The invisibile can be harmful, the handling of active principles by pharmacists, nurses, doctors and other health workers can be seriously dangerous for their physical and reproductive health, and damage can often occur without noticing.

Serious damage to patients and a few death cases, were detected by studies performed internationally. The causes are attributed to multifactorial mistakes when each one of these interacts in many levels of the drug management process.

Special Precautions have to be taken for all the activities required for the pharmacological therapy. The reconstitution and administration of the active principles represent the most critical phase of the management process.
A wrong preparation and administration of a drug can have many causes, some of which:

• wrong dilution and reconstitution.
• Drug mixture physically or chemically incompatible with one another or with the solutions used for the dilution.
• Unreadable writing on the infusion container of the drug to be reconstituted.
• Deterioration of the drug (expired drug, or drug not correctly stored).
• Preparation errors.

The Institute for Safe Medication Practices – USA has drafted a list of High-Alert Medications, which are the drugs that require special management and use attention, due to their potential toxicity, their low therapeutic index and their high interaction possibility, for example:
Adrenergic agonists, general intravenous anesthetic agents, local injectable anesthetic agents, neuromuscular blocking agents, antithrombic agents (anticoagulants), Hepharin, Warfarin, Antiarrhythmic agents, Antineoplastics, Psychoactive drugs, Opioids, Intravenous Benzodiazepines, Digoxin, Insulin, Oral Hypoglycemics, Nitroprussice Sodium, Hypertonic Sodium Chloride for injection concentrate, Potassium Chloride for injection concentrate, Potassium Phosphates injection, Calcium injection, Magnesium sulfate injection.

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