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Background and Importance Automated medication dispensing systems (AMDS) have improved high-risk medication (HRM) management, but challenges in transaction accuracy and patient identification persist.Aim and Objectives To evaluate the quality of dispensation performed by AMDS in managing HRMs.Material and Methods A retrospective observational study analysed HRM dispensations recorded by AMDS from January 1 to August 31, 2025, in a tertiary hospital. The study included all HRMs stocked in four AMDS(Omnicell ) in the ICU, Surgical Block (SB), Observation (OBS), and Emergency Department (ED). HRMs were classified by therapeutic group. Variables collected included total dispensations (TD), dispensation to identified patients (ID), and dispensation to generic patient profiles (GP).Results Abstract 5PSQ-109 Table 1 OBS ICU ED SB THERAPEUTIC GROUP TD ID(%) GP(%) TD ID(%) GP(%) TD ID(%) GP(%) TD ID(%) GP(%) Adrenergic Agonists (IV) 163 23.9 76.1 158 98.1 1.9 45 84.4 15.6 582 29.4 70.0 General Anaesthetics (Inhaled/IV) 395 24.3 75.7 4032 98.0 2.0 2454 33.2 63.5 Adrenergic Antagonists (IV) 118 26.3 73.7 105 100.0 0.0 7 14.3 85.7 200 26.5 66.5 Antiarrhythmics (IV) 289 22.2 76.5 360 100.0 0.0 167 19.8 80.2 920 32.2 67.8 Anticoagulants (O) 644 44.4 55.3 8 100.0 0.0 12 25.0 83.3 Antidiabetics (O) 37 32.4 67.6 Neuromuscular Blockers 55 20.0 80.0 372 100.0 0.0 874 58.2 18.0 Heparins 1834 42.6 57.4 1732 97.6 2.3 443 23.0 77.0 108 26.9 73.1 Other Antithrombotic Agents 2 0.0 100.0 Inotropes (IV) 349 35.8 64.2 14 100.0 0.0 32 3.1 96.9 12 50.0 0.0 Opioids 2406 39.2 60.8 1580 99.3 0.7 1584 27.9 65.5 2782 34.6 65,4 Sedatives (IV) 2435 30.9 69.1 903 95.3 5.0 4181 23.2 79.3 889 3.3 7.6 Hypertonic Glucose(≥20%) 141 24.1 75.9 93 97.8 0.0 56 26.8 73.2 22 22.7 77.3 Thrombolytics- Fibrinolytics 29 48.3 51.7 20 100.0 0.0 Insulins 51 29.4 70.6 14 100.0 0.0 Other 591 26.4 74.8 178 100.0 0.0 21 19.0 81.0 219 57.1 42.9 TOTAL 9539 35.2 76.1 9555 98.1 1.9 6548 24.6 75.4 9076 33.2 66.8 Conclusion and Relevance AMDS use in the ICU ensures high traceability and safety in HRM management. However, high generic dispensations in other areas reveal the need for stronger controls and staff training. Hospital pharmacy is essential for leading efforts in safety strategies and educational programs to improve HRM management and patient safety across all departments.Conflict of Interest No conflict of interest