High Alert Medications

  1. 0 [font=akzidenzgroteskbe-boldcn][font=akzidenzgroteskbe-boldcn]ismp issues list of high-alert medications




    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-bold]high-alert [font=vectoralh-light]medications are drugs that pose a heightened risk of causing significant
    [font=vectoralh-light]patient harm when they are used in error. although mistakes may or may not be more [font=vectoralh-light]common with these drugs, the consequences of an error are clearly more devastating [font=vectoralh-light]to patients. based on error reports submitted to the usp-ismp medication errors
    [font=vectoralh-light]reporting program and reports of harmful errors in the literature, ismp has created a [font=vectoralh-light]list of potential high-alert medications. during august and september of 2003, more [font=vectoralh-light]than 350 practitioners responded to an ismp survey designed to identify which of these [font=vectoralh-light]medications were most frequently considered high alert by individuals and organizations.
    [font=vectoralh-light]further, to assure relevance and completeness, the clinical staff at ismp, members
    [font=vectoralh-light]of our advisory board, and safety experts throughout the us were asked to review
    [font=vectoralh-light]the potential list.

    [font=vectoralh-light]the following list of 33 drugs and drug categories reflects the collective thinking of all [font=vectoralh-light]who provided input. we hope you will use this list to determine the medications that [font=vectoralh-light]require special safeguards to reduce the risk of errors. this may include strategies like [font=vectoralh-light]limiting access; using auxiliary labels and automated alerts; standardizing the ordering,[font=vectoralh-light]concentrations, preparation, and administration of these products; using premixed [font=vectoralh-light]solutions; and employing automated or independent double-checks when necessary.
    [font=vectoralh-light](note: manual double-checks are not always the optimal error reduction strategy and [font=vectoralh-light]may not be practical for a few of the medications on the list.) during 2004, we plan to [font=vectoralh-light]issue a series of surveys to learn more about the special precautions healthcare organizations [font=vectoralh-light]have in place for several of these medications.

    [color=white][font=akzidenzgroteskbe-bold]class/category of medications

    drug categories:
    [font=vectoralh-light][font=vectoralh-light]adrenergic agonists, iv (e.g., epinephrine)
    [font=vectoralh-light][font=vectoralh-light]adrenergic antagonists, iv (e.g., propranolol)

    [font=vectoralh-light][font=vectoralh-light]anesthetic agents, general, inhaled and iv (e.g., propofol)

    [font=vectoralh-light][font=vectoralh-light]cardioplegic solutions (used to induce cardiac arrest in open heart surgery)

    [font=vectoralh-light]chemotherapeutic agents, parenteral and oral

    [font=vectoralh-light]dextrose, hypertonic, 20% or greater

    [font=vectoralh-light]dialysis solutions, peritoneal and hemodialysis
    [font=vectoralh-light]epidural or intrathecal medications
    [font=vectoralh-light]glycoprotein iib/iiia inhibitors (e.g., eptifibatide)
    [font=vectoralh-light]hypoglycemics, oral (e.g., glyburide)
    [font=vectoralh-light]inotropic medications, iv (e.g., digoxin, milrinone)
    [font=vectoralh-light]liposomal forms of drugs (e.g., liposomal amphotericin b)
    [font=vectoralh-light]moderate sedation agents, iv (e.g., midazolam)
    [font=vectoralh-light]moderate sedation agents, oral, for children (e.g., chloral hydrate)
    [font=vectoralh-light]narcotics/opiates, iv and oral liquid concentrates (immediate- and sustained-release)
    [font=vectoralh-light]neuromuscular blocking agents (e.g., vecuronium)
    [font=vectoralh-light]radiocontrast agents, iv
    [font=vectoralh-light]thrombolytics/fibrinolytics, iv (e.g., tenecteplase)
    [font=vectoralh-light]total parenteral nutrition solutions








    [font=vectoralh-light][font=vectoralh-light]drugs:
    [font=vectoralh-light][font=vectoralh-light]amiodarone, iv
    [font=vectoralh-light][font=vectoralh-light]colchicine injection
    [font=vectoralh-light][font=vectoralh-light]heparin, low molecular weight, injection
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]heparin, unfractionated, iv
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]insulin, subcutaneous and iv
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]lidocaine, iv[font=vectoralh-light][font=vectoralh-light]
    [font=vectoralh-light][font=vectoralh-light]magnesium sulfate injection
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]methotrexate, oral, non-oncologic use
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]nesiritide, iv
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]nitroprusside, sodium, for injection[font=vectoralh-light]
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]potassium chloride for injection[font=vectoralh-light][font=vectoralh-light]
    [font=vectoralh-light][font=vectoralh-light]concentrate[font=vectoralh-light]
    [font=vectoralh-light]potassium phosphates injection
    [font=vectoralh-light]sodium chloride injection, hypertonic

    [font=vectoralh-light](more than 0.9% concentration)
    [font=vectoralh-light][font=vectoralh-light][font=vectoralh-light]warfarin

    http://www.ismp.org/tools/highalertmedications.pdf

    Last edit by NRSKarenRN on Apr 24, '10
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