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
• The most frequent error in anesthesia, and in
healthcare practice ingeneral.
• Similarity ofdrug names,containers, and label colors

13. Medication errors
• Dosing errorsrelated to the frequent need for individual
• Error in numerical calculations when drawing
and mixing drugs for bolus administration or IV
infusion.
• Wrong drug (e.g., among various insulinformulations)
• Flushingacatheter with asolution 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.