Which of the following is considered a high-alert medication?

• A. Epinephrine, subcutaneous
• B. Hydrochlorothiazide
• C. Vitamin C
• D. Potassium supplement, oral

Answer: (A)

High-alert medications are drugs that pose a high risk of significant patient harm if they are misused, misdosed, or given through the wrong route, so they require extra safeguards and checks in the system.

Epinephrine given subcutaneously is considered high-alert because even small dosing or route errors can produce dramatic and dangerous cardiovascular effects, such as severe tachycardia, hypertension, arrhythmias, or myocardial ischemia. In emergency use for anaphylaxis, the dose and administration must be precise, and mistakes can quickly lead to life-threatening situations. This combination of powerful effects, narrow therapeutic margin, and the potential for rapid harm makes it a classic high-alert medication.

The other options aren’t typically categorized as high-alert. Hydrochlorothiazide and vitamin C are common medications with relatively wide safety margins when used as directed, and while overdose is harmful, they do not carry the same systemic, high-risk profile. Potassium supplements taken by mouth can be dangerous if misused, but the most hazardous form is concentrated or IV potassium, which is the version usually highlighted as high-alert; oral potassium is not on that same high-alert list.