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Top Ten Drugs Linked to Serious Injuries

The Institute of Safe Medicine Practices ( has compiled data for the first quarter of this year and determined the top ten medications associated with serious injuries.  They are as follows:

  1. varenicline (Chantix smoking cessation aide)
  2. heparin
  3. fentanyl
  4. interferon beta
  5. infliximab (a monoclonal antibody used for autoimmune diseases – Remicade)
  6. etanercept (recombinant DNA drug for arthritis – Embrel)
  7. Plavix
  8. Lyrica
  9. Acetaminophen
  10. oxycodone

In reviewing these medications, note that there has only been a link established and correlation does not equate to causation.  In other words, maybe the underlying reason these medications are prescribed contribute to the risk of serious injury.

Note that the first listed medication is a stop smoking aide.  Your patients along with their prescribers should assess the benefits of stopping smoking against the risks of continuing to smoke.  Also of interest is that acetaminophen made the list.  Acetaminophen is also linked to medication deaths.  It may be that a little restraint is in order when it comes to everyone’s favorite over the counter medication.

Also two medications listed are anticoagulants. If your clinical record audit tools do not already include an indicator for verifying anticoaguation safety, it might an idea to add one or do a focused audit to determine if this is necessary.

I encourage all of you to avail yourself of the wealth of information that ISMP offers at no charge.  The monthly newsletter is current and relevant to any area of nursing practice.

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