Transcript Pharmacy Technician*s Course. LaGuardia Community College

Terminology and Abbreviations
 Every 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.
Prefix
 A 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 (βίος) If you add this to
logy meaning “study of” from the Greek logos (λόγος) you get biology
meaning “study of life”
 i.e. geront0 means “old” from the Greek word, γέρων (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: anesthesia
“ante” means before/example: anterior
“anti” means inhibit/example: antibiotic
“brady” means slow/ example:bradycardia, slow heart rate
“Contra” means against/ contraindicated
“dys” means abnormal/ dysmorphic, abnormal shape
“hyper” means too much/ hyperkalemia, too much potassium
“hypo” means too little/ hypokalemia, too little potassium in the blood
“Intra” 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
skin
Tachy means fast/Tachycardia is a rapid heart rate
Important root words in Pharmacy
ROOT
MEANING
EXAMPLE
Arter
Artery
Arterial
Arthr
Joint
Arthritis
Bronch
Airway in the lung
Bronchitis
Carcino
Cancer
Carcinogen
Cardi
Heart
Cardiac
Derma
Skin
Dermatits
Enter
Intestine
Enteral nutrition
Gastr
Stomach
Gastric pain
Gluco
Sugar
Glucose meter
Hemo
Blood
Hematology
Important Root words in Pharmacy
continued
ROOT
MEANING
EXAMPLE
Hepat
Liver
Hepatitis
My
Muscle
Myalgia
Nasa
Nose
Nasal
Nephr
Kidney
Nephrology
Neur
Nerve
Neurology
Oste
Bone
Osteoporosis
Pneu
Lung
pneumonia
Procto
Rectum
Proctotitis
Pulmo
Lung
Pulmonary
Ren
Kidney
Renal
Thromb
Clot
thrombosis
Suffix
 A 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
suffixes
SUFFIX
MEANING
EXAMPLE
Ac
Pertaining to
Cardiac
Al
Pertaining to
Renal
Algia
Pain
Myalgia
Ase
Enzyme
Protease
Cyte
Cell
Hepatocyte
Ectomy
Surgical removal
Hysterectomy
Emia
Blood condition
hyperkalemia
Itis
Inflammation
Hepatitis
Logy
Study of
Cardiology
Rrhea
Flowing discharge
Diarrhea, rhinorrhea
Uro
Urine
Urology
 There 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
know
A medical dictionary is key to have and to review on a
regular basis
Learning or knowing different languages always helps
General Pharmacy Abbreviations
Meaning
Abbreviation
Adverse drug reaction
ADR
Average wholesale price
AWP
Controlled release
CR
Discontinue
DC
Dispense as written
DAW
Drug utilization review
DUR
Enteric coated
EC
Extended release
ER
Fluid
Fl.
Maximum allowable cost
MAC
No known drug allergies
NKDA
Nothing by mouth
NPO
General Pharmacy Abbreviations
Table 2
MEANING
ABBREVIATION
Over the counter
OTC
Pediatric
Ped
Prescription
Rx
Schedule 1
CI
Schedule 2
CII
Schedule 3
CIII
Schedule 4
CIV
Schedule 5
CV
Solution
Soln
Suppository
Supp
Wholesame acquisition cost
WAC
Pharmacy SIG codes
 SIG is the part of the prescription that includes the
directions for use. SIG is short for the Latin signetur
“let it be written”
 You will see on an Rx (remember this abbreviation?)
 Sig: 1 tab qd po HS
 Qnty: 30
 Refills: 1
 This means “take one tablet very day by mouth at
bedtime” dispense 30 tablets and give one refill
 We will cover this list in class.
Dangers of SIG codes and medical
abbreviation in general
 The 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 Don’t 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 JCAHO’s 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 patient’s 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 point
 In 2001, a case was report to the FDA via medwatch, see article,
http://www.fda.gov/downloads/Drugs/DrugSafety/MedicationErrors/UCM080654
 The 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 errors
 Both 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.
