Drug Errors

[Abdicade]

Drug Erorrs

Drug errors contribute to morbidity. They are estimated to cost the US health care system up to $177 billion (depending on definitions) annually. Drug errors may involve:

The wrong choice of a drug or a prescription for the wrong dose, frequency, or duration
An error in reading the prescription by the pharmacist so that the wrong drug or dose is dispensed
Incorrect instructions to the patient
Incorrect administration by a health care practitioner or patient
Incorrect storage of a drug by the pharmacist or patient, altering the drug's potency
Use of outdated drug, altering the drug's potency
Confusion of the patient so that the drug is taken incorrectly
Unscrupulous replacement of a drug with an inferior, diluted, or inactive product
Errors in prescribing are common, especially for certain populations. The elderly (see Drug Therapy in the Elderly, especially Therapy in the Elderly: High-Risk Drugs in the Elderly (Based on Beers Criteria) ), women of childbearing age, and children are particularly at risk. Drug interactions particularly affect those taking many drugs. To minimize risk, a physician should know all drugs being taken—including those prescribed by others and OTC drugs—and keep a complete problem list.

Prescriptions must be written as clearly as possible. The names of some drugs are similar and cause confusion if not written clearly. Changing some traditional but easily confused notations may also help reduce errors. For example, “qd” (once/day) may be confused with “qid” (4 times/day). Writing “once/day” is preferred.

Drugs may be administered incorrectly, especially in institutions. A drug may be given to the wrong patient, at the wrong time, or by the wrong route. Certain drugs must be given slowly when given IV, and some drugs cannot be given simultaneously. When an error is recognized, it should be reported immediately to a physician, and a pharmacist should be consulted.

A pharmacist should store drugs to ensure their potency. Mail-order pharmacies should follow procedures to ensure proper transportation. Storage by patients is often suboptimal. If stored incorrectly, drugs are likely to decrease in potency long before the stated expiration date. Labeling should clearly state whether a drug needs to be stored in the refrigerator or kept cool, needs to be kept out of excessive heat or sun, or otherwise requires special storage. On the other hand, unnecessary precautions decrease adherence and waste patient time. For example, unopened insulin should be refrigerated, but a bottle in use can be stored safely outside the refrigerator for a relatively long time if not exposed to excessive heat and sun.

Use of outdated drugs is common. For some drugs (eg, aspirin, tetracycline), risk of harm is great when outdated drug is used. Prescriptions should be written and filled for only as much drug as is likely to be used before expiration.

Most commonly, drug error results from a patient's confusion about how to take drugs. Patients may take the wrong drug or dose. Dosing instructions for each drug, including why the drug has been prescribed, should be completely explained to patients. They should be advised to ask their pharmacist for additional advice about taking their drugs. Packaging should be convenient but safe. If children are not likely to have access to the drug and patients may have difficulty opening the packaging, packaging that is not childproof should be used.

 

[Pharmacist]

Thanks abdicade for this important topic.

If drug errors cost the US health care system up to 177$ billion and injure more than 1.5 million americans per year.
What do you think about Somalia?

I don't say drug error should not occur, but at least the prescriber has to be knowledgeable enough to choose an effective treatment suitable for the individual patient, taking into account age, infirmity, and possible interactions with other drugs. Having selected the right agent and the correct dose, the prescriber has to transmit the message to the dispenser, who has then to hand the drug to the patient or to a carer or nurse, who has to see that the drug is given in the correct way and at the specified times. The process is complex, and, not surprisingly, errors occur.

Unfortunately, In somalia, drug errors occur in all these steps of drug prescription process.
the doctor may prescribe the wrong drug, wrong dose, neglecting your age, your infirmity, your medical condition& drug interactions.
the dispenser will give you the expired drug and the patient will take the medication as he wish.
so tell me how to correct this system?!!

Real Pharmacist

[Abdicade]

 thanks mr pharmacist for discussing about this important matter.

we know really that most of our people they are not well trained or educated about the use of drugs or how to prescribe drug ,either those selling pharmacy shops or the patient's.

We wonder: what is the effect on someone who daily gets the wrong medication, the wrong dose, the wrong procedure; how do we measure the accumulated burden of injury; and when the patient finally succumbs after the tenth error and more.....................

 hospital errors are spread out over the country in thousands of different locations. They are also perceived as isolated and unusual events. However, the most important reason that medical error is unrecognized and growing, according to Leape, was, and still is, that doctors and nurses are unequipped to deal with human error, due to the culture of medical training and practice. and also insufficient knowledge about the drug and its mechanism ,side effects.

so we all know that there is no universities in somalia overing the knowledge of pharmacist , and also there is no well trained doctors insomalia due to instability .

therefore when ever u go medical shops u will see very young people who are prescribing the drug ,also there is no factor in somalia manufacturing drugs therefore somali business men are getting the chance for exporting expired drugs in cheap rates.

how ever  we are in critical situation and we need well trained pharmacist and doctors those can save somali community ......i hope u guys will do so.

the only way we can get save is to get strong governments which can control drugs.........and  i advise somali bussines men to be aware of exporting expired drugs .

if u have any other ways or suggestions ......u can suggest thanks all.

[Pharmacist]

Thanks for the reply.
As we see, this problem is complicated with many parts involved, to get rid of it we should get drug control agency with qualified drug inspectors.
Health education is not that enough to correct the situation & without strong government we can't correct this situation.
If someone else has solution please let us know!.
Daawadu Waa Sun La Kafiifiyay.
Real Pharmacist

[Pharmacist]

A somewhat different top 10 list identifies medications that are most commonly misused or mishandled in some way by healthcare professionals. This list is based on information from the United States Pharmacopoeia (USP), which maintains a database of medication errors that are reported anonymously.
The figures represent drug errors associated with acute hospital care.
1-Insulin (4%);
2-Morphine (2.3%);
3-Potassium chloride (2.2%);
4-Albuterol (1.8%);
5-Heparin (1.7%);
6-Vancomycin (1.6%);
7-Cefazolin (1.6%);
8-Acetaminophen (1.6%);
9-Warfarin (1.4%); and
10-Furosemide (1.4%).
Real Pharmacist

[SomaliDoc]

Walaal Pharmacist, waa ku mahadsantahay mawduucyada faaidada leh aad webka ku qortid, lakin waxaa jeclaan lahaa si wacyi galinta loo kordhiyo in qoraalo ku saabsan qeybta daawooyinka oo afsomali ah inaad noo soo diyaarisid si ay uga faaideystaan dadka aan luqadaha qalaad ku hadlin.
Mar labaad waa mahadsantahay.
SomaliDoc

[Pharmacist]

Walaal waa ra'yi fiican, waadna ku mahadsantahay xasuusintaada.
Insha'lah marka soo socota waxaan isku dayayaa inaan soo qoro qoraal afsomali ah.
thanks
Real Pharmacist