December 18, 2014:
A Mix-up between Short- and Long-Acting Medications Administered by Injection: When Does the “Salt” Matter?
Medications may be formulated as salts or esters (collectively referred to as “salts”), usually to improve the properties of the therapeutic moiety (e.g., its stability, bioavailability, or duration of action). In most cases, the type of salt does not influence how the drug is therapeutically used. In some cases, however, the particular salt significantly affects the drug’s pharmacological properties. Depot medications are one such group of drugs. These agents are typically formulated as various salts that are used differently from their short-acting counterparts. ISMP Canada recently received a report of an incident in which a short-acting (immediate-release) intramuscular (IM) form of an antipsychotic was administered by injection to a patient instead of the prescribed long-acting (depot) formulation.
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