| Classes/Categories of Medications |
| adrenergic agonists, IV (e.g., epinephrine, phenylephrine, norepinephrine) |
| adrenergic antagonists, IV (e.g., propranolol, metoprolol, labetalol) |
| anesthetic agents, general, inhaled and IV (e.g., propofol, ketamine) |
| antiarrhythmics, IV (e.g., lidocaine, amiodarone) |
| antithrombotic agents (anticoagulants), including warfarin, low-molecular-weight heparin, IV unfractionated heparin, Factor Xa inhibitors (fondaparinux), direct thrombin inhibitors (e.g., argatroban, lepirudin, bivalirudin), thrombolytics (e.g., alteplase, reteplase, tenecteplase), and glycoprotein IIb/IIIa inhibitors (e.g., eptifibatide) |
| cardioplegic solutions |
| chemotherapeutic agents, parenteral and oral |
dextrose, hypertonic, 20% or greater |
| dialysis solutions, peritoneal and hemodialysis |
| epidural or intrathecal medications |
| hypoglycemics, oral |
| inotropic medications, IV (e.g., digoxin, milrinone) |
| liposomal forms of drugs (e.g., liposomal amphotericin B) |
| moderate sedation agents, IV (e.g., midazolam) |
| moderate sedation agents, oral, for children (e.g., chloral hydrate) |
narcotics/opiates, IV, transdermal, and oral (including liquid concentrates, immediate
and sustained-release formulations) |
| neuromuscular blocking agents (e.g., succinylcholine, rocuronium, vecuronium) |
| radiocontrast agents, IV |
total parenteral nutrition solutions |
|
| Specific Medications |
| colchicine injection*** |
| epoprostenol (Flolan), IV |
| insulin, subcutaneous and IV |
| magnesium sulfate injection |
| methotrexate, oral, non-oncologic use |
| opium tincture |
| oxytocin, IV |
| nitroprusside sodium for injection |
| potassium chloride for injection concentrate |
| potassium phosphates injection |
| promethazine, IV |
| sodium chloride for injection, hypertonic (greater than 0.9% concentration) |
sterile water for injection, inhalation, and irrigation
(excluding pour bottles) in containers of 100 mL or more |
***Although colchicine injection should no longer be used, it will remain on the list until shipments of unapproved colchicine injection cease in August 2008. For details, please visit: www.fda.gov/bbs/topics/NEWS/2008/NEW01791.html.
| Background |
Based on error reports submitted to the USP-ISMP Medication Errors Reporting Program, reports of harmful errors in the literature, and input from practitioners and safety experts, ISMP created and periodically updates a list of potential high-alert medications. During February-April 2007, 770 practitioners responded to an ISMP survey designed to identify which medications were most frequently considered high-alert drugs 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. |
|
