Sound Alike / Look Alike (SALA or LASA) Drugs

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What are sound-alike and look-alike drugs

Some proprietary (brand name) and non-proprietary names (generic name) sound or appear to be similar to other drugs when written or spoken. These confusing drug names are one of the main causes of medication error.

There are many sound and look alike drugs that would result in medication error. These errors may cause harm or even death to patients. According to the results from United States Pharmacopoeia, around 1400 commonly used medications were involved in such errors.

Health products affected by SALA issue:

• Pharmaceutical drug products for use in humans and veterinary medicine.
• Natural drug products for human use.

To date, majority of errors are seen in human prescription drugs.

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List of SA/LA drugs

The most common errors identified in generic names were between:

• Cisplatin - Carboplatin
• Ephedrine - Epinephrine
• Fentanyl - Sufentanil
• Lantus - Lente
• Humalog - Humulin
• Novolog - Novolin
• Humulin - Novolin
• Humalog -Novolog
• Doxorubicin - Daunorubicin
• Taxol - Taxotere
• Acetohexamide - Acetazolamide
• Advicor - Advair
• Avinza - Evista
• Chlorpropamide - Chlorpromazine
• Diabeta - Zebeta
• Folic acid - Folinic acid
• Heparin - Hespan
• Lamivudine - Lamotrigine
• Leukeran - Leucovorin
• Prilosec - Prozac
• Retrovir - Ritonavir
• Tizanidine -Tiagabine
• Wellbutrin SR - Wellbutrin XL
• Zantac - Xanax
• Zantac - Zyrtec
• Oxycontin - Oxynorm
• Imipenem - Meropenem
• Accutane - Accupril
• Selegiline - Salagen

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How to prevent the medication errors:

Below are given some suggestions to reduce the medication mix-ups

Manufacturers

Manufacturers are responsible for naming of health products. They should:

1. Choose unique drug names, easily written and pronounced
2. While proposing a drug name (brand and generic), they should do complete research to ensure that there are no drugs with similar names in the market (computer searches on SALA).

Physicians, Nurse Practitioners

In order to avoid SALA confusion, the prescriber can

1. Clearly write the prescriptions
2. Avoid using short forms or abbreviation of drug names
3. Make further comment about the drugs (include both generic and brand names)
4. Avoid verbal prescriptions to a maximum extent.

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Pharmacists

Pharmacists should ensure that a patient receives the correct drug, as directed by the physician. They can do so by

1. Separating SALA drugs from one another
2. Installing warning system to staff – Computer alerts or warnings on stock bottles
3. Double checking the drug
4. Contacting the physician in case of any clarification regarding the prescription
5. Becoming familiar with SALA drugs

Consumers

Consumers can also reduce the chance of getting the wrong medications.

1. Consumers must be aware as to why that particular drug is prescribed and the appropriate usage the medication.
2. They should confirm that the physician has clearly written the name of the drug (i.e. the patient must be able to read the name of the drug).
3. After buying, they should ensure to see whether the drug in hand is the same as the one in the prescription.

Apart from SALA, bad handwriting, workplace distractions, shortage of inexperienced staff and workers are the other reasons for medication errors.