Inhalation is the best way to take a medicine used to treat asthma or chronic obstructive pulmonary disease (COPD). (See the Sidebar for information about asthma and COPD.) The medicine acts faster to control breathing if inhaled directly into the lungs. Also, inhaled medicines can often be taken in a lower dose than an oral tablet of the medicine. This can help to reduce the risk of bad side effects.
Do you or someone you know have a history of bone disease and easily prone to fractured bones? Medication bottles with safety caps are designed to protect children from accidental ingestion, but, on occasion, can contribute to patient harm. An elderly patient with multiple myeloma (a type of bone cancer) suffered a spiral fracture of the right arm while trying to remove the child-resistant cap on her medication bottle. The act of pushing down and twisting broke the weakened bone and caused the fracture.
Our organization, the Institute for Safe Medication Practices (ISMP), often receives medication error reports that result from confusion with drug names that look or sound alike. One look-alike and sound-alike pair that often results in confusion is hydrALAZINE and hydrOXYzine.
“Talk Before You Take” is a national awareness campaign launched by the National Council on Patient Information and Education (NCPIE) to encourage and improve communications between healthcare providers (HCPs) and patients about the benefits and potential risks of prescription medicines.
Caregivers of small children who are either hospitalized or visiting someone in the hospital should be aware of an unsuspecting source of choking. The small object is called a disinfection cap and is commonly used in the healthcare setting as a barrier on an intravenous port. The small cap has a foam sponge inside saturated with alcohol to help prevent infection. However, these brightly colored caps may be attractive to young children and could be a potential choking hazard.
CVS brand of Arthritis Pain Relief extended-release tablets come in geltabs containing 650 mg of acetaminophen. A single dose is typically 650 mg, or one geltab. Several people who live in a retirement community reported that they found the markings on the geltabs that state “350” to be confusing (image below). Several thought the “350” designation on the tablet meant its strength—350 mg. They thought they had to take two of the geltabs as a single dose, but again were confused because two of the geltabs would equal 700 mg, not the 650 mg dose they thought they were supposed to take.
Have you ever thought about where medicines are kept in your home through the eyes of your child? Medicines left on counters, nightstands, in purses and bags, or on the ground are easily within reach of a young child. What's more, many medicines are brightly colored and look like candy, making them appetizing to children.
Brintellix and Brilinta mix-ups. An elderly woman required hospitalization when the pharmacy confused Brintellix and Brilinta and gave her the wrong medicine. Brintellix (vortioxetine) is a medicine used to treat depression. Brilinta (ticagrelor) is a medicine that helps to prevent clots in patients with certain heart diseases. The woman was given a prescription for Brilinta 90 mg to take twice a day. But the pharmacy staff misread the medicine label on the bottle that was selected from the shelf and filled the prescription with Brintellix 10 mg. The medicine bottles for Brilinta and Brintellix were on the same shelf, side-by-side, and the wrong bottle was picked up.
Oral chemotherapy is cancer medicine that is taken by mouth. These medicines come as tablets, capsules, or liquids that can be swallowed. As a result, oral chemotherapy can be taken at home. For people with cancer, taking a medicine by mouth is easier than intravenous (IV) chemotherapy given through a vein because they don't have to go to the hospital or clinic to have the medicine administered. However, even though these medicines can be taken by mouth, they are not necessarily safer than IV chemotherapy. In fact, chemotherapy pills can be just as strong as the chemotherapy given through a vein by injections and infusions. Mistakes with oral chemotherapy medicine can lead to serious side effects and even death.