Look Alike & Sound Alike Drugs
[Pages:5]Look Alike & Sound Alike Drugs
To prevent medication errors involving drugs that may look alike or sound alike, consider the following practices:
Medication Ordering PRINT clearly DO NOT ABBREVIATE drug name Write both GENERIC and BRAND names Write INDICATION for use
Distinguishing Medications By: Purchase DIFFERENT BRAND Store in SEPARATE areas DISTINGUISH names
TALL MAN lettering Circle/highlight/underline differences
Medication Administration/Storage: DOUBLE CHECK against order and MAR before
administration HIGH ALERT meds require independent double
checks Physical separation in storage (with warning on
shelf, different color bins)
POTENTIALLY ERROR-PRONE DRUG PAIRS /GROUPS OF DRUGS
POTENTIAL ERRORS & CONSEQUENCES
ERROR PREVENTION MEASURES
Acetazolamide (DiaMOX?)
Similarity in generic and brand names may
Physical separation in storage
Chlorothiazide (DiuRIL?)
lead to errors
1
Medications have the same indication
AmiloRIDE (Midamor?)
Similarity in generic names, dosage strengths, Physical separation in storage
AmlodiPINE (Norvasc?)
and dosing may lead to errors
Medications have some overlapping
indications
Amphotericin B (Fungizone?)
Confusion may occur between conventional Liposomal formulation requires ID approval
Amphotericin B ? Liposomal (AmBisome?,
and liposomal formulations; products are NOT
Amphotec?)
INTERCHANGEABLE
BuPROPion Sustained Release (Wellbutrin SR?, Similarity in generic names may lead to errors Wellbutrin XL is on formulary, Wellbutrin SR is
Zyban?)
Both BuPROPions come in 150mg tablets but
non-formulary
BuPROPion Extended Release (Wellbutrin XL?)
can be dosed either twice daily (SR) or once Formulary status (bupreNORphine;
BupreNORphine (Subutex?)
daily (XL).
bupreNORphine/naloxone are both formulary
BupreNORphine/naloxone (Suboxone?) BusPIRone (Buspar?)
These medications have different indications
with restrictions)
(Rev Feb 2018 Admin Policies 16.31 Appendix D, 16.30 Appendix A)
POTENTIALLY ERROR-PRONE DRUG PAIRS /GROUPS OF DRUGS
CARBOplatin (Paraplatin?) CISplatin (Platinol?)
CarBAMazepine (Tegretol?) OXcarbazepine (Trileptal?)
CarVEDilol (Coreg?) CapTOPril (Capoten?) CHLORpromazine (Thorazine?) ProchlorPERazine (Compazine?) ProMETHazine (Phenergan?) EScitalopram (Lexapro?) CITalopram (CELexa?) CloNIDine (Catapres?) CloZAPine (Clozaril?, Fazaclo ODT?) ClonazePAM (KlonoPIN?)
Divalproex (Depakote?, Depakote Sprinkle?) Divalproex Extended Release (Depakote ER?) Valproic Acid/Sodium Valproate (Depakene?) DOPamine (Intropin?) DOBUTamine (Dobutrex?) DOCEtaxel (TaxoTERE?) PACLItaxel (TaxOL?)
POTENTIAL ERRORS & CONSEQUENCES
ERROR PREVENTION MEASURES
Similarity in generic names may lead to errors Double check process with chemotherapy audit
Doses appropriate for CARBOplatin usually
tool for order review, compounding, and
exceed the maximum safe dose of CISplatin
administration
Tall Man lettering in pumps
Similarity in generic and brand names may
Physical separation in storage
lead to errors
Medications have some overlapping
indications
Similarity in generic names, indication and
Physical separation in storage, with warning on
dosage strengths may lead to errors
shelf, different color bins
Similar generic names may lead to errors
Look-Alike alert decal on Omnicell lid
Medications have some overlapping
Encourage written orders with both generic and
indications
brand names
Similarity in generic names and indications
Look-Alike alert decal on Omnicell lid
may lead to errors
Similarity in generic names may lead to errors Look-Alike alert decal on Omnicell lid
2
Medications have different indications
Preprinted order form for initial clozapine
orders
Formulary status (CloZAPine ODT is restricted)
Confusion may occur between the regular
Look-Alike alert decal on Omnicell lid
release and extended release formulations, Pop-up in Siemens Rx system
which may result in under/over-dosing
Bar code verification in all MAK units
Similarity in names and strengths may lead to Physical separation in storage, with warning on
errors
shelf, different colored bins
Similarity in generic and brand names may
Double check process with chemotherapy audit
lead to errors
tool for order review, compounding, and
Interchanging these two drugs may result in
administration
serious dosing errors
Physical separation in storage, with warning on
shelf, different colored bins
(Rev Feb 2018 Admin Policies 16.31 Appendix D, 16.30 Appendix A)
POTENTIALLY ERROR-PRONE DRUG PAIRS /GROUPS OF DRUGS
POTENTIAL ERRORS & CONSEQUENCES
ERROR PREVENTION MEASURES
DOXOrubicin (conventional) (Adriamycin?)
Similarity in generic and brand names may
Double check process with chemotherapy audit
DOXOrubicin (liposomal) (Doxil?, Lipodox 50?)
lead to errors Interchanging these two drugs may result in
serious dosing errors
tool for order review, compounding, and administration Physical separation in storage, with warning on shelf, different colored bins
FluPHENazine (ProLIXIN?)
Similarity in generic and brand names may
Physical separation in storage, with warning on
FluPHENazine Decanoate (LONG acting
lead to errors
shelf, different colored bins
ProLIXIN?)
Medications have different indications
FluOXETine (ProZAC?)
