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American Journal of Health-System Pharmacy, Vol. 63, Issue 2, 139-142
Copyright © 2006 by American Society of Health-System Pharmacists
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Special Feature

Improving the safety of neuromuscular blocking agents: A statement from the USP Safe Medication Use Expert Committee

Marjorie Shaw Phillips and Roger L. Williams

MARJORIE SHAW PHILLIPS, M.S., FASHP, is Medication Safety Coordinator and Clinical Research Pharmacist, Medical College of Georgia Health System, and Clinical Professor of Pharmacy Practice, College of Pharmacy, University of Georgia, Augusta. ROGER L. WILLIAMS, M.D., is Executive Vice President and Chief Executive Officer, United States Pharmacopeia, Rockville, MD.

Address correspondence to Ms. Phillips at the Pharmacy Department, Medical College of Georgia Health System, 1120 15th Street, BI-2101, Augusta, GA 30912.


Purpose. Recommendations of the interdisciplinary Safe Medication Use Expert Committee of the United States Pharmacopeia (USP) to assist health care professionals, manufacturers, and organizations in handling neuromuscular blocking agents (NMBAs) safely and effectively are discussed.

Summary. Review and analysis of the USP Medication Errors Reporting Program and MEDMARX program databases showed a continuing risk of patient harm or death due to errors with NMBAs. Medication errors involving wrong concentrations, wrong doses, wrong drugs, look-alike packaging, and sound-alike names, combined with lack of monitoring and communication, have been associated with the use of NMBAs in health care institutions. Serious adverse events occur when NMBAs are used without adequate safeguards. Recommendations for improving safety were developed through review and discussion of root causes and areas of concern with these medications.

Conclusion. Medical errors with NMBAs continue to result in patient morbidity and mortality. Increased awareness and action on the part of all parties involved are needed to improve the safety of this class of medications.

Index terms: Concentration; Death; Dosage; Errors, medication; Hospitals; Nomenclature; Packaging; Reports; Skeletal muscle relaxants; Toxicity; United States Pharmacopeia

 





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