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Dispensing Error Leading to Alendronate Ingestion

2003· article· en· W4230497281 on OpenAlexaff
Benoit Carrière, Benoît Bailey, Gilles Chabot, Denis Lebel

Bibliographic record

VenueAnnals of Pharmacotherapy · 2003
Typearticle
Languageen
FieldMedicine
TopicPharmaceutical studies and practices
Canadian institutionsCentre Hospitalier Universitaire Sainte-Justine
Fundersnot available
KeywordsMontelukastMedicineDiscontinuationLeukotriene receptorAsthmaPediatricsSurgeryInternal medicine

Abstract

fetched live from OpenAlex

AbstractOBJECTIVETo report a case of medication dispensing error by administration of similarly packaged drugs.CASE SUMMARYA 6-year-old East Indian boy with asthma was mistakenly given alendronate, a bisphosphonate, for 3 months instead of montelukast, a leukotriene-receptor antagonist. Symptoms of esophageal irritation developed and disappeared on discontinuation of alendronate.DISCUSSIONAlendronate and montelukast have very similar packaging and are available in dosages that also can be similar for some patients. Alendronate caused symptoms of irritative gastritis in this child before the error was identified. This case report emphasizes one of the possible sources of medication dispensing errors: a mistaken identification due to similar packaging (confirmation bias). Manufacturers can help to prevent medication errors in many ways; in this case, more distinct packaging would have decreased the risk of error. A standard bar-coding scheme among manufacturers could lead to an important improvement in the safety of medication dispensation. Practitioners are also encouraged to report such errors to the United States Pharmacopoeia Medication Errors Reporting Program.CONCLUSIONSWith increased awareness of medication errors, healthcare practitioners, manufacturers, and patients should take precautionary steps to prevent dispensing errors and their consequences. ResumenOBJETIVOInformar sobre un caso de un error en dispensación que llevó a la administración incorrecta de un fármaco cuyo empaque era similar al del fármaco prescrito.RESUMENUn niño de 6 años que padecía de asma recibió por equivocación durante un período de 3 meses el fármaco alendronato, un bifosfonato, en lugar de montelukast, un antagonista del receptor de leucotrieno. Los síntomas de irritación exofágica se hicieron presente y desaparecieron al descontinuarse el fármaco.DISCUSIÓNAlendronato y montelukast tienen un empaque similar y están disponibles en dosis que pueden ser similares para diferentes pacientes. Alendronato ocasionó síntomas de irritación gástrica en este caso antes de que el error fuera captado. Este informe de caso enfatiza una de las posibles fuentes de errores en dispensación, el problema de confusión que ocurre con fármacos que tienen empaques similares. Los fabricantes pueden ayudar a prevenir errores en medicación. En este caso, si el fabricante hubiera usado un empaque diferente, el error se hubiera podido prevenir. El desarrollo de un esquema de codificación estándar entre los fabricantes podría ayudar a mejorar la seguridad del proceso de dispensación de fármacos. También se recomienda que los practicantes informen los errores al programa de errores en medicación de la Farmacopea de los Estados Unidos (USP, por sus siglas en inglés).CONCLUSIONESA medida que aumente el conocimiento sobre errores en medicación, los proveedores de salud, fabricantes, y pacientes deben tener precaución para prevenir errores en dispensación y sus consecuencias. RésuméOBJECTIFRapporter un cas d'erreur médicamenteuse de dispensation, soit l'administration de médications avec des emballages quasiidentiques.RÉSUMÉ DU CASUn garçon de 6 ans souffrant d'asthme a reçu par erreur de l'alendronate, un bisphosphonate, pour 3 mois plutôt que du montélukast, un antagoniste des récepteurs de leukotriène. Des symptômes d'irritation œsophagienne étaient présents et disparurent suite à l'arrět de la médication erronée.DISCUSSIONL'alendronate et le montélukast ont des emballages très similaires, et sont administrés à des doses qui peuvent se ressembler pour différents patients. L'alendronate a causé des symptômes de gastrite irritative dans ce cas-ci, avant que l'erreur médicamenteuse soit découverte. Ce cas rapporté met l'emphase sur une des sources possibles d'erreur médicamenteuse de dispensation, soit un biais de confirmation dû à un emballage similaire. Les manufacturiers peuvent aider à prévenir les erreurs médicamenteuses de plusieurs façons. Pour le cas rapporté ici, si le manufacturier avait utilisé un emballage plus distinctif, l'erreur aurait pu ětre évitée. Un système de code à barres standardisé parmi les manufacturiers pourrait entraîner une amélioration de la sécurité de la dispensation des médicaments.CONCLUSIONSAvec la plus grand sensibilisation du public face aux erreurs médicales de toutes sortes, toutes les étapes devraient ětre prises pour prévenir les erreurs médicamenteuses de dispensation et leurs conséquences, et ce, par les professionnels de la santé, les manufacturiers pharmaceutiques et les patients.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Bench or experimental · Consensus signal: Bench or experimental
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.454
Threshold uncertainty score0.774

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.261
GPT teacher head0.506
Teacher spread0.245 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designBench or experimental
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations1
Published2003
Admission routes1
Has abstractyes

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