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Preventing Drug Mix-Ups: Bumetanide and Norepinephrine

Posted on April 29, 2008

The Institute for Safe Medication Practices is warning health care professionals about several recent mix-ups between two injectable drugs made by Bedford Laboratories: bumetanide, a diuretic, and norepinephrine, used to treat MI and hypotension. These mix-ups occurred because the vial labels and caps make the two bottles look very similar.

In one report, a pharmacy bin marked “bumetanide” was mistakenly filled with vials of norepinephrine. A pharmacy technician, pharmacist and nurse all failed to notice the mistake. As a result, a patient who should have been received 1 mg of bumetanide instead was given 4 mg of norepinephrine. The patient developed chest pain and ventricular tachycardia and had to be transferred to the ICU.

ISMP says that Bedford Laboratories changed the color of the bumetanide cap from silver to green in April 2006. However, these recent errors suggest that the older vials may still be in circulation. And once the cap is removed, these two vials still look very similar. So it remains important to take extra care when handling and administering bumetanide and norepinephrine made by this firm.

Additional Information:

ISMP Medication Safety Alert! Look-alike Vial Alert! Volume 12, Issue 4. February 22, 2007.
http://www.ismp.org/newsletters/acutecare/articles/20070222a.asp

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