RT Journal Article
SR Electronic
T1 Prescribing lessons from an ocular chemical injury: Vitaros inadvertently dispensed instead of VitA-POS
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2018-227468
DO 10.1136/bcr-2018-227468
VO 11
IS 1
A1 Edington, Magdalena
A1 Connolly, Julie
A1 Lockington, David
YR 2018
UL http://casereports.bmj.com/content/11/1/bcr-2018-227468.abstract
AB We wish to report an ocular chemical injury caused by inadvertent dispensing and administration of an erectile dysfunction cream (Vitaros) instead of an ocular lubricant (VitA-POS) to highlight this potential source of error. Prescribing errors are common, and medications with similar names/packaging increase risk. However, it is unusual in this case that no individual (including the patient, general practitioner or dispensing pharmacist) questioned erectile dysfunction cream being prescribed to a female patient, with ocular application instructions. The patient was treated for a mild ocular chemical injury with topical antibiotics, steroids and lubricants, with good response. However, we believe this to be an important issue to report to enhance awareness and promote safe prescribing skills.