GlipiZIDE (Glucotrol?)
Similarity in names, strengths, and indications Look-Alike alert decal on Omnicell lid
GlyBURide (Micronase?, Diabeta?,Glynase?)
may lead to errors
GlipiZIDE = shorter acting; max dose 40 mg/day
GlyBURide = longer acting; max dose 20 mg/day
Haloperidol Decanoate (LONG acting -- Haldol?) Confusion may occur between the long acting Look-Alike alert decal on Omnicell lid
Haloperidol Lactate (SHORT acting -- Haldol?)
and immediate release injectable formulation
which may result in under/over-dosing
3
Haemophilus B vaccine(Pedvax HIB?, ActHIB?, Similarities in names and reference to
Physical separation in storage, with warning on
Hiberix?)
Haemophilus B vaccine as "HIB" and Hepatitis
shelf, different colored bins
Hepatitis B vaccine (Recombivax HB?, Engerix-B?)
B Vaccine as "Hep B" may lead to errors
HydrALAZINE (Apresoline?)
Similarity in generic names and strengths may Pop-up in Siemens Rx system
HydrOXYzine (Vistaril?)
lead to errors
Physical separation in storage, with warning on
Medications have different indications
shelf, different colored bins
IdaruCIZUMAB (Praxbind?) IDArubicin (Idamycin?) InFLIXimab (Remicade?) RiTUXimab (Rituxan?)
Similarity in generic names may lead to errors Medications have different indications
Formulary status (IDArubicin is non-formulary) InFLIXimab restricted to Rheumatology & GI use Double check process with chemotherapy audit
tool for order review, compounding, and administration Physical separation in storage
(Rev Feb 2018 Admin Policies 16.31 Appendix D, 16.30 Appendix A)
POTENTIALLY ERROR-PRONE DRUG PAIRS /GROUPS OF DRUGS
Insulin Glargine (Lantus?) long-acting basal Insulin Lispro (HumaLOG?) rapid-acting Insulin Aspart (NovoLOG?) rapid-acting Insulin Regular (HumuLIN R?, NovoLIN R?) Insulin 70/30 products (NovoLIN 70/30?, NovoLOG Mix 70/30?) KadCYLA? (ado-trastuzumab emtansine) KyPROLIS? (carfilzomib)
LamiVUDine (Epivir?) LamoTRIgine (LaMICtal?) Terbinafine (LamISIL?) Labetalol (Trandate?)
LevoFLOXacin (Levaquin?) Levothyroxine (Synthroid?) LevETIRAcetam (Keppra?) MetFORMIN (Glucophage?) MetroNIDAZOLE (Flagyl?)
NiCARdipine (Cardene?) NiMODipine (Nymalize?) NIFEdipine (Procardia?) NORepinephrine (Levophed?) PHENYLephrine (Neosynephrine?) EPINEPHrine (Adrenalin?) EPHEDrine (Akovaz?) PredniSONE PrednisoLONE PHENobarbital (Luminal?) PENTobarbital (Nembutal?) RifAMPin (Rifadin?) RifAXImin (Xifaxin?)
POTENTIAL ERRORS & CONSEQUENCES
Similarity in names, strengths and concentration ratios may lead to errors
ERROR PREVENTION MEASURES
Look-Alike alert decal on Omnicell lid Formulary status (Insulin glargine and aspart
are restricted, insulin lispro is non-formulary) On High Alert Medication List, requiring two
independent double checks
Similarity in brand names may lead to errors Double check process with chemotherapy audit
Interchanging these two drugs may result in
tool for order review, compounding, and
serious dosing errors
administration
Similarity in generic and brand names and
Look-Alike alert decal on Omnicell lid
strengths may lead to errors
Consequences of errors may include Stevens-
Johnson syndrome (lamotrigine)
Medications have different indications
Similarity in generic names have lead to errors Look-Alike alert decal on Omnicell lid
Medications have different indications
4
Similarity in names and strengths may lead to errors
Medications have different indications Similarity in generic names may lead to errors Medications have some overlapping
indications Similar generic names and indications may
lead to errors
Look-Alike alert decal on Omnicell lid
NiCARdipine is restricted to use by Anesthesia, Neurology, and Neurosurgery
Physical separation in storage Encourage written and verbal communication
with both generic and brand names
Similar generic names and indications may lead to errors
Similarity in generic names and indications may lead to errors
Similarity in generic names may lead to errors Medications have different indications
Physical separation in storage
PENTobarbital is restricted to use in the ICU/OR Physical separation in storage Physical separation in storage
(Rev Feb 2018 Admin Policies 16.31 Appendix D, 16.30 Appendix A)
POTENTIALLY ERROR-PRONE DRUG PAIRS /GROUPS OF DRUGS
POTENTIAL ERRORS & CONSEQUENCES
ERROR PREVENTION MEASURES
RisperiDONE (RisperDAL?)
Similarity in generic and brand names may
Physical separation in storage, with warning on
ROPINIRole (Requip?)
lead to errors
shelf, different colored bins
Medications have different indications
SulfaSALAzine (Azulfidine?, Sulfazine?)
Similarity in names may lead to errors
Encourage writing indications with medication
SulfaDIAzine
Medications have different indications
orders
Tacrolimus (Prograf?, Astagraf XL?)
? Similarity in names may lead to errors
? Encourage writing indications with medication
Tamsulosin (Flomax?)
? Medications have different indications
orders
Tdap (Boostrix?, Adacel?)
Similarity in names, strengths and
Product information posters showing which
DTaP (Infanrix?)
concentration ratios may lead to errors.
one is for which age group
Tdap = adults; DTaP = children 6 weeks to ................
................
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