DRUG SAFETY.pptx

Drug Safety is the science relating to collection, detection, assessment, monitoring and prevention of adverse effects with pharmaceutical products. It mainly focuses on adverse drug reactions

1. 1 Drug Safety Presented by: Sujata Walode Msc ( OT & AT ) MGM SBSA

2. INTRODUCTION Drug Safety is the science relating to collection, detection, assessment, monitoring and prevention of adverse effects with pharmaceutical products. It mainly focuses on adverse drug reactions.

3. 2 Drug Safety  No medicine is absolutely safe and all pose some magnitude of safety and health risks  Making sure that medicines are safe for their intended use is an on-going process that starts in the developmental stage & continues long after medicine is in the market.  The process is closely monitored by manufactures and the Regulatory Agencies.

4. Contd.. Why health damage through drug use? Misuse and abuse of drugs ‘Off-label use’ for pleasure or addiction Compensation for life style Human error Prescription errors/Unknown interactions and contra-indications Inappr.off -label use/Patient non-compliance Inherent safety issues of drugs

5. Contd … Instruments to enhance Drug Safety should look at: Patients, Physicians and Pharmacists Pharmaceutical Industry

6. Anesthesia professionals in the OR are the only med personnel who Martin DE, Penn State College of Medicine. APSF Consensus Conf. 2010 Prescribe Secure Prepare Administer and Document medications… …a process of up to 41 steps.

7. These steps usually occur within a very short time interval, typically without standardized protocols and often in a distracting environment. …a process of up to 41 steps.

8. Poor lighting Cluttered space Noise Interruption Multi-tasking Grissinger M, Ann Meeting American Pharmacists Ass 2007, Atlanta, GA Key System Elements that influence medication use most

9. Similar very small writing on amp Same manufacturer Same size Amp/Vial Swaps

10. Administration of undiluted potassium by rapid intravenous infusion can cause ventricular fibrillation and cardiac arrest. Neostigmine given without an antimuscarinic drug can cause asystole , severe bradycardia and atrioventricular block and can be fatal. Succinylcholine can cause severe hyperkalemia and dysrhythmias , may trigger malignant hyperthermia.

11. Medications to which a patient is allergic can cause anaphylaxis. Administering the wrong blood can cause an incompatibility reaction that can be fatal.

12. Medication errors Th e most frequ e nt erro r in anesthe s ia , a nd in healthcare practice in general. Similarity of drug names, containers, and label colors

13. Medication errors Dosing errors related to the frequent need for individual E r r o r in nu m e r ica l calculat i on s w h e n drawing and mixing drugs for bolus administration or IV infusion. Wrong drug (e.g., among various insulin formulations) Flushing a catheter with a solution containing another potent drug, Confusion in the programming of infusion pumps

14. How to avoid Be Familiar with the medication you use,know clearly its indications and contraindications. Administrate the medication strictly according to instructions. Know the patient’s history of allergy Cross-check blood type

15. Precautions All drugs should be clearly labelled The label on both ampoule and syringe should be read carefully before the drug is drawn up or injected Ideally drugs should be drawn up and labelled by the anaesthetist who administers them.

16. Steps for Drug Safety Identification of drugs Dilution of drug Contents Clarity Expiry date compatibility

17. Identification Identifying the drug of use. Five right of medical administeration : right patient, the right drug, the right dose, the right route, and the right time. Diagnosis of disease and planning drugs accordingly.

18. Dilution Dilution of drugs according to manufacturers policy. Do not dilute and keep drug prepared for long. Diluting proper concentration of drugs.

19. Contents Checking components of drugs Content of drugs if patient is allergic. Concentration of all contents should be appropriate.

20. Clarity The drug should look clear. No accumulation of dust or foreign particles, if present immediately change the drug Look for appearance of drugs.

21. Expiry dates Checking the inventory for expiry dates If the drugs are expired it should be removed from storage While administering always check for expiry of drugs.

22. Compatibility Drugs should be always given according to age,weight and height of patients including co morbid conditions. The patient should be able to handle the dose of drugs If the patient is not cardio stable the patient should be given any cardiac drugs.