Page 83 - Registrar Orientation Manual 2016

High-risk medicines
While most medicines have a large margin of safety, a small number can potentially cause signi cant harm even when used as intended. The medicines most frequently involved in serious adverse drug events are called high-risk medicines. Special attention is needed when they are prescribed, dispensed, supplied, stored, administered or taken.
Factors that increase high-risk medicines’ potential for harm include:
• having a narrow therapeutic index – too little or too much has the
• potential to cause harm
• complex or unusual dosing – for example, weekly rather than daily
• high monitoring requirements
• signi cant interactions with other medicines, herbal products and food
• availability in multiple strengths and forms
look-alike, sound-alike naming and packaging.
Errors are not necessarily more common with high-risk medicines. But if errors are made there is more likely to be harm and often the consequence for patients is more serious. Patients su er and there are extra costs to the health care system.
warfarin
‘High-risk medicines... can be de ned as those which have a heightened risk of causing signi cant or catastrophic harm when used in error.’ Department of Health, Victoria, Australia
High-risk medicines include
oral methotrexate
In New Zealand and internationally there are other medicines considered high-risk. Individual organisations may also identify medicines in their organisation that are high-
risk. Check what activities are happening in your organisation to reduce harm from any of these medicines.
You can include any medicine identi ed as high-risk within your organisation in your Open for better care campaign activities and messages.
insulin
morphine
heparin
concentrated potassium