臺北榮總高警訊藥品專區
一個藥品使用錯誤時，若有極高機率對病人造成明顯傷害， 則稱此藥為高警訊藥品 (high-alert medications)。 本部比照美國 ISMP (Institute for Safe Medication Practices) 公布之高警訊藥品，訂定本院之高警訊藥品品項， 並定期更新公告，提供全院醫療人員參考。
本院依據美國 ISMP（Institute for Safe Medication Practices）發布之《ISMP List of High-Alert Medications in Acute Care Settings © ISMP 2024》，涵蓋 21 類藥品及 13 項特定品項，訂定本院高警訊藥品（high-alert medications）清單。高警訊藥品係指使用錯誤時，較可能造成病人嚴重傷害之藥品。本院於藥名中嵌入「#」警示記號，例如：Traceton FC #^* tab（tramadol 37.5 mg＋acetaminophen 325 mg），提醒醫療人員於處方開立、藥品調劑、護理給藥、病人用藥與用藥後追蹤，以及藥品庫儲管理等各環節加強確認，並配合各項防誤機制，以減少用藥疏失及提升用藥安全。本院高警訊藥品品項詳見表一、表二。
本院將高警訊藥品中具接觸性細胞毒性之化療針劑、靜脈胰島素輸注（intravenous insulin infusion, IVII）、靜脈輸注之高單位 heparin 針劑、digoxin 針劑、高濃度氯化鉀（KCl）針劑及神經肌肉阻斷注射劑（Esmeron®、Nimbex®、Relaxin®），列為高危險藥品（high-risk medications）。此類藥品於藥名中嵌入「##」警示記號，護理給藥時須由兩位護理人員共同核對並簽名（double check, double sign），以加強給藥安全。
應提高警覺之 21 類藥品
- Adrenergic agonists, iv
- Adrenergic antagonists, iv
- Anesthetic agents, general, inhaled and iv
- Antiarrhythmics, iv
- Antithrombotic agents, including: Anticoagulants (warfarin, LMWH, UFH); Direct oral anticoagulants and factor Xa inhibitors; Direct thrombin inhibitors; Glycoprotein IIb/IIIa inhibitors; Thrombolytics
- Cardioplegic solutions
- Chemotherapeutic agents, parenteral and oral
- Dextrose, hypertonic, 20% or greater
- Dialysis solutions, peritoneal and hemodialysis
- Epidural and intrathecal medications
- Inotropic medications, iv
- Insulin, subcutaneous and IV
- Liposomal forms of drugs and conventional counterparts (e.g., liposomal amphotericin B and amphotericin B deoxycholate)
- Moderate sedation agents, IV
- Moderate and minimal sedation agents, oral, for children
- Opioids, all routes of administration
- Neuromuscular blocking agents
- Parenteral nutrition preparations
- Sulfonylurea hypoglycemics, oral
- Sterile water for injection, inhalation, and irrigation (excluding pour bottles) in containers of 100 mL or more
- Sodium chloride for injection, hypertonic, greater than 0.9% concentration
應提高警覺之 13 項特定藥品
- EPINEPHrine, IM and subcutaneous
- Epoprostenol (e.g., Flolan), IV
- Insulin U-500 (special emphasis)
- Magnesium sulfate injection
- Methotrexate, oral, non-oncologic use
- Opium tincture
- Oxytocin, IV
- Nitroprusside, sodium, for injection
- Potassium chloride for injection concentrate
- Potassium phosphates injection
- Promethazine injection
- Vasopressin, IV and intraosseous
- Tranexamic acid injection
最後更新：