Readers are invited to write in with their questions about decisions of the Pharmaceutical Benefits Advisory Committee (PBAC). Australian Prescriber publishes selected questions from readers, together with answers from the PBAC. Questions may address issues such as regulatory decisions, pharmaceutical benefits listings and withdrawals.
This exclusive arrangement helps Australian Prescriber readers understand how the contents of the Pharmaceutical Benefits Scheme (PBS, see www.pbs.gov.au) are determined.
Letters and responses are reviewed by the Editorial Executive Committee and may be edited before publication. It may not be possible to reply to all individual questions.
Your question to the PBAC
Sir, For the medical management of severe anaphylactic reactions in children under the age of 12 years, it is recommended that adrenaline should be used in the dilution of 1:10 000 (wall chart 'Medical management of severe anaphylactoid and anaphylactic reactions', insert to Aust Prescr Vol. 17 No. 4 1994).
In the Emergency Drug (Doctor's Bag) Supplies, I note that adrenaline is only available in a dilution of 1:1000. I think that adrenaline also should be available in a 1:10 000 strength.
Dr James A. Keipert
East Melbourne, Vic.
The Pharmaceutical Benefits Advisory Committee (PBAC) considered an application for the inclusion of the above-mentioned item on the Emergency Drug (Doctor's Bag) Supplies List at its March 1995 meeting.
The application was rejected since the only known adrenaline 1:10 000 injection product is supplied in 10 mL ampoules in packs of 50, whereas a single 1 mL ampoule (or at least no more than 5) would be most suitable for pharmaceutical benefit listing.
Further, the PBAC felt that by using a tuberculin syringe, an appropriate volume could be extracted from the currently listed adrenaline 1:1000 product. In addition, the presence of two strengths of adrenaline in a doctor's bag could lead to confusion in an emergency.