Adequacy of poisoning antidote stocks in the pharmacies of public health service hospitals in the Spanish autonomous community of the Balearic Islands

Objective: To analyze whether pharmacies in public health service hospitals in the

Spanish autonomous community of the Balearic Islands are stocking sufficient amounts

of poison antidotes.

Methods: Descriptive cross-sectional study of public hospital pharmacy stocks of antidotes

and other medicines for treating acute poisoning. The head of each hospital pharmacy

completed a questionnaire about stocks. The results on which antidotes were in stock, the

amounts, and the storage locations were assessed for compliance with recommended

quality indicators for emergency care in acute poisonings (CALITOX-2006) and the

Antidote Stocking Guidelines (ASG-2009).

Results: The 7 hospitals met the CALITOX-2006 availability criteria for over 85% of items

and the ASG-2009 criteria for 68%. Inadequate stocking mainly involved sodium sulfate,

apomorphine, oral cyanide antidote kits, and crotaline snake antivenom. An average of

83% of the stocks were adequate; pyridoxine was the substance most often found to be

understocked. Activated charcoal and N-acetylcysteine were the items most often

overstocked. Glucagon and fomepizole were understocked in the referral hospital. Over

80% of items were stored in appropriate locations in the emergency departments of

level 1 hospitals (68% in level 2 hospitals; 94% in the referral hospital).

Conclusions: Public health system hospitals are highly compliant with recommendations on

stocking antidotes and other medicines to treat acute poisoning (what to stock, where, and in what amounts); the distribution of stocks safely guarantees they will be available when

needed. Among level 2 hospitals, a facility’s location (proximity to the best-equipped referral

hospital for poisonings) had greater influence on compliance than the hospital’s level of

complexity