High-Alert/High-Risk Medications (PCTB PTCE Pharmacy Technician Test Prep)

Summary

Key Points

• High-alert or high-risk medications are drugs that carry an increased risk of significant patient harm or injury if misused or if an error occurs. 0:31
• While not necessarily more prone to errors, mistakes with high-alert medications can have life-threatening or permanent consequences. 0:53
• Narrow Therapeutic Index (NTI) drugs have a small difference in dose or blood concentration that can lead to serious therapeutic failures or life-threatening adverse reactions, and many high-alert medications are also NTI drugs. 1:37
• Organizations like the Institute for Safe Medication Practices (ISMP) and The Joint Commission (JC) provide resources and lists to help identify and manage high-alert medications in different healthcare settings. 2:02
• Common classes of high-alert medications include insulins, sulfonylureas, anticoagulants, opioid pain medications, chemotherapy drugs, IV beta-blockers, IV antiarrhythmics, immunosuppressants, intrathecal/epidural medications, neuromuscular blocking agents, and concentrated electrolytes. 2:56
• Errors with insulins can lead to coma and death due to potent blood sugar lowering effects. 3:55
• Opioid errors can cause respiratory depression, leading to cessation of breathing and death. 4:14
• Anticoagulant errors increase the risk of severe bleeding, which can be fatal. 4:22
• Specific high-alert medications mentioned include epinephrine, epoprostenol, vasopressin, sodium nitroprusside, IV oxytocin, concentrated injectable potassium, concentrated injectable sodium chloride (greater than 0.9%), and concentrated insulin (U500). 5:46
• The Joint Commission specifically highlights insulin, opiates/narcotics, injectable potassium concentrates, IV anticoagulants (like Heparin), and sodium chloride solutions above 0.9% as having the highest risk. 8:08
• Concentrated electrolytes like potassium and hypertonic sodium chloride solutions can cause dangerous imbalances (hyperkalemia, hypernatremia) leading to cardiac issues, brain damage, and death. 9:31
• Strategies to reduce errors with high-alert medications include staff education, using auxiliary labels, limiting access, implementing independent double checks, and utilizing technology for automated checks. 10:01