High Alert & LASA Medication Storage guidelines - Outside Pharmacy

Narcotic; Morphine,  Store in double lock

Fentanyl  Store ampoules, where available in High alert medication bag.
(ampoules, syringes)  Medication bin to be labelled with High alert medication sticker.
 Patient doses to be stored in narcotic cabinet.
Concentrated  Not stored outside pharmacy, exceptions include:
electrolytes
o Potassium chloride available o Paste sticker “must be diluted before use” on individual
in cardiac OR only vial.
o Store in High alert bag
o Label medication bin with High alert medication sticker
o Magnesium sulfate in Labor o Paste sticker “must be diluted before use” on individual
room, Cardiac OR and ampoule.
emergency crash carts. o Store in High alert bag
o Label medication bin with High alert medication sticker.

Anticoagulants Warfarin Not available on any floor stock

Heparin vials o Store in High alert bag
o Label medication bin with High alert medication sticker.
o Once opened, label the vial with opening date, opening
time, beyond use date, staff initials.
o Discard the opened vial within 28 days from opening or
if the vial content appears not usable.
Thrombolytic Streptokinase Not stored outside pharmacy
Alteplase Not stored outside pharmacy
Chemotherapeutic Chemotherapeutics Not stored outside pharmacy
(Parenteral)
Look-alike and sound- Look –alike and Sound-alike o Store in LASA bag
alike medications medications from institutional o Label medication bin with LASA caution sticker
current LASA list o Store separate from its look-alike medication
o The below LASA drugs will be stored with drug specific
caution sticker pasted on neck of the ampoule:
Inj. Avil 22.7mg/ml, Inj. Serenace 5mg, Inj.
Aminophylline 250mg/10ml, Inj. Bupivacaine
50mg/10ml, Inj. Naloxone 0.4mg/ml
Insulin o Store in High alert bag
o Label medication bin with High alert medication sticker.
o Before opening store, the vial at 2-8oC. After opening will be stored at controlled room
temperature for 28 days only. Refer the insulin flyer for details.
o Once opened, label the vial with opening date, opening time, beyond use date, staff initials.
o Discard the opened vial within 28 days from opening or if the vial content appears not usable.
Neuromuscular o Available as floor stock only in Critical Care, Recovery room, ED, operating rooms and in rapid
blocking agents sequence intubation (RSI) bag.
(NMBAs) o Each ampoule is individually labelled with NMBA paralyzing sticker.
o On floor stock store in NMBA bag; “Paralyzing Agent-Causes Respiratory Arrest”.
o In floor stock, store in original commercial pack, where possible.
o Label the medication bin with NMBA paralyzing sticker.
o Note: Label medication bin of inj. cis-atracurium 10 mg with an additional LASA caution
sticker along with NMBA paralyzing sticker.
 Narcotic Heparin

Insulin

Look-alike
medication
(e.g.
Pheniramine
Maleate)

Concentrated
electrolyte
(Potassium
chloride)

Concentrated
electrolyte
(Magnesium
Sulphate)

NMBA (e.g.
cis-
atracurium,
succinyl
choline)