Mistakes in the use of a medication are sometimes serious problem. Problems can include adverse reactions and interactions with other medications, and also basic administrative errors such as patients being given the wrong medication or wrong dosage.
A less studied aspect of mistakes involving medications is the misdiagnosis of a disease when the real cause is a side effect of a medication.
Children and infants are particularly at risk of medication errors mainly due to incorrect dosage, because of the need to modify dosages based on age and weight, dosage modification may be either overlooked or miscalculated. Various studies have shown high error rates in doctors and nurses in calculating weight-dependent dosages in infants an especially neonates.
Errors with medication can occur in hospitals, at the pharmacy, in the doctor’s office, and even due to the patient.
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The dispensing of prescription medications at the pharmacy can have various errors. The wrong medication can be given particularly when medications are named or packaged similarly. There are particular drugs that are known to have problems because their names are very similar. The pharmacy can also give out the wrong dosage of the drug in some cases.
Most studies of medication errors only analyzed hospital medication usage, and there is a large volume of medications prescribed in doctor’s offices and dispensed by pharmacies.
The medications causing most problems are cytotoxics, cardiovascular drugs, antihypertensives, anticoagulants, and NSAIDs.
An adverse drug reaction (ADR) occurs when a patient suffers a reaction, side effect, or other injury from a medication. This can occur without an error, such as when a patient has an allergy to a medicine, but has never shown any signs or risk factors for this allergy previously. On the other hand, an error would occur if a previous allergy was known but the medication was still given to the patient.
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The list of medications most frequently causing adverse reactions in order of incidence is given below.
1. antibiotics,
2. chemotherapeutic agents,
3. anticoagulants,
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4. cardiovascular agents,
5. anticonvulsants,
6. antidiabetic agents,
7. antihypertensives,
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8. analgesics,
9. antiasthma agents,
10. sedative-hypnotic agents,
11. antidepressants,
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12. antipsychotic agents, and
13. antiulcer agents.
Following types of errors are generally found in the dispensing of prescription:
1. misdiagnosis (40%),
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2. medication error (28%),
3. medical procedure error (22%),
4. administrative error (4%),
5. communication error (2%),
6. incorrect laboratory results (2%),
7. equipment malfunction (1%), and
8. other error (7%).
Medication errors generally occur in following locations.
1. hospital (48%),
2. doctor’s office (22%),
3. operating room (7%),
4. clinic (5%),
5. emergency room (5%),
6. pharmacy (4%),
7. home (3%),
8. medical laboratory (1%),
9. nursing home (1%), and
10. other (5%).
About 70% of all errors are believed to be preventable. The remainder are presumably non- preventable errors such as a patient reacting to a drug who had no previous history of an allergy to the drug.