LASA (LOOK A LIKE SOUND A LIKE) MEDICINES

LOOK A LIKE SOUND ALIKE REGARDING MEDICINES MISUSE OF ADMINSTRATION..WIHTOUT KEEN OBSERVATION...KEEN LISTING...WHILE DISPENSEING

1. Look - Alike, Sound -Alike Drugs GOVT. GENERAL HOSPITAL, GUNTUR Dr. N V RAMA RAO M.Pharm ., Ph.D., Professor & HOD Dept. of Pharmacy Practice Chalpathi Institute of Pharmaceutical Sciences (Autonomous)

2. Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program ( MERP) DRUG RELATED PROBLEMS (DRPS)

3. Some proprietary ( B rand name) and non-proprietary names ( G eneric name) sound or appear to be similar to other drugs when written or spoken. These confusing drug names are one of the main causes of medication error. There are many sound and look alike drugs that would result in medication error. These errors may cause harm or even death to patients.

4. A group of medicines that have similar actions often have similar sounding brand names. The generic medicine is one that contains identical amounts of the same active ingredient, in the same strength and in the same dosage form. When doctor writes a prescription they will nominate the medicine to be used –usually the originate brand name for the drug required. Certain drugs have names that may appear similar when carelessly written; liable to confusion. Problems are likely if the strengths and doses of the two preparations are similar.

5. Doubts should be resolved by checking with the prescriber. Most cases, mistakes have occurred, because the item was dispensed without a second thought.

6. ERROR PRONE DRUG PAIRS 1 . L A S A d rugs -Sim i lar brand nam e s, d i ffe r ent generic composition (Category I) 2. LASA drugs- Similar brand names, same generic composition (Category II) 3. LASA drugs- Similar brand names with additional letter (Category III) 4 . L A S A dr u gs - Simil ar b r a nd nam e s of the A nt i b i ot i cs gro u p (Category IV) 5 . L A S A dru g s - S a me dru g , d i ffe r ent Do s age for m s (Category V) 6. LASA drugs- Same drug, different release characteristics (Category VI) 7. LASA drugs- Same brand name, different composition, different country (Category VII) 8. LASA drugs- Generic Drug pairs (Category VIII)

7. Breast cancer Anti anxiety Anti hypertensive drug Converts Vitamin -k Decrease secreation,heart beat normal

8. : Insulin brand names Humulin “Log” ordered instead of Humulin-L (Lente). Nurse thought Humalog” was to be given.

9. DISPENSERS SHOULD READ SPELLING ,CATEGARY

10. T ECHNOLOGY - DRUG PRODUCT INTERFACE : Levophed for Lopressor

11. EX A MPLES AMGIT (Metronidazole) ALASPAN (Loratadine) LEVOZIN (Levocetrizine) ANXIT (Alprazolam) ALSPAN (Hyoscine butyl Br.) LIVOGEN (Iron) ENTEXIN (Ofloxacin) XIM ( Cefixime ) INFE TAZAR ( Piperacillin+Tazobactam ) CETIN ( Cetirizine ) ASTAT-10 ( Atorvastatin ) FLUNAR ( Flunarizine ) PAAZ ( Alprazolam ) DIAMOX ( Acetazolamide ) TOZAAR (Losartan) CETIL (Cefuroxime) AMTAS-10 (Amlodipine) FLUNAZ (Fluconazole) PIOZ (Pioglitasone) DAMOXY (Amoxycillin) UMERAN (Diclofenac sodium) UMINORM (Metoclopramide)

12. EX A MPLES Epitab Epitan Ceftab Ceftas Wormnil W ormon i l Phenytoin 100 mg Phenobarbitone 60 mg Cefuroxime 250 mg Cefixime 200 mg Mebendazole 100 mg Albendazole 400 mg Aquamide Furosemide 50 mg/Spironolactone 20 mg Aquazide Hydrochlorothiazide 12.5 mg

13. GM DRUGS (Sound Alike) INJECTIONS Cefotaxime Sodium Injection IP 250 Mg (ABX) Cefuroxime Injection IP 250 Mg (ABX) Fentanyl Inj. 100mcg/2ml ( Opioid ) Phenytoin Inj. 100mg/2ml (Anti epileptic )

14. Eptoin Inj. 100mg/2ml (Anti epileptic ) Epoetin Inj 20,000 U/2ml (Human erythropoietin ) Amoxycillin Inj 1000 Mg (ABX) Ampicillin Injection IP 500 Mg (ABX)

15. Tablets Amoxicillin Capsules IP 250 Mg (ABX) Amoxicillin Capsules IP 500 Mg (ABX) Amoxycillin 500mg + 125mg Clavulanic Acid Tablets IP (ABX) Amoxycillin + Clavulanic Acid 250 Mg (ABX) Amoxycillin +125 Mg Potassium Clavulanate Tablets (ABX)

16. Clotrimazole Pessaries IP 100 Mg (Anti fungal) Co- Trimoxazole Tablets IP Trimethoprim 160mg + Sulphamethoxazole 800 Mg (ABX) Erythromycin Tab 500mg (ABX) Azithromycin Tablets IP 500 Mg (ABX)

