Medication Errors
Michael R. Cohen ScD, MS, RPH

January 2013 
Volume 43  Number 1
Pages 12 - 12
  PDF Version Available!

The labels on vials of acetylcysteine solution, manufactured by Roxane Laboratories, indicate 10% or 20% for inhalation (mucolytic agent) or oral administration (acetaminophen antidote). The labels don't specify the mg per mL concentration anywhere. The extra step a healthcare professional must make to calculate how many mL to withdraw can lead to a calculation error.In one reported incident, the prescribed dose was 600 mg. Working with the information on the label of a 20% vial (as shown above), a healthcare professional couldn't calculate that 3 mL was needed. Had the label simply stated the contents as 200 mg/mL, the volume amount could have been calculated with ease.The product manufacturer has been contacted and says it's changing the label. In the meantime, facilities should consider purchasing a generic alternative that indicates the mg/mL concentration.An unresponsive patient was brought to an ED by his family. The patient had been given a prescription for transdermal fentaNYL.

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