Milan’s List of Must Know Drugs
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
ACTIVASE®
ALTEPLASE
PULMONARY
EMBOLISM
ACCUPRIL®
QUINAPRIL
HYPERTENSION
ACTONEL®
RISEDRONATE
OSTEOPOROSIS
ADENOCARD®
ADENOSINE
RAPID HEART RATE
ALDACTONE®
SPIRONOLACTONE
HYPERTENSION
ALLEGRA®
FEXOFENADINE
ALLERGIES
ALTACE®
RAMIPRIL
HTN(?), HEART
DISEASE
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
AMARYL®
GLIMEPIRIDE
DIABETES MELLITUS
(DM)
AMBIEN®
ZOLPIDEM
INSOMNIA
AMIKIN ®
AMIKACIN SULFATE
BACTERIAL
INFECTIONS
AMOXIL ®
AMOXICILLIN
BACTERIAL
INFECTIONS
KEFZOL®
CEFAZOLIN
BACTERIAL
INFECTIONS
APRESOLINE®
HYDRALAZINE
HYPERTENSION (HTN)
ARICEPT®
DONEPEZIL
ALZHEIMER’S DISEASE
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
ASTRAMORPH PF®
MORPHINE SULFATE
POST OP PAIN,
EPIDURAL ANALGESIA
ATACAND ®
CANDESARTAN
HTN
ATARAX®
HYDROXYZINE
ALLERGIES
ATIVAN ®
LORAZEPAM
ANXIETY
ATROVENT®
IPRATROPIUM
BROMIDE
COPD, ASTHMA
AUGMENTIN ®
AMOXICILLIN/CLAVUL
ANATE, POTASSIUM
BACTERIAL
INFECTIONS
AVAPRO ®
IRBESARTAN
HTN
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
BENADRYL®
DIPHENHYDRAMINE
INSOMNIA, ALLERGY
BIAXIN®
CLARITHROMYCIN
BACTERIAL
INFECTIONS
BUSPAR®
BUSPIRONE
DEPRESSION
CALAN®
VERAPAMIL HCL
HTN, RAPID HEART
RATE
CAPOTEN®
CAPTOPRIL
HTN, CARDIAC HEART
FAILURE
CARBATROL®
CARBAMAZEPINE
SEIZURES
CARDIZEM®
DILTIAZEM
HTN, RAPID HEART
RATE
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
CATAPRES®
CLONIDINE
HTN
CEFTIN®
CEFUROXIME
BACTERIAL
INFECTIONS
CELEBREX®
CELECOXCIB
RA
CELEXA®
CITALOPRAM
DEPRESSION
CIPRO®
CIPROFLOXACIN
BACTERIAL
INFECTIONS
CLARITIN®
LORATIDINE
SESSIONAL ALLERGIES
CLEOCIN®
CLINDAMYCIN
BACTERIAL
INFECTIONS
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
COMBIVENT®
ALBUTEROL/IPRATROP
IUM
COPD
COMBIVIR®
ZIDOVUDINE/LAMIVU
DINE
HIV
CORDARONE
AMIODARONE
CARDIAC ARRTHYMIAS
COUMADIN®
WARFARIN
BLOOD CLOTTING
CRIXIVAN®
INDINAVIR MESYLATE
HIV
DEPAKOTE®
DIVALPROEX SODIUM
SEIZURES
DIABETA®
GLYBURIDE
DM
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
DIFFERIN®
ADAPALENE
ACNE
DIFLUCAN®
FLUCONAZOLE
FUNGAL INFECTION
DIGITEK® OR
LANOXIN®
DIGOXIN
HEART FAILURE
DILANTIN®
PHENYTOIN SODIUM
SEIZURES
DILAUDID ®CII
HYDROMORPHONE
HCL
PAIN
DIOVAN®
VALSARTAN
HTN
DOBUTREX®
DOBUTAMINE
HEART FAILURE, LOW
BLOOD PRESSURE
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
EFFEXOR®
VENLAFAXINE
DEPRESSION
E-MYCIN® ERY-TAB®
ERYTHROMYCIN BASE
BACTERIAL INFECTION
FEOSOL ®
FERROUS SULFATE
IRON DEFFICIENCY
FIORICET®
BUTALBITAL, CAFFEINE PAIN
