依美國ISMP定義 當一個藥物在使用錯誤時，有很高的機率對病人造成明顯傷害危險，就稱其為高警訊 藥品（high-alert medications）。 美國ISMP (Institute for Safe Medication Practices)定義高警訊藥品共有19類及 13項特定品項。 應提高警覺之13項特定藥品 1. Colchicine injection 2. Epoprostenol 3. Insulin, subcutaneous & iv 4. Magnesium sulfate injection 5. Methotrexate, oral, non-oncologic use 6. opium tincture 7. oxytocin, iv 8. Nitroprusside sodium, for injection 9. Potassium chloride for injection concentrate 10. Potassium phosphates injection 11. Promethazine 12. Sodium chloride injection, hypertonic, 　 more than 0.9% concentration 13. Sterile water for injection, inhalation, and 　 irrigation (excluding pour bottles) in 　 containers of 100 ml or more 應提高警覺之19類藥品 1. Adrenergic agonists, iv 2. Adrenergic antagonists, iv 3. Anesthetic agents, general, inhaled & iv 4. Antiarrhythmics, iv 5. Antithrombotic agents, including warfarin, 　 low-molecular-weight heparin, iv 　 unfractionated heparin, factor Xa 　 inhibitors, direct thrombin inhibitors, 　 thrombolytics, and glycoprotein IIb/IIIa 　 inhibitors 6. Cardioplegic solutions 7. Chemotherapeutic agents, parenteral & oral 8. Dextrose, hypertonic, 20% or greater 9. Dialysis solutions, peritoneal & hemodialysis 10. Epidural or intrathecal medications 11. Hypoglycemics, oral 12. Inotropic medications, iv 13. Liposomal forms of drugs 14. Moderate sedation agents, iv 15. Moderate sedation agents, oral, for children 16. Narcotics/opiates, iv , transdermal & oral 　 (including liquid concentrates, immediate- & sustained- release) 17. Neuromuscular blocking agents 18. Radiocontrast agents, iv 19. Total parenteral nutrition solutions 12. Inotropic medications, iv 13. Liposomal forms of drugs 14. Moderate sedation agents, iv 15. Moderate sedation agents, oral, for children 16. Narcotics/opiates, iv , transdermal & oral 　 (including liquid concentrates, immediate- & sustained- release) 17. Neuromuscular blocking agents 18. Radiocontrast agents, iv 19. Total parenteral nutrition solutions 參考資料 http://www.ismp.org/tools/highalertmedications.pdf 同樣是高警訊藥品如何判定級別? 黃字是100年第二次藥師考的題目 調劑學與臨床藥學 41.下列那些屬於高警訊藥品(high-alert medication)? (1)dextrose 20%, 500ml (2)KCL 20 mEq/amp (3)Magnesium sulfate 10%, 20ml/amp (4)Sodium chloride 0.9%, 1 L (A)123 (B)124 (C)134 (D)234 公佈答案 (A) --

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