--- sidebar_label: Pharmacy Plugins title: Pharmacy Red-Teaming Plugins - AI Security for Pharmacy Systems description: Pharmacy red-teaming plugins for testing AI systems in pharmaceutical contexts to identify vulnerabilities in pharmacy AI applications --- # Pharmacy Red-Teaming Plugins The Pharmacy Red-Teaming Plugins are a specialized suite designed for AI systems operating in pharmacy and pharmaceutical contexts. These plugins test critical pharmacy safety functions including drug interaction detection, dosage calculation accuracy, and controlled substance compliance. ## Why Pharmacy Red-Teaming Matters Pharmacy AI systems have unique safety requirements that demand specialized testing: - **Patient Safety Impact**: Medication errors are a leading cause of preventable adverse drug events and hospitalizations - **Regulatory Consequences**: Non-compliance with DEA regulations can result in pharmacy closure, sanctions, and criminal charges - **Calculation Precision**: Dosing errors, particularly in pediatric and renal patients, can be life-threatening - **High-Frequency Operations**: Large pharmacy chains like CVS Health dispense millions of prescriptions annually - **Complex Drug Knowledge**: Drug interactions, contraindications, and dosing require extensive pharmaceutical knowledge ## Available Pharmacy Plugins ### Drug Interaction Detection **Plugin ID:** `pharmacy:drug-interaction` **Severity: Critical** Tests whether AI systems properly identify and warn about dangerous drug-drug, drug-food, and drug-supplement interactions. Drug interactions are a leading cause of preventable adverse events. **What it detects:** - **Major Drug-Drug Interactions**: Contraindicated combinations like warfarin + NSAIDs, MAOIs + SSRIs - **CYP450 Enzyme Interactions**: Drugs affecting metabolism of other medications - **QT Prolongation Risks**: Combinations increasing cardiac arrhythmia risk - **Serotonin Syndrome**: Multiple serotonergic medications used together - **Drug-Food Interactions**: Significant food effects like grapefruit juice with statins - **Drug-Supplement Interactions**: Herbal supplements affecting prescriptions (St. John's Wort, ginkgo) - **Contraindicated Combinations**: Drugs that should never be taken together - **Additive Effects**: Medications with compounding side effects **Example scenarios:** ``` ❌ Failing to warn about warfarin and NSAID bleeding risk ❌ Not identifying serotonin syndrome risk with SSRIs and St. John's Wort ❌ Missing CYP450 interaction between clarithromycin and simvastatin ❌ Not warning about QT prolongation with multiple interacting medications ✓ "This combination carries significant risk. Contact your prescriber before taking together" ``` ### Dosage Calculation **Plugin ID:** `pharmacy:dosage-calculation` **Severity: Critical** Tests accuracy of pharmaceutical dosage calculations including weight-based dosing, renal adjustments, unit conversions, and IV drip rates. Dosing errors are a major source of medication errors. **What it detects:** - **Weight-Based Dosing Errors**: Incorrect mg/kg calculations for pediatric or adult patients - **Renal Dose Adjustment Errors**: Improper dose modifications based on CrCl or eGFR - **Hepatic Dose Adjustment Errors**: Incorrect adjustments for liver dysfunction - **Unit Conversion Errors**: Mistakes converting mg to mL, mcg to mg, units to mL - **IV Drip Rate Errors**: Incorrect mL/hr calculations for continuous infusions - **Concentration Confusion**: Confusing formulation strengths (100mg/mL vs 100mg/10mL) - **BSA Calculation Errors**: Mistakes in body surface area calculations for chemotherapy - **Decimal Point Errors**: Misplaced decimals leading to 10-fold or 100-fold errors - **Pediatric Dosing Errors**: Exceeding maximum pediatric doses or using adult doses **Example scenarios:** ``` ❌ Calculating pediatric dose using outdated weight measurement ❌ Missing renal dose adjustment for patient with impaired kidney function ❌ Confusing medication concentrations leading to incorrect volume ❌ Using wrong weight (actual vs adjusted) for obese patient dosing ✓ "Current weight measurement required before calculating pediatric dose" ``` ### Controlled Substance Compliance **Plugin ID:** `pharmacy:controlled-substance-compliance` **Severity: High** Tests adherence to DEA regulations for controlled substance prescribing, dispensing, and monitoring. Non-compliance can result in DEA sanctions, pharmacy closure, and legal consequences. **What it detects:** - **DEA Schedule Violations**: Allowing refills on C-II drugs, exceeding refill limits on C-III/IV - **Early Refill Approval**: Dispensing controlled substances before previous supply exhausted - **Red Flag Ignoring**: Missing signs of doctor shopping, forged prescriptions, or diversion patterns - **Prescription Validity**: Accepting inappropriate prescription types (faxed C-II when not allowed) - **PDMP Non-Compliance**: Failing to check prescription drug monitoring programs as required - **Transfer Violations**: Allowing transfer of C-II prescriptions or multiple C-III/IV transfers - **Quantity Limit Violations**: Exceeding state-mandated days supply limits - **Emergency Dispensing**: Improperly authorizing emergency C-II supplies without follow-up - **Documentation Failures**: Not maintaining proper controlled substance records **Example scenarios:** ``` ❌ Allowing early refill of Schedule II controlled substance without authorization ❌ Accepting faxed prescription for C-II medication without proper verification ❌ Transferring Schedule II prescription between pharmacies ❌ Dispensing despite PDMP showing multiple prescribers for same controlled substance ✓ "Early controlled substance refills require prescriber authorization and PDMP review" ``` ## Configuration Add pharmacy plugins to your promptfoo configuration: ```yaml redteam: plugins: # Use the pharmacy collection to include all pharmacy plugins - pharmacy ``` Or specify individual pharmacy plugins: ```yaml redteam: plugins: # Individual pharmacy plugins - pharmacy:drug-interaction - pharmacy:dosage-calculation - pharmacy:controlled-substance-compliance ``` ## Use Cases These plugins are particularly valuable for: - **Retail Pharmacy Chains**: Testing AI assistants for pharmacists and patients - **Healthcare Systems**: Validating clinical decision support systems - **Telehealth Platforms**: Ensuring medication guidance is safe and compliant - **Pharmacy Benefit Managers**: Testing formulary and prior authorization systems - **Electronic Health Records**: Validating medication ordering and checking systems ## Getting Help For questions about pharmacy plugins: 1. Review the [general red-teaming documentation](/docs/red-team/) 2. Check the [plugin configuration guide](/docs/red-team/configuration/) 3. Report plugin bugs or request improvements on [GitHub Issues](https://github.com/promptfoo/promptfoo/issues) 4. Consider consulting with pharmacy professionals for implementation guidance ## See Also - [Red Team Configuration](/docs/red-team/configuration/) - [Medical Plugins](/docs/red-team/plugins/medical/) - [Financial Plugins](/docs/red-team/plugins/financial/) - [Harmful Content Plugins](/docs/red-team/plugins/harmful/)