{
  "schema": "upg.factor.v1",
  "id": "ptce/safety/high-alert",
  "exam": [
    "PTCE"
  ],
  "confidence": 0.97,
  "updated_at": "2026-09-07",
  "token_cost_hint": 220,
  "integrity": "practice_only",
  "domain": "Patient Safety & Quality Assurance",
  "title": "High-alert medications (ISMP)",
  "claim": "High-alert medications bear a heightened risk of causing significant patient harm when used in error. ISMP publishes setting-specific high-alert lists (e.g., acute care) that include classes such as anticoagulants, insulin, opioids, and neuromuscular blocking agents \u2014 used to drive extra safeguards, not to ban the drugs.",
  "plain": "High-alert \u2260 \u201cnever use.\u201d It means extra checks (independent double-check, smart pumps, limited access). Know the ISMP class examples.",
  "citations": [
    {
      "authority": "ISMP List of High-Alert Medications in Acute Care Settings (2024)",
      "url": "https://www.ismp.org/system/files/resources/2024-01/ISMP_HighAlert_AcuteCare_List_010924_MS5760.pdf",
      "pin": "ISMP High-Alert Acute Care List Jan 2024",
      "retrieved_at": "2026-09-07",
      "quote": "Classes/Categories of Medications \u2026 antithrombotic agents \u2026 insulin, subcutaneous and IV \u2026 neuromuscular blocking agents \u2026 opioids, all routes of administration"
    }
  ],
  "html": "/factors/ptce/safety/high-alert",
  "json": "/factors/ptce/safety/high-alert.json"
}