Pharmacy Technicians Course. LaGuardia Community College
Terminology and AbbreviationsEvery profession has its own unique
language.In the worlds of finance, accounting and equity markets,
analysts look at P & L statements, statements of cash flow,
accounts receivables, etc.The medical professions have their own
unique language. These terms are usually combinations of prefixes,
root words, and suffixes.The terms have their roots in Greek and
Latin. Some knowledge of Greek/Latin will help you in figuring out
this complex world of medical terminology.PrefixA word that when
attached to the beginning of a root word modifies it in
someway.i.e. Bio means life from the Greek word bios () If you add
this to logy meaning study of from the Greek logos () you get
biology meaning study of lifei.e. geront0 means old from the Greek
word, (geront) meaning old man and you add this to logy you get
gerontology, meaning the study of the social, physiologically and
mental aspects of aging. Geriatrics is the branch of medicine that
studies disease in elderly people.A harder one: glio means gluey in
Greek and glial cells in the brain refers to cells that support
other cells in the brain. Blasto comes from a Greek word meaning
sprouting and refers in science to a developing cell. When this two
prefixes are added to oma (typically refers to cancer cells) you
have the word glioblastoma meaning a cancer of young glial cells in
the brain and is the most highly malignant type of brain
cancer.Important Prefixes for pharmacy (other listed in text
book)an means without/ example: anesthesiaante means
before/example: anterioranti means inhibit/example: antibioticbrady
means slow/ example:bradycardia, slow heart rateContra means
against/ contraindicateddys means abnormal/ dysmorphic, abnormal
shapehyper means too much/ hyperkalemia, too much potassiumhypo
means too little/ hypokalemia, too little potassium in the
bloodIntra means within/ intradermal (within the skin), intervenous
(within a vein)micro means very small or can mean (1 per 1,000,000)
in the metric system i.e. microgram (one millionth of a gram)neo
means new/ neonate is a newly born baby.poly means too many/
polypharmacy is used to mean the practice of prescribing to many
medications for the same purpose.Sub means below/ sublingual means
below the tongue. Subcutaneous means below the skinTachy means
fast/Tachycardia is a rapid heart rate
Important root words in Pharmacy
ROOTMEANINGEXAMPLEArterArteryArterialArthrJointArthritisBronchAirway
in the
lungBronchitisCarcinoCancerCarcinogenCardiHeartCardiacDermaSkinDermatitsEnterIntestineEnteral
nutritionGastrStomachGastric painGlucoSugarGlucose
meterHemoBloodHematologyImportant Root words in Pharmacy
continuedROOTMEANINGEXAMPLEHepatLiverHepatitisMyMuscleMyalgiaNasaNoseNasalNephrKidneyNephrologyNeurNerveNeurologyOsteBoneOsteoporosisPneuLungpneumoniaProctoRectumProctotitisPulmoLungPulmonaryRenKidneyRenalThrombClotthrombosisSuffixA
suffix is a word that is added at the end of a root word to
indicate or qualify its meaning. For example, arthr (joint) plus
itis yields the word arthritis which meaning inflammation of a
joint.
Important Pharmacy related
suffixesSUFFIXMEANINGEXAMPLEAcPertaining to CardiacAlPertaining
toRenalAlgiaPainMyalgiaAseEnzymeProteaseCyteCellHepatocyteEctomySurgical
removalHysterectomyEmiaBlood
conditionhyperkalemiaItisInflammationHepatitisLogyStudy
ofCardiologyRrheaFlowing dischargeDiarrhea,
rhinorrheaUroUrineUrologyThere are literally hundred of root words
and prefixes and suffixes. These list is not all inclusive by any
means.It is based on my experience on what is important to knowA
medical dictionary is key to have and to review on a regular
basisLearning or knowing different languages always helps
General Pharmacy AbbreviationsMeaningAbbreviationAdverse drug
reactionADRAverage wholesale priceAWPControlled
releaseCRDiscontinueDCDispense as writtenDAWDrug utilization
reviewDUREnteric coatedECExtended releaseERFluidFl.Maximum
allowable costMACNo known drug allergiesNKDANothing by
mouthNPOGeneral Pharmacy Abbreviations Table
2MEANINGABBREVIATIONOver the counterOTCPediatricPedPrescription
RxSchedule 1CISchedule 2CIISchedule 3CIIISchedule 4CIVSchedule
5CVSolutionSolnSuppositorySuppWholesame acquisition costWACPharmacy
SIG codesSIG is the part of the prescription that includes the
directions for use. SIG is short for the Latin signetur let it be
writtenYou will see on an Rx (remember this abbreviation?)Sig: 1
tab qd po HSQnty: 30Refills: 1This means take one tablet very day
by mouth at bedtime dispense 30 tablets and give one refillWe will
cover this list in class.
Dangers of SIG codes and medical abbreviation in generalThe
Institute of Safe Medication Practices (ISMP) publishes a list of
unsafe medication codes whether SIG codes or other codes for which
many hospitals and institutions adhere to in the goal of preventing
medication related errors.The Joint Commission on the Accreditation
of Healthcare Organizations (JCAHO) also in collaboration with the
ISMP publishes a minimum Dont abbreviate List (Do not use list)that
healthcare organization must include. We will cover this list in
class in our discussion.Both the ISMP and JCAHOs do not use list
apply to all health related communication between healthcare
practitioners. This means that in addition to drug orders, these
abbreviation are not to be used anywhere in a patients chart,
documentation or reports.The Institute of Medicine (IOM) in 1999
published a report stating that between 44,000 and 96,000 deaths
each year happen due to medical errors, many because of unclear
abbreviations and codes
Case in pointIn 2001, a case was report to the FDA via medwatch,
see article,
http://www.fda.gov/downloads/Drugs/DrugSafety/MedicationErrors/UCM080654The
case involved an infant transferred from an obstetrics unit to a
nursery for well babies with an order for DTO 0.7 ml PO q4h.The
pharmacist in the case recognized the order as deodorized tincture
of opium USP, which has a concentration of 60 mg/ml morphine. The
prescribed dose translates into give 0.7 ml (42 mg) by mouth every
four hours. This dose is 252 mg per day of morphine, a dose that
can kill or send a newborn baby to the hospital for respiratory
arrest.The pharmacist verified the order as diluted tincture of
opium which is 25 fold dilution of the original drug. The actual
dose is 0.7 ml(1.6 mg) by mouth every four hours.
How to report medication errorsBoth patients and healthcare
providers can report errors involving medications to the ISMP
through its website, www.ismp.org. Click onto the MERP, medication
error reporting program.United States Pharmacopeia, www.medmarx.com
collects medication errors and adverse events data.
Milans List of Must Know DrugsBRAND DRUGGENERIC NAMEMOST COMMON
INDICATIONACTIVASEALTEPLASEPULMONARY
EMBOLISMACCUPRILQUINAPRILHYPERTENSIONACTONELRISEDRONATEOSTEOPOROSISADENOCARDADENOSINERAPID
HEART
RATEALDACTONESPIRONOLACTONEHYPERTENSIONALLEGRAFEXOFENADINEALLERGIESALTACERAMIPRILHTN(?),
HEART DISEASEBRAND DRUGGENERIC NAMEMOST COMMON
INDICATIONAMARYLGLIMEPIRIDEDIABETES MELLITUS
(DM)AMBIENZOLPIDEMINSOMNIAAMIKIN AMIKACIN SULFATEBACTERIAL
INFECTIONSAMOXIL AMOXICILLINBACTERIAL
INFECTIONSKEFZOLCEFAZOLINBACTERIAL
INFECTIONSAPRESOLINEHYDRALAZINEHYPERTENSION
(HTN)ARICEPTDONEPEZILALZHEIMERS DISEASEBRAND DRUGGENERIC NAMEMOST
COMMON INDICATIONASTRAMORPH PFMORPHINE SULFATEPOST OP PAIN,
EPIDURAL ANALGESIAATACAND
CANDESARTANHTNATARAXHYDROXYZINEALLERGIESATIVAN
LORAZEPAMANXIETYATROVENTIPRATROPIUM BROMIDECOPD, ASTHMAAUGMENTIN
AMOXICILLIN/CLAVULANATE, POTASSIUMBACTERIAL INFECTIONSAVAPRO
IRBESARTANHTNBRAND DRUGGENERIC NAMEMOST COMMON
INDICATIONBENADRYLDIPHENHYDRAMINEINSOMNIA,
ALLERGYBIAXINCLARITHROMYCINBACTERIAL
INFECTIONSBUSPARBUSPIRONEDEPRESSIONCALANVERAPAMIL HCLHTN, RAPID
HEART RATECAPOTENCAPTOPRILHTN, CARDIAC HEART
FAILURECARBATROLCARBAMAZEPINESEIZURESCARDIZEMDILTIAZEMHTN, RAPID
HEART RATEBRAND DRUGGENERIC NAMEMOST COMMON
INDICATIONCATAPRESCLONIDINEHTNCEFTINCEFUROXIMEBACTERIAL
INFECTIONSCELEBREXCELECOXCIBRA
CELEXACITALOPRAMDEPRESSIONCIPROCIPROFLOXACINBACTERIAL
INFECTIONSCLARITINLORATIDINESESSIONAL
ALLERGIESCLEOCINCLINDAMYCINBACTERIAL INFECTIONSBRAND DRUGGENERIC
NAMEMOST COMMON
INDICATIONCOMBIVENTALBUTEROL/IPRATROPIUMCOPDCOMBIVIRZIDOVUDINE/LAMIVUDINEHIV
CORDARONEAMIODARONECARDIAC ARRTHYMIASCOUMADINWARFARINBLOOD
CLOTTINGCRIXIVANINDINAVIR MESYLATEHIVDEPAKOTEDIVALPROEX
SODIUMSEIZURESDIABETAGLYBURIDEDMBRAND DRUGGENERIC NAMEMOST COMMON
INDICATIONDIFFERINADAPALENEACNEDIFLUCANFLUCONAZOLEFUNGAL
INFECTIONDIGITEK OR LANOXINDIGOXINHEART FAILUREDILANTINPHENYTOIN
SODIUMSEIZURESDILAUDID CIIHYDROMORPHONE
HCLPAINDIOVANVALSARTANHTNDOBUTREXDOBUTAMINEHEART FAILURE, LOW BLOOD
PRESSUREBRAND DRUGGENERIC NAMEMOST COMMON
INDICATIONEFFEXORVENLAFAXINEDEPRESSIONE-MYCIN ERY-TABERYTHROMYCIN
BASEBACTERIAL INFECTIONFEOSOL FERROUS SULFATEIRON
DEFFICIENCYFIORICETBUTALBITAL, CAFFEINE AND
ACETAMINOPENPAINFIORINALBUTALBITAL, CAFFEINE AND ASPIRINPAINFLAGYL,
METROGELMETRONIDAZOLEPROTOZOAN
INFECTIONFOSAMAXALENDRONATEOSTEOPOROSISBRAND DRUGGENERIC NAMEMOST
COMMON INDICATIONFUNGIZONEAMPHOTERICIN BSEVERE FUNGAL
INFECTIONSFURADANTINNITROFURANTOINURINARY TRACT
INFECTIONSGAMMAGARDINTRAVENOUS IMMUNE GLOBINBLOOD
DISORDERSGLUCOPHAGEMETFORMINDMIIGLUCOTROLGLIPIZIDEDMIIHALDOLHALOPERIDOLSCHIZOPRENIA,
TRANQUILIZERHUMALOGHUMAN INSULIN LISPRODMI AND DMIIBRAND
DRUGGENERIC NAMEMOST COMMON INDICATIONHYDRODIURIL,
EsidrixHYDROCHLOROTHIAZIDEHTNIMODIUMLOPERAMIDEDIARRHEAINDERALPROPRANOLOLHTN,
CARDIAC FAILUREIMDURISOSORBIDE MONONITRATECARDIAC PAIN
(ANGINA)INTROPINDOPAMINE HCLLOW BLOOD PRESSUREISOSORDILISOSORBIDE
DINITRATEANGINAKAYEXELATESODIUM POLYSTRENE
SULFONATEHYPERKALEMIABRAND DRUGGENERIC NAMEMOST COMMON
INDICATIONKEFLEXCEPHALEXINBACTERIAL INFECTIONSLASIX FUROSEMIDEHEART
FAILURE, EDEMALIPITORATORVASTATINHIGH
CHOLESTEROLLOPRESSORMETOPROLOL TARTARATEHTN, CARDIAC FAILURELOVENOX
ENOXAPARINDVT, PE, AND MIMAALOXALUMINUM AND MAGNESIUM
HYDROXIDEGASTROINTESTINAL UPSET/ACID REFLUXMARCAINBUPIVACAINE
HCLLOCAL ANESTHETICMost commonly abbreviated medical conditions you
will see Medical ConditionsAbbreviationCommon meaningMyocardial
InfarctionMIHeart attackCongestive Heart failureCHFHeart muscle is
dyingAtrial fibrillationAFibA cardiac heart beat that is fast and
abnormalVentricular Fibrillation
VFA cardiac heart beat that is fast and almost always
fatalCerebral Vascular AccidentCVA
Stroke/loss of blood flow to brainDiabetes MellitusDMA disorder
of carbohydrate metabolismHypertensionHTNHigh blood pressureMedical
ConditionsAbbreviationCommon meaningCABGCoronary artery bypass
graftSurgery to re-establish blood flow to the heartATNAcute
tubular necrosisA disorder of the kidneyRARheumatoid ArthritisA
joint disease that effects older peopleRIRenal InsufficiencyPoorly
functioning kidneysPEPulmonary EmbolismA blood clot that travels to
the lung DVTDeep vein ThrombosisA blood clot in the leg that often
travel to the lungNot an all inclusive but include very common
conditionsMedications commonly abbreviatedThe following medications
are commonly abbreviated in the fieldJoint Commission and the ISMP
however have established guidelines to reduce the use of such
shortcuts.Medication
AbbreviationsAbbreviationDrugIndicationASAAspirinPain, post MI
useAPAPAcetaminophenPain, fever reducer in
children5FUFlurouracilAnti cancer
drugSMX/TMPSulfamethoxazole/trimethoprimAntibioticHCTZHydrochlorothiazidediureticINHIsoniazidAnti-TB
(tuberculosis) drug6-MP6 mercaptopurineImmune suppressantMedication
AbbreviationsAbbreviationDrugIndicationNTGNitroglycerinChest pain
(angina)SSKISuper saturated potassium
iodideHyperthyroidismT4Levothyroxine
(synthroid)hyperthyroidismKCLPotassium chloridePotassium
deficiencyMgSO4Magnesium SulfateMagnesium deficiencyMSO4Morphine
sulfatePain killerPCNPenicillin antibioticMedication
AbbreviationsAbbreviationDrugIndicationAZTZidoviduneHIV NSNormal
SalineIV fluidD5WDextrose 5% in waterIV fluidD5WNSDextrose 5% in
water with normal salineIV fluidMVIMultiple vitaminsVitamin
replacementISDNIsosorbide dinitrateChest painMTXMethotrexateCancer
drugMost Common Sig Codes in PharmacySig CodeMeaningSig:Let it be
writtenPCPost Cena (after meals)ACAnte Cena (before meals)UDAs
directedAd libAs desiredPRNAs neededHSAt
bedtimeQddailySigMeaningQEveryQ+blank+HEvery blank hoursBIDTwice a
dayTIDThree times a dayQIDFour times a dayQODEvery other dayQWEvery
week (once)BIWTwice a weekTIWThree times a weekCommon Routes of
AdministrationRouteMeaningPOBy mouthSLSublinguallyBUBuccallyINH or
INInhalationIVPIntravenous PushIVPBIntravenous
PiggybackIMIntramuscularSC or SubQSubcutaneouslyOpthVia the
eyesRouteMeaningOTOtic (via
ears)PRRectallyPVVaginallyEXTopicallyIPIntraperitonealUncommon
Routes of administrationCertain routes are not commonly usedOften
to avoid confusion and the potential for error the routes are
spelled out on medical ordersExample 1 Epidural Medication is given
just outside the spinal cord next to the dura mater.Used in cases
where high doses of pain medications are needed but side effects
need to be minimized.Used in obstetrics ward in women undergoing
laborUsed for post operative patients in PACUExample of a drug is
Fentanyl 2 mcg/ml with 0.0625% bupivacaine in 250 ml of NS
Example 2 Intrathecal RouteInvolves passing the medication
through the spinal cord into the subarachnoid space to allow for
direct bathing of the neural tissue in the drugIntrathecal
chemotherapy i.e. methothexate, cytarabineIntrathecal Baclofen in
cerebral palsy patientsAdvantages are that very small amounts of
drug can be used leading to less side effectsDisadvantages are high
risk for infections and inadvertent overdosesEpidural Injection
Courtesy of:
http://richardspatafora.com/2011/05/19/lumbar-epidural-cortisone-injection/Common
Abbreviations for
quantitiesAbbreviationMeaningMgMilligramsGGramsGrGrainsMlMillilterLLiterFl.
OZOunces
(fluid)TabTabletsmEqMilliequivalentsTspTeaspoonTBSPTablespoonccCubic
centimeter (= 1 ml)Gtt(s)Drop(s)Putting the Rx togetherA
prescription will consist of the following elementsSig:A numerical
quantity (with the dosage form)Route of administrationTime
FrequencyDay supply or total quantityRefills Example:Vasotec 5
mgSig: take 1 tab qd30 tabletsRefills: 2 A tougher example:Humulin
NSig: inject 25 units qam and 25 units qhsRefills: 11Example
3Amoxicillin Susp 400 mg/5 mlSig: 1 tsp TIDFor 14 daysRefills:
2Total amount to dispense for 14 days?JCAHOs Minimum Do not use
ListIn 2004, JCAHO published its minimum do not use list which the
joint commission encourages health care institutions it accredits
to use (at a minimum)
AbbreviationProblemPreferred IUMistaken as IV or 10International
unitsMS, MSO4 or MgSO4Confused for each otherMorphine
sulfate/magnesium sulfateQ.D. and QODConfused for each otherDaily
and every other dayTrailing zero and no preceding zero (3.0 or
.3)10 fold overdose possible3 or 0.3ULook like 0Use unitsMistake
for mgWrite microgramHS or qHSMistaken for every hourWrite at
bedtime
gAbbreviationProblemPreferredAS, AD, AU and OS, OD, OUMistaken
for each otherUse left eye, left ear, etcDC or D/CMistaken for
discontinue medsWrite dischargeCcMistaken for zerosWrite mlsSC or
SQMistaken for SL or 5 everyUse subQ or write
subcutaneouslyTIWMistaken for three times a dayWrite three times a
weekLess commonly known pharmacy terminologyTermMeaningAnalgesicA
drug for painAnorecticA drug for appetite suppressionAnalepticA
drug that stimulates the CNSIV AdmixtureA drug product made by
adding the drug to an IV bagAnestheticA drug that block sensations
of pain or feeling in generalAnaphylactic ShockA severe allergic
reaction to a drugAnticoagulantA drug that blocks blood
clottingAntitussiveA drug that blocks coughingAntiemeticA drug that
stop N/VAntipruriticA drug that stop itchingTermMeaningAseptic
TechniquesTechniques used in making parenteral drug products that
minimizes microrganism contaminationClinical TrialsMandated by the
FDA for the marketing of new drugs in the USContraindicationAn
aspect of a patients condition that is not compatable with the
treatmentEmulsionA pharmaceutic dosage form where two immiscible
liquid drugs are mixed togetherNSAIDNon steroidal anti-inflammatory
drugsCorticosteroidsSteroid drugs used in autoimmune
conditionsGlucocorticoidsSame as above. Two terms are used
interchangeableNeurolepticsDrugs that cause an effect on the CNS
used to refer to old type of anti psychotic drugs like
HaldolTermMeaningNarcoticA drug that induces sleep (from the greek
word for stupor)AntisialagogueA drug that dry mucus and saliva
secretion. Used before anesthesia to dry
secretions.NMBNeuromuscular blockerSuspensionA drug dosage form
that consists of suspended drug particles in aqueous
solutionSolutionA uniform homogenous mixture of a drug in
waterOintmentA semisolid mixture of drug in oily solid baseTrocheA
drug made into a lozenge dose formTinctureAn alcoholic mixture of a
drug with at 25% V/V alcoholEnemaA drug in a fluid vehicle
delivered into the rectumTermMeaningNACDSNational Association of
chain drug storesAphAAmerican Pharmaceutical AssociationNDCNational
drug code issued by the FDA. The first five digits are the
manufacturer; the second set of four digits are the drug, dose,
dosage form; the third set of two number is the package sizeUPC
codeBarcoded drug informationCOGSCost of goods soldMARMedication
administration recordeMARElectronic medication administration
recordASHPAmerican society of health system
pharmacistsTermMeaningBioavailabilityThe amount of drug that
reaches the blood stream from a route of administration other than
intravenousBioequivalenceThe comparison of bioavailability between
two dosage formsEnterohepatic circulationThe excretion of the drug
from the liver in the bile flow and its reaborption back to the
liverFirst PassThe amount of drug that is metabolized by the liver
before it reaches the blood, i.e. expressed as a percentage.
Example is LidocaineGeometric dilutionThe mixing of powder of
unequal sizesGlomerular FiltrationThe process of kidney filtration
of the bloodOrange BookThe FDA official collection of approved
drugsOBRA 90Omnibus budget reconciliation act of 1990 which require
pharmacists counselingTermMeaningEnteral or AlimentaryDescribes the
organs of digestion and nutrient absorption from the mouth to the
anusAseptic techniqueA technique used in the manipulation of a IV
products to maintain their sterile conditionUSP 797A standard
published by the USP to provide guidance in the use of aseptic
techniqueAuxiliary LabelAn extra label placed on a dispensed
product that may add information for the patientExtemporaneous
CompoundingThe preparation of a patient specific drug
productHypersensitivityEqual to allergic drug reaction; anaphylaxis
is the most severe typeTeratogenicityA characteristic of drug that
produces known birth defects