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Pharmaceutical Waste Reduction Strategies

Use an alternate delivery method

Drugs which would be wasted if delivered the usual way, such as using an IV mixture are delivered in a different manner, such as a syringe.

Reduces Amount: Yes
Reduces Toxicity: No

Examples of Applying this Strategy

Generic Drug: Epinephrine

Proprietary Drug(s): Epinephrine

For more information:


200 Oak Street SE, Sutie 350
Minneapolis, MN, 55455-2008

Phone: (612) 624-1300
Fax: (612) 624-3370

Dr. Rachel Stratman, PharmD, clinical pharmacist for perioperative services at Barnes-Jewish Hospital, reduced atropine, phenylephrine, lidocaine, succinylcholine, neostigmine, insulin, epinephrine, dubutamine, norepinephrine, rocuronium, vecuronium, and glycopyrrolate by using pre-filled syringes instead of provider-mixed IVs. The wastage of most of these drugs was reduced by more than 90%. The strategy involved: 1) standardizing anesthesia trays incorporating ready to use syringes of medications commonly used for anesthesia induction, reversal and emergencies; 2) purchasing premixed ready-to-use syringes of with tamper-evident seals; and 3) providing bolus doses of insulin, epinephrine and norepinephrine. The cost of prefilled syringes with less waste were similar to provider-mixed IVs with more waste. In addition, anesthesiologists saved time, and problems that could have led to patient harm were corrected. The article mentions possible questions regarding the safety of products from outside compounders. See: Blum, Karen, "In Operating Room, a Switch To Prefilled Syringes Pays Off." Pharmacy Practice News Vol 40, March 2013. (URL below)

Delivery Method(s): Injectable

For more information:


Stratman, Rachel C., PharmD, BCPS
Barnes-Jewish Hospital South
1 Barnes-Jewish Hospital Plaza
St. Louis, MO 63110

Phone: (314) 747-3000
Fax: (314) 454-7625
Email: rcs1713@bjc.org

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