High Alert Medications:

More presentations from Naina Mohamed Pakkir Maideen

Ø High alert Medications (HAMs) are the drugs or medications having heightened risk of causing significant patient harm when they used in error.

Ø Hypertonic electrolytes solutions are considered as High Alert Medications due to their nature of abundant release of electrolytes in to the bloodstream.

Ø Hypertonic Calcium Chloride Injection:

·       It is indicated in Cardiac Resuscitation, Hypocalcemic Tetany, Magnesium Sulphate overdose and lead coli.

·       It is Contraindicated in Ventricular Fibrillation.

·       Overdose of Calcium Chloride 10% Injection leads to Hypercalcemia. If not treated it may cause confusion, delirium and coma followed by death.

·        Overdose of Calcium Chloride 10% Injection is treated by 4–6 L of intravenous saline over the first 24 h to treat Dehydration and by loop diuretics to enhance sodium and calcium excretion.

Ø Hypertonic Magnesium Sulphate Injection:

·       Magnesium sulphate is indicated in patients with Hypomagnesemia, Torsades de Pointes, Status Asthmaticus, Eclampsia & Pre eclampsia and Uterine Tetany.

·       Magnesium sulphate is Contraindicated in patients with Heart block, Myocardial damage and Impaired Renal function.

·       Overdose of Magnesium sulphate Injection leads to progressive weakness of respiratory muscles leading to respiratory failure. If not treated it may cause hypoxia, ischemia and cardiac arrest.

·       Overdose of Magnesium sulphate is treated by One ampoule of Calcium gluconate 1gm (10ml of 10% Solution) given intravenously for over 2-3 minutes.

Ø Hypertonic Potassium Chloride Injection:

·       It is indicated in Hypokalemia.

·       It is Contraindicated in Hyperkalemia and Renal failure.

·       Overdose of Hypertonic Potassium Chloride Injection may cause Paresthesias of the extremities, Muscular or respiratory paralysis, Mental confusion, Weakness, Hypotension, Cardiac arrhythmias, Heart block, Electrocardiographic abnormalities and Cardiac arrest.

·       Overdose of Hypertonic Potassium Chloride Injection can be treated by intravenous Dextrose Injection, USP, 10% or 25%, containing 10 units of crystalline insulin per 20 grams of dextrose and is administered 300 to 500 mL per hour.

Ø Insulins:

·       Insulin is indicated for the treatment of both Type 1 and Type 2 diabetes mellitus.

·       It is Contraindicated in Hypoglycemia.

·       Overdose of Insulin leads to hypoglycemia. If untreated it may cause impairment of brain functions, convulsions and coma followed by death.

·       Hypoglycemia and Hypokalemia caused by overdose of Insulin should be monitored.