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1. Anticoagulants (Blood thinners)

Used to prevent or treat clots, but can cause severe bleeding if misused.

• Heparin
• Warfarin
• Enoxaparin

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2. Insulins

Errors can quickly lead to dangerous hypo or hyperglycemia.

• Insulin

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3. Opioids

Risk of respiratory depression and overdose.

• Morphine
• Fentanyl
• Oxycodone

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4. Sedatives and Anesthetics

Can suppress breathing and consciousness.

• Propofol
• Midazolam

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5. Chemotherapy Agents

Toxic to both cancer and healthy cells dosing errors can be fatal.

• (e.g., Methotrexate)

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6. Electrolyte Concentrates

Especially dangerous when given in high doses or wrong route.

• Potassium chloride (IV form is high risk)

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7. Neuromuscular Blocking Agents

Cause complete paralysis must be used with ventilation support.

• Vecuronium

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8. Antiarrhythmics

Used for heart rhythm issues can cause dangerous cardiac effects.

• Amiodarone

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Why They’re High Risk

• Narrow therapeutic range (small difference between safe and harmful dose)
• Complex dosing or preparation
• Serious consequences if errors occur (e.g., bleeding, cardiac arrest, respiratory failure)

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Safety Strategies

• Double-checking doses and patient identity
• Using standardized protocols
• Limiting access and special labeling
• Monitoring patients closely
• Staff training and use of infusion pumps