Short answer: Learn the high-alert medicines (insulin, heparin, concentrated potassium and opioids), their antidotes, the common adverse effects of major drug classes, and the checks that prevent errors: right patient, drug, dose, route and time, independent double-checks and clear documentation.
The checks that prevent errors
Use two patient identifiers, check the right drug, dose, route and time, and document immediately after giving. Independent double-checks are standard for high-alert drugs.
High-alert medicines
These carry a higher risk of serious harm when misused.
- Insulin: monitor glucose and watch for hypoglycaemia.
- Heparin and other anticoagulants: monitor clotting and bleeding.
- Concentrated potassium: never give as a bolus.
- Opioids: monitor sedation and respiratory rate.
Antidotes to know
Vitamin K for warfarin, protamine for heparin, naloxone for opioids, flumazenil for benzodiazepines, N-acetylcysteine for paracetamol and atropine for organophosphates.
Adverse effects worth remembering
ACE inhibitors cause a dry cough, aminoglycosides risk kidney and ear damage, loop diuretics lower potassium, statins can cause muscle problems and NSAIDs risk stomach bleeding.
When something looks wrong
Stop, check, and ask. If you make an error, assess the patient first, inform the prescriber and report openly.
Related guide
For deeper guides on one angle each, see high-alert medications and look-alike drugs and the five rights in exam questions.
Frequently asked questions
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