Medication use safety is an important healthcare issue that can impact patient health. Adverse effects from unsafe medication use lead to over 1 million emergency room visits and 350,000 hospitalizations annually in the US. The elderly are particularly at risk. Pharmacists play a key role in medication safety by ensuring appropriate prescribing, dispensing, administration, lab monitoring, and adherence. They educate patients on safe medication use, review dosing and side effects, evaluate appropriateness and safety, and improve adherence.

1. 8-Medication Use Safety
I.Dr.Sami Khudeir Suhaim

2. Medication use safety is an important aspect of the healthcare
delivery system to consider in all patients as it can affect the
patient’s overall health at home and within the healthcare system.
Adverse effects often result from unsafe medication use, leading
to more than one million visits to the emergency room and
350,000 hospitalizations on an annual basis.
1 Billions of dollars are spent addressing ADEs, with the elderly
population particularly at risk.

3. Prescribing
1-Choosing an appropriate medication for a given clinical
situation, taking individual patient factors into account, indictions,
contraindications, allergies, pregnancy, comorbidities
2-Selecting the administration route, dose , time and regiem
3-Communicating details of the plan to the patient or next of kin
4-Documentation:legible,complete,no ambiguity
Right drug, Right dose, Right route, Right time and Right patient

4. Provide the patient with the following information
1-Name, purpose and action of the medication
2-Dose, route and administration schedule
3-Special instructions, directions and precautions
4-Common side effects and interactions
5-How the medication will be monitored

5. Wrong monitoring
1-Lack of monitoring for side effects
2-Drug not ceased if not working , or course completed
3-Drug ceased before course completed
4-Drug levels not measured or not followed up
5-Communication failure

6. Causes of medication errors
1-Inadequate information about the patient
2-Inadequate information about the drug
3-Communication and teamwork failure
4-Unclear, absent or look-alike drug labels and packages and
confusing , look-alike or sound-alike drug names
5-Unsafe drug standardizations, storage and distribution
6-Nonstandard or unsafe medication delivery devices
7-Environmental factors and staffing patterns that does not
support safety

7. 8-Inadequate patient education about medication and medication
errors
9-lack of a supportive culture of safety , failure to learn from
mistakes and absent error-reduction strategies

8. Staff factors in medication error
1-Inexperience
2-Rushing
3-Doing two things at once
4-Interruptions
5-Fatigue, boredom
6-Failure to double-check habit
7-Poor team work and/or communication between colleagues
8-Reluctance to use memory aids
9-Inadequate education, supervision and competency validation

9. Causes of adverse effects
Reasons for this include
1-Physiologic changes
2-Health literacy barriers
3-Health disparities
4-Polypharmacy
5-Nonadherence.
Nonadherence can be intentional or unintentional and affected by
medication efficacy, side effects, perceptions of one’s health or
illness, or cultural beliefs, cost, availability

10. 6-The addition of harmful substances (bacteria-laced water,
paint, floor wax, boric acid, powdered cement, and antifreeze),
7-Incorrect active ingredient in the product
8-Wrong concentration or dose
9-Internet pharmacies: Many companies claim that the
medications are being manufactured in a very well known country
, but this has been proven to be false.
They often provide medications that are not approved by the
ministry of health.

11. physical impairments can also result in medication nonadherence
and ADEs. Impairments can include, but are not limited to,
dexterity, vision, mental status, and hearing.

12. The Medication Appropriateness Index (MAI) is a tool that can be
used to prevent ADEs; this tool consists of 10 questions that a
pharmacist may ask regarding each drug a patient is taking.
The questionnaire assesses a medication’s indication,
effectiveness, dose, directions for use, administration,
interactions, duration of use, and cost.
Based on a score ranging between 0 and 18, the MAI provides a
final rating of appropriateness:
appropriate, marginally appropriate, or inappropriate.

13. The role of pharmacists
Pharmacists are uniquely positioned to
1-Ensure access to medication
a-evaluate ability to pay for medication
b-explore alternative medication
c-explore alternative means of payment
2-Supply medication information
a-educate patient on safe and effective medication use
b-reviewing proper dosing

14. c-Providing information about adverse effects, interactions and
common medication errors
3-Evaluate medication appropriateness: assess medication
appropriateness, effectiveness and safety for each individual
patient.
4-Improve medication adherence: suggesting changes in dosing
or additional therapies that improve patient adherence to the
medication
5-Provide health and wellness services:deliver direct health
services

15. 6-Medication management: review of full medication regiem to
ensure medications work well together and avoid problems like
interactions
7-Assess health status
a-Determine current patient status and medication effectiveness
b-Provide guidance regarding medication therapy
8-Coordinating care transitions: reviewing the list of drugs in use
and discovering any interaction

16. Pharmacists are the key professionals positioned to address
medication safety by ensuring
1-Appropriate prescribing
2-Appropriate dispensing
3-Appropriate administration
4-Lab monitoring, and
5-Adherence