17. Moxifloxacin Tab. 400mg (ABX) Ofloxacin Tablets 100mg (ABX) Norfloxacin Tablets IP 400mg (ABX) Rifabutine Capsule 150mg(ABX-anti tubercular) Rifaximin Tab 550mg (traveler's diarrhea) Rifampicin Tab 300 mg (ABX-anti tubercular)

18. Cinnarizine tablets IP 25mg (To treat nausea and vomiting associated with motion sickness, vertigo) Cetirizine Dihydrochloride 10 mg (Antihistamine) Flunarazine Tablets 5mg (To treat nausea and vomiting associated with motion sickness, vertigo) Furazolidone Tablets IP 100 Mg ( Nitrofuran antimicrobial agent used in the treatment of diarrhea or enteritis caused by bacteria or protozoan infections)

19. PEDIATRICS (Sound alike) Chloroquine Phosphate Syrup 50 Mg / 5 Ml In 60ml (anti malarials ) Cyclosporine Oral Solution Usp 100mg/Ml In 50ml ( Immunosupressants ) Albendazole Suspension 200 Mg/ 5 Ml In 10ml Bottle (Antihelmintics) Metronidazole Benzoate Oral Suspention Ip 100mg/5ml In 60ml (ABX)

20. Domperidone Suspension Ip 1 Mg / Ml In 30ml Bottle Furazolidone Suspension Ip 25mg/5ml,60ml Carbamazepine Suspension Usp 100mg/5ml, In 100ml Promethazine Hcl Syrup Ip 5 Mg / 5 Ml In 60ml

21. Ambroxal Syrup 30mg/5ml 60 Ml Bottle Salbutamol Sulphate Syrup Ip 2 Mg / 5 Ml In 100 Ml Bottle Ambroxal Syrup 30mg/5ml 60 Ml Bottle Albendazole Suspension 200 Mg/ 5 Ml In 10ml Bottle

22. Albendazole Suspension 200 Mg/ 5 Ml In 10ml Bottle Co- Trimoxazole Oral Suspension I.P Trimethoprim 40mg + Sulphamethoxazole 200mg/5ml In 50ml Bottle Metronidazole Benzoate Oral Suspention Ip 100mg/5ml In 60ml

23. LOOK ALIKE DRUGS

24. 1.Tranexamic acid 2.Ciprofloxacin 1 2

25. B-Complex Loperamide Ondansetron

26. 1.Prednisone 2.Deriphyllin 1 2

27. 1. Metrogyl 2.Metformin 1 2

28. 1.Acetyl salicyclic acid 2. Chloroquine Phosphate 1 2

29. 1.Calcium 2.Carbamazepine 1 2

30. GYNAECOLOGY Pheniramine Maleate Injection IP 22.75 Mg / Ml In 2ml Amp (Anti histamine) Promethazine Hcl Injection IP 25 Mg / Ml In 2ml Ampoule (Anti emetic) Dexamethasone Injection Ip 8 Mg / 2ml Hydrocortisone Sodium Succinate Injection Ip Contains Hydrocortisone 100 Mg/In 5ml Vial

31. Cefotaxime Sodium Injection IP 250mg(ABX) Cefotaxime Sodium Injection IP 1000mg(ABX) Cefuroxime Injection IP 250 Mg(ABX) Cefuroxime Injection IP 750 Mg (ABX)

32. Dicyclomine Hcl Injection IP 10mg/Ml In 2ml Amp ( Anticholinergic agent) Hyoscine Butyl Bromide Injection IP 20 Mg / Ml 1 Amp ( Anti spasmodic)

33. Human Premixed Insulin Injection IP 30/70 In 10 Ml Vial Insulin Injection (Soluble) Human Injection IP 40 IU / Ml In 10 Ml Vial Anti-D Immunoglobulin (Human) Injection 300mcg/2ml Vial Antitetanus Human Immunoglobulin 250 IU

34. Cetirizine Hcl Tablets IP 10mg Chlorpheniramine Maleate Tablets IP 4 Mg Ciprofloxacin Tablets IP 500 Mg Moxifloxacin Tablets IP 400mg

35. Oncology Dexamethasone Injection IP 8 Mg / 2ml Hydrocortisone Sodium Succinate Injection IP Contains Hydrocortisone 100 Mg/In 5ml Vial Trastuzumab For Injection (R- Dna Origin) 150 Mg Trastuzumab Inj. (R- Dna Origin) 440mg Vial

36. Vinblastine Injection IP 10mg/10ml Vial Vincristine Injection IP 1mg/Ml In 1ml Amp Diclofenac Sodium 50mg Tablets IP (Enteric Coated Tablets) Diclofenac Sodium Tab100mg

37. Melphalan Tablets IP 2 Mg Melphalan Tablets IP 5 Mg various treatment of cancer Methotrexate Tablets IP 2.5 Mg Methotrexate Tablets IP 7.5 Mg --Immunosuppressant Tacrolimus Capsules 0.5Mg Tacrolimus Capsules 5 Mg- Immunosupressent

38. THANK YOU