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    ISMP High Alert Medication List

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    Aryanti Dwiputri
    List of high-alert medications in acute care, emergency & ambulatory settings

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    © All Rights Reserved
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    ISMP High Alert Medication List

    Uploaded by

    Aryanti Dwiputri
    4K views1 page
    List of high-alert medications in acute care, emergency & ambulatory settings

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    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    List of high-alert medications in acute care, emergency & ambulatory settings

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4K views1 page

    ISMP High Alert Medication List

    Uploaded by

    Aryanti Dwiputri
    List of high-alert medications in acute care, emergency & ambulatory settings

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Institute for Safe Medication Practices

    ISMPs List of High-Alert Medications

    igh-alert medications are drugs that bear a heightened risk of


    causing significant patient harm when they are used in error.
    Although mistakes may or may not be more common with these drugs,
    the consequences of an error with these medications are clearly more
    devastating to patients. We hope you will use this list to determine which
    medications require special safeguards to reduce the risk of errors.

    This may include strategies like limiting access to these medications,


    using auxiliary labels and automated alerts, standardizing the ordering,
    preparation, and administration of these products, and employing
    automated or independent double checks when necessary. (Note: manual
    independent double checks are not always the optimal error reduction
    strategy and may not be practical for all of the medications on the list).

    Classes/Categories of Medications

    Specific Medications

    adrenergic agonists, IV (e.g., epinephrine)

    amiodarone, IV

    adrenergic antagonists, IV (e.g., propranolol)

    colchicine injection

    anesthetic agents, general, inhaled and IV (e.g., propofol)

    heparin, low molecular weight, injection

    cardioplegic solutions

    heparin, unfractionated, IV

    chemotherapeutic agents, parenteral and oral

    insulin, subcutaneous and IV

    dextrose, hypertonic, 20% or greater

    lidocaine, IV

    dialysis solutions, peritoneal and hemodialysis

    magnesium sulfate injection

    epidural or intrathecal medications

    methotrexate, oral, non-oncologic use

    glycoprotein IIb/IIIa inhibitors (e.g., eptifibatide)

    nesiritide

    hypoglycemics, oral

    nitroprusside sodium for injection

    inotropic medications, IV (e.g., digoxin, milrinone)

    potassium chloride for injection concentrate

    liposomal forms of drugs (e.g., liposomal amphotericin B)

    potassium phosphates injection

    moderate sedation agents, IV (e.g., midazolam)

    sodium chloride injection, hypertonic (more than 0.9% concentration)

    moderate sedation agents, oral, for children (e.g., chloral hydrate)

    warfarin

    narcotics/opiates, IV and oral (including liquid concentrates,


    immediate- and sustained-release formulations)

    Background

    neuromuscular blocking agents (e.g., succinylcholine)

    ISMP 2005

    radiocontrast agents, IV
    thrombolytics/fibrinolytics, IV (e.g., tenecteplase)
    total parenteral nutrition solutions

    Based on error reports submitted to the USP-ISMP Medication Errors Reporting


    Program and reports of harmful errors in the literature, ISMP created a list of potential high-alert medications. During August and September, 2003, more than 350
    practitioners responded to an ISMP survey designed to identify which of these
    medications were most frequently considered high alert by individuals and organizations. Further, to assure relevance and completeness, the clinical staff at ISMP,
    members of our advisory board, and safety experts throughout the US were asked to
    review the potential list. This list of drugs and drug categories reflects the collective
    thinking of all who provided input.

    Permission is granted to reproduce material for internal newsletters or communications with proper attribution. Other reproduction is
    prohibited without written permission. Unless noted, reports were received through the USP-ISMP Medication Errors Reporting Program
    (MERP). Report actual and potential medication errors to the MERP via the web at www.ismp.org or by calling 1-800-FAIL-SAF(E).
    ISMP guarantees confidentiality of information received and respects reporters wishes as to the level of detail included in publication.

    Institute for Safe


    Medication Practices
    www.ismp.org

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