Chapter 10.1: Look-Alike, Sound-Alike

hydrALAZINE vs hydrOXYzine

• hydrALAZINE: vasodilator

• hydrOXYzine: antihistamine

• clinical danger: BP crash vs sedation

  • giving potent BP reducer to pt needing allergy relief → hypotension and fainting

predniSONE vs predniSOLONE

• predniSONE: must be converted by liver into prednisolone to work

• predniSOLONE: given to patients with liver failure bc predniSONE will be ineffective for them

• both corticosteroids

cloNIDine vs KlonoPIN (clonazePAM)

• cloNIDine: antihypertensive

• KlonoPIN: benzodiazepine

• clinical danger: hypotension vs sedation

  • confusing BP patch w/ sedative pill → cardiovasc. instability/withdrawal

DAUNOrubicin vs DOXOrubicin

• both chemotherapy drugs

• clinical danger: toxic dosing

  • they each have different lifetime cumulative dose limits

  • DAUNOrubicin: lower cardiotoxicity = less likely to cause damage to heart

  • DOXOrubicin: higher cardiotoxicity → lower cumulative dose = less total exposure

• swapping them → irreversible heart damage

metFORMIN vs metroNIDAZOLE

• metFORMIN: antidiabetic

• metroNIDAZOLE: antibiotic

• clinical danger: no metformin = higher blood sugar; no metronidazole = untreated infection

laMICtal vs lamISIL

• laMICtal: anticonvulsant

• lamISIL: antifungal

• pt w/ epilepsy who gets antifungal instead of seizure med → more risk for breakthrough seizures

celeBREX vs celeXA

• celeBREX: NSAID / COX-2

• celeXA: antidepressant

• clinical danger: pt needing pain meds gets no help, while risking serotonin syndrome if alr on other psych meds

vinBLAStine vs vinCRIStine

• both chemotherapy drugs

• clinical danger: fatal route error

  • both are vinca alkaloids, but vinCRIStine is fatal if given intrathecally (into spine)

sulfADIAZINE vs sulfASALAzine

• sulfADIAZINE: antibiotic

• sulfASALAzine: GI anti-inflammatory

• clinical danger: used for different conditions

  • toxoplasmosis vs ulcerative colitis

acetaZOLAMIDE vs acetoHEXAMIDE

• acetaZOLAMIDE: diuretic/glaucoma

• acetoHEXAMIDE: antidiabetic

• clinical danger: swapping diuretic for sulfonylurea → less blood sugar

who developed tall man lettering?

• FDA and ISMP

• uses mixed case letters to highlight specific points of a drug name that are different, effectively forcing readers eye to pause and process distinctions