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 (Brand name) and non-proprietary
names (Generic 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. LASA drugs-Similar brand names, different 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. LASA drugs- Similar brand names of the Antibiotics group
(Category IV)
 5. LASA drugs- Same drug, different Dosage forms
(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

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

10. TECHNOLOGY-DRUG PRODUCTINTERFACE:
 Levophed for Lopressor

11. EXAMPLES
AMGIT (Metronidazole)
ALASPAN (Loratadine)
LEVOZIN (Levocetrizine)
ANXIT (Alprazolam)
ALSPAN (Hyoscine butyl Br.)
LIVOGEN (Iron)
ENTEXIN (Ofloxacin) XIM (Cefixime)
INFETAZAR (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. EXAMPLES
 Epitab
 Epitan
 Ceftab
 Ceftas
 Wormnil
 Wormonil
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