Medication Errors

Documentation

Proper documentation of medication errors follows facility policies and regulatory requirements. All entries must be dated, timed, and signed. Errors are corrected with a single line through the incorrect entry, initialed and dated. Never erase or cover with correction fluid.

Common Errors

Frequent errors with medication errors in pharmacy practice:

1. Misreading sig codes. For reference: AU = both ears; BID = twice daily; QHS = at bedtime; SL = sublingual; PC = after meals; QID = four times daily
2. Calculation errors in dosage. Always double-check units (mg vs mcg, mL vs L)
3. Wrong DEA schedule classification affecting storage and dispensing requirements

Differential Diagnosis

Distinguishing between related concepts for medication errors:

ACE inhibitors: Examples: lisinopril, enalapril, ramipril. Mechanism: Block angiotensin-converting enzyme, decrease angiotensin II, cause vasodilation and decreased aldosterone. Key side effects: Dry cough (10-15%); Hyperkalemia.

Fluoroquinolones: Examples: ciprofloxacin, levofloxacin, moxifloxacin. Mechanism: Inhibit bacterial DNA gyrase and topoisomerase IV, bactericidal. Key side effects: Tendon rupture (Achilles); QT prolongation.

Exam Focus Areas

On the Ptcb exam(s), questions about medication errors typically test:

1. Drug interactions and contraindications that affect patient safety
2. Mathematical calculations: dosage, days supply, dilutions, and compounding
3. Drug classification, mechanism of action, and common side effects

Historical Context

Pharmacy regulation in the U.S. began with the Pure Food and Drug Act of 1906. The Federal Food, Drug, and Cosmetic Act of 1938 required proof of safety. The 1962 Kefauver-Harris Amendment added efficacy requirements. Understanding medication errors within this regulatory history helps pharmacy technicians appreciate why current standards exist, as each major regulation was prompted by a public health crisis.