ALWAYS TAKE EXTRA CARE WITH: APINCH
High Risk Medications
High risk medications are those medicines that have a high risk of causing significant patient harm or death when used in error.
Commonly described medicines identified by APINCH:
A - Antimicrobials/anti-infectives
Commonly prescribed aminoglycocides, including gentamicin, and tobramycin, as well as amphotericin, vancomycin, etc
P - Potassium IV and concentration electrolytes
Injections of potassium, magnesium, calcium, hypertonic sodium chloride. Concentrated electrolytes, including: potassium chloride 15% amps, potassium phosphate amps, sodium chloride 30% amps, magnesium sulfate 50% / 20% / 10% amps
I - Insulin*
All insulins. Commonly prescribed insulins include: Novorapid, Actrapid, Lantus, Levemir, Humulin M3, Mixtard 30
* remember, all insulins should be prescribed by brand name
N - Narcotics/Opioids and Sedatives
Commonly prescribed opioids include hydromorphone, oxycodone, morphine, fentanyl, alfentanil, remifentanil tapentadol, and analgesic patches (fentanyl patches, buprenorphine patches).
Commonly prescribed sedatives include benzodiazepines ( eg diazepam, midazolam, lorazapam).
Thiopentone, propofol and other short term anaesthetics
C - Cytotoxic/Chemotherapeutic drugs
Commonly prescribed cytotoxic drugs include methotrexate, azathioprine, mercaptopuring, valganciclovir, capecitabine, vincristine, etoposide
H - Heparin and other anticoagulants
Commonly prescribed anticoagulants include heparin sodium and low molecular weight heparins (enoxaparin and tinzaparin), warfarin and DOACs (dabigatran, rivaroxaban, apixaban, edoxaban)