personnel know what to look for (pralidoxime) or whether their storeroom even has the product? Abbreviations can be dangerous when someone is unfamiliar with the lingo. Just-in-time delivery may be too late for patients if an agent must be given within 24 hours after exposure.

Has anyone checked to see whether the pharmacies in a community have sufficient supplies to last through the first 24 or 36 hours after an act of terrorism?

Rational thinking must prevail. While pharmacies contemplate the expense of stocking supplies for an event that no one wishes to happen, the general public wants to protect itself.

The government’s Advisory Committee on Immunization Practices recommends the use of doxycycline or ciprofloxacin to prevent the germination of anthrax spores after inhalation. Preventive therapy must continue for at least 30 days, perhaps 60 days, but no one knows for certain. Are pharmacists willing to help prescribers or the public stockpile anti-infective agents?

As yet, there does not appear to be a manual that pharmacists can rely on to learn about and prepare for emergencies involving terrorism. Although not a substitute for such a manual, the ASHP Emergency Preparedness—Counterterrorism Resource Center offers convenient links to information available on the World Wide Web and elsewhere.

ASHP’s Educational Services Division is earnestly working to pull together an educational session on bioterrorism for the Midyear Clinical Meeting and Exhibits in New Orleans. The first choice is to have last year’s Public Health Service and Department of Defense speakers repeat their presentations. But those government employees may still be responding to the national state of emergency that started in September. Please check the meeting’s daily newspaper for more information on the session.