AND ACETAMINOPEN
FIORINAL®
BUTALBITAL, CAFFEINE PAIN
AND ASPIRIN
FLAGYL®, METROGEL®
METRONIDAZOLE
PROTOZOAN
INFECTION
FOSAMAX®
ALENDRONATE
OSTEOPOROSIS
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
FUNGIZONE®
AMPHOTERICIN B
SEVERE FUNGAL
INFECTIONS
FURADANTIN®
NITROFURANTOIN
URINARY TRACT
INFECTIONS
GAMMAGARD®
INTRAVENOUS
IMMUNE GLOBIN
BLOOD DISORDERS
GLUCOPHAGE®
METFORMIN
DMII
GLUCOTROL®
GLIPIZIDE
DMII
HALDOL®
HALOPERIDOL
SCHIZOPRENIA,
TRANQUILIZER
HUMALOG®
HUMAN INSULIN
LISPRO
DMI AND DMII
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
HYDRODIURIL®, Esidrix®
HYDROCHLOROTHIAZI
DE
HTN
IMODIUM®
LOPERAMIDE
DIARRHEA
INDERAL®
PROPRANOLOL
HTN, CARDIAC FAILURE
IMDUR®
ISOSORBIDE
MONONITRATE
CARDIAC PAIN (ANGINA)
INTROPIN®
DOPAMINE HCL
LOW BLOOD PRESSURE
ISOSORDIL®
ISOSORBIDE DINITRATE
ANGINA
KAYEXELATE®
SODIUM POLYSTRENE
SULFONATE
HYPERKALEMIA
BRAND DRUG
GENERIC NAME
MOST COMMON
INDICATION
KEFLEX®
CEPHALEXIN
BACTERIAL
INFECTIONS
LASIX ®
FUROSEMIDE
HEART FAILURE,
EDEMA
LIPITOR®
ATORVASTATIN
HIGH CHOLESTEROL
LOPRESSOR®
METOPROLOL
TARTARATE
HTN, CARDIAC
FAILURE
LOVENOX ®
ENOXAPARIN
DVT, PE, AND MI
MAALOX®
ALUMINUM AND
MAGNESIUM
HYDROXIDE
GASTROINTESTINAL
UPSET/ACID REFLUX
MARCAIN®
BUPIVACAINE HCL
LOCAL ANESTHETIC
Most commonly abbreviated
medical conditions you will see
Medical Conditions
Abbreviation
Common meaning
Myocardial Infarction
MI
Heart attack
Congestive Heart failure
CHF
Heart muscle is dying
Atrial fibrillation
AFib
A cardiac heart beat that
is fast and abnormal
Ventricular Fibrillation
VF
A cardiac heart beat that
is fast and almost always
fatal
Cerebral Vascular
Accident
CVA
Stroke/loss of blood flow
to brain
Diabetes Mellitus
DM
A disorder of
carbohydrate metabolism
Hypertension
HTN
High blood pressure
Medical Conditions
Abbreviation
Common meaning
CABG
Coronary artery bypass
graft
Surgery to re-establish
blood flow to the heart
ATN
Acute tubular necrosis
A disorder of the kidney
RA
Rheumatoid Arthritis
A joint disease that effects
older people
RI
Renal Insufficiency
Poorly functioning
kidneys
PE
Pulmonary Embolism
A blood clot that travels
to the lung
DVT
Deep vein Thrombosis
A blood clot in the leg
that often travel to the
lung
Not an all inclusive but
include very common
conditions
Medications commonly
abbreviated
 The following medications are commonly abbreviated
in the field
 Joint Commission and the ISMP however have
established guidelines to reduce the use of such
shortcuts.
