significant harm with even small error
APINCHS
- A - Antimicrobials
- Aminoglycosides: gentamicin, tobramycin and amikacin
- vancomycin
- amphotericin – liposomal formulation
- P - Potassium and other electrolytes
- Injections of concentrated electrolytes: potassium, magnesium, calcium, hypertonic sodium chloride
- I - Insulin: All insulins
- N - Narcotics (opioids) and other sedatives
- hydromorphone, oxycodone, morphine, fentanyl, alfentanil, remifentanil and analgesic patches
- Benzodiazepines: diazepam, midazolam
- thiopentone, propofol and other short-term anaesthetics
- C - Chemotherapeutic agents
- vincristine, methotrexate, etoposide, azathioprine
- Oral chemotherapy
- H - Heparin and other anticoagulants
- warfarin, enoxaparin, heparin
- Direct oral anticoagulants (DOACs): dabigatran, rivaroxaban, apixaban
- S - Systems
- Medication safety systems such as independent double checks, safe administration of liquid medications, standardised order sets and medication charts etc