竹山秀傳醫(yī)院藥劑科

1、竹山秀傳醫(yī)院藥劑科病人用藥安全系列高警訊藥物(High Alert Medications)一、 說明高警覺性藥物使用安全性之改善(Improve the safety of using high-alert medications)而High alert medication高警訊藥物主要分為兩類1. Nonstandardized dosages沒有固定規(guī)則化之使用劑量藥品2. Narrow margins of safety安全指數(shù)狹窄的藥物因若使用不當容易危及病人安全，故使用過程中須提高警覺以下為本院之高警訊藥品，使用之護理人員或藥師於調劑或領用交付時，都應該保持高度警覺二、 辦法A.

2、 護理站不放置高濃度電解質，如potassium chloride, sodium chloride > 0.9%等。B. 標準化及限制醫(yī)療機構中可取得之藥品濃縮物(drug concentrations)數(shù)量。C. 建立院內高警訊藥品清單三、 本院之藥物清單分類如下n 高警訊藥物A. Anti-diabetic agents降血糖藥物，因為容易引起低血糖癥狀B. Narcotic analgesics麻醉性止痛藥及一二級管制藥，長期使用會有生理依賴性發(fā)生C. 抗凝血劑，影響血液的藥品，密切觀察是否發(fā)生出血的併發(fā)癥D. 抗腫瘤藥物，具細胞毒性E. Electrolyte電解質類藥品F.

3、Anticonvulsants，Anxiolytics，Sedatives焦慮解除劑及安眠藥，影響中樞神經且具藥物依賴性G. Bronchodilators支氣管擴張劑，治療的有效範圍小，過量可能引發(fā)致命性的心律不整H. Anesthetics，Neuromuscular blocker agent-麻醉劑和神經肌肉阻斷劑I. Cardiovascular agents-心臟血管用藥，影響血壓及心臟的藥品J. 其他u Reference:Institute for safe medication practices. ISMP Medication safety. http:/www.ismp

4、.orgA. Anti-diabetic agents降血糖藥物，因為容易引起低血糖癥狀編號院內代碼品名1.OMETF5Metformin(Glibudon F.C) 500mg2.OEUGLEuglucon(Gliben)5mg3.OGLICLGliclazide 80mg(Gluzide)4.OGLIMGlimepiride(Amaryl) 2mg5.OREPARepaglinide(Novonorm) 1mg6.OGLUBGlucobay 50mg7.OAVANRosiglitazone 4mg (Avandia)8.OGLUC2Glucomine 250mg9.OGLIPGlipizi

5、de 5mg(Glidiab)10.IACTRActrapid HM 100iu/ml 10ml/vial11.IMIXPNovomix 30 penfill 3ml12.IMOHMMonotard HM 100iu/ml 10ml/vial13.IPROTPInsulatard HM penfill 3mlB. Narcotic analgesics麻醉性止痛藥及一二三級管制藥，長期使用會有生理依賴性發(fā)生編號院內代碼品名1.OMORPMorphine 10mg/tab2.IDEME5Demeral 50mg/ml/amp3.IFENTFentanyl4.TFENT2Fentanyl TTS

6、25ug/hr(Durogesic)5.TFENT5Fentanyl TTS 50ug/hr(Durogesic)6.IMORPMorphine 10mg/ml/amp7.IMORP2Morphine 20mg/ml/amp8.IKETAKetalar 50mg/1ccC. 抗凝血劑編號院內代碼品名1.IHEPRMHeparin 25000/5ml/vail2.ITPA5Actilyse 50ml/vail3.IENOXEnoxaparin Sodium 60mg/vail4.OWARFWarfarin 5mgD. 抗腫瘤藥物編號院內代碼品名1.I5FFluoro-uracil 250mg(5

7、-Fu) 2.IMITOMitoxantrone(HCL)(Novantrone)2mg/ml 10ml3.IMTXMTX 50mg 4.IADRIAdrimycin 10mg (Adriblastina)5.IMITCMitomycin-C 2mg 6.IZOLAZoladex 3.6mg/depot 7.IBCGBCG Immunotherapeutic Immucyst 81mg8.IIRINIrinotecan 100mg/vial (Campto) 9.IVINCVincristine Sulfate 1mg10.IVINO1Vinorelbine (Navelbine) 10mg/

8、ml 11.IOXALOxaliplatin 50mg/10ml/vial12.OMELPMelphalan(Alkeran) 2mg 13.OCAPECapecitabine 500mg(Xeloda) 14.OFUTRFutraful 200mg15.OMETXMethotrexate 2.5mg16.OTEGATegafur (Ufur) 100mg 17.OFUGEFugerel 250mg 18.OTAMOTamoxifen 10mg(Nolvadex)19.OCLODClodronate 400mg(Bonefos) E. Electrolyte電解質類藥品編號院內代碼品名1.IP

9、OTCKCL 15% 20ml(Potassium-chloride)2.INACL35Sodium chloride(Nacl 3% 500ml)3.IMAGLMagnesium sulfate(Maglol 10%/20ml)F. Anticonvulsants，Anxiolytics，Sedatives焦慮解除劑及安眠藥，影響中樞神經且具藥物依賴性編號院內代碼品名1.IVALIDiazepam 10mg/2ml(Valium)2.IDORMDormicum 15mg/3ml/Amp(Midazolam)3.IDORM5Dormicum 5mg/5ml/amp(Midazolam)4.ID

10、ILADilantin 100mg/amp5.OPHENPhenobarbital 30mg6.ODILADilantin 100mg7.OROHY1Rohypnol 1mg(Flunitrazepam)G. Bronchodilators支氣管擴張劑，治療的有效範圍小，過量可能引發(fā)致命性的心律不整編號院內代碼品名1.IAMILAminophylline 250mg/10ml2.OXANTXanthium 200mgH. Anesthetics，Neuromuscular blocker agent-麻醉劑和神經肌肉阻斷劑編號院內代碼品名1.IPROPPropofol 10mg/ml 20ml

11、/amp(Anesvan)2.IXYLO25Xylocain 2% 100mg/5ml/Amp3.IXYL2EXylocain 2% + E 4.IXYLO2Xylocaine 2% 20ml I. Cardiovascular agents-心臟血管用藥，影響血壓及心臟的藥品編號院內代碼品名1.IADREAdrenalin 1mg/ml(Bosmin)2.ICORDCordarone 150mg/amp3.IDIGODigoxin 0.5mg/2ml/amp 4.IDOBUDobuject 250mg/amp 5.IDOPA2Dopamine 200mg 6.IDOPA4Dopamine 400mg 250ml/bot 7.INITRNitroglycerin 50mg/10ml8.ILEVOLevophed 4mg/4ml9.IVERAVer