Medication Abbreviations
Abbreviation
Drug
Indication
ASA
Aspirin
Pain, post MI use
APAP
Acetaminophen
Pain, fever reducer in
children
5FU
Flurouracil
Anti cancer drug
SMX/TMP
Sulfamethoxazole/trimeth
oprim
Antibiotic
HCTZ
Hydrochlorothiazide
diuretic
INH
Isoniazid
Anti-TB (tuberculosis)
drug
6-MP
6 mercaptopurine
Immune suppressant
Medication Abbreviations
Abbreviation
Drug
Indication
NTG
Nitroglycerin
Chest pain (angina)
SSKI
Super saturated potassium
iodide
Hyperthyroidism
T4
Levothyroxine (synthroid®) hyperthyroidism
KCL
Potassium chloride
Potassium deficiency
MgSO4
Magnesium Sulfate
Magnesium deficiency
MSO4
Morphine sulfate
Pain killer
PCN
Penicillin
antibiotic
Medication Abbreviations
Abbreviation
Drug
Indication
AZT
Zidovidune
HIV
NS
Normal Saline
IV fluid
D5W
Dextrose 5% in water
IV fluid
D5WNS
Dextrose 5% in water with
normal saline
IV fluid
MVI
Multiple vitamins
Vitamin replacement
ISDN
Isosorbide dinitrate
Chest pain
MTX
Methotrexate
Cancer drug
Most Common Sig Codes in
Pharmacy
Sig Code
Meaning
Sig:
Let it be written
PC
Post Cena (after meals)
AC
Ante Cena (before meals)
UD
As directed
Ad lib
As desired
PRN
As needed
HS
At bedtime
Qd
daily
Sig
Meaning
Q
Every
Q+blank+H
Every blank hours
BID
Twice a day
TID
Three times a day
QID
Four times a day
QOD
Every other day
QW
Every week (once)
BIW
Twice a week
TIW
Three times a week
Common Routes of Administration
Route
Meaning
PO
By mouth
SL
Sublingually
BU
Buccally
INH or IN
Inhalation
IVP
Intravenous Push
IVPB
Intravenous Piggyback
IM
Intramuscular
SC or SubQ
Subcutaneously
Opth
Via the eyes
Route
Meaning
OT
Otic (via ears)
PR
Rectally
PV
Vaginally
EX
Topically
IP
Intraperitoneal
Uncommon Routes of
administration
 Certain routes are not commonly used
 Often to avoid confusion and the potential for error the
routes are spelled out on medical orders
 Example 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 labor
Used for post operative patients in PACU
Example of a drug is Fentanyl 2 mcg/ml with 0.0625% bupivacaine in
250 ml of NS
 Example 2 Intrathecal Route
 Involves passing the medication through the spinal cord
into the subarachnoid space to allow for direct bathing
of the neural tissue in the drug


Intrathecal chemotherapy i.e. methothexate, cytarabine
Intrathecal Baclofen in cerebral palsy patients
 Advantages are that very small amounts of drug can be
used leading to less side effects
 Disadvantages are high risk for infections and
inadvertent overdoses
Epidural Injection
Courtesy of:
http://richardspatafora.com/2011/05/19/lumbar-epiduralcortisone-injection/
Common Abbreviations for quantities
Abbreviation
Meaning
Mg
Milligrams
G
Grams
Gr
Grains
Ml
Millilter
L
Liter
Fl. OZ
Ounces (fluid)
Tab
Tablets
mEq
Milliequivalents
Tsp
Teaspoon
TBSP
Tablespoon
cc
Cubic centimeter (= 1 ml)
Gtt(s)
Drop(s)
Putting the Rx together
 A prescription will consist of the following elements
 Sig:
 A numerical quantity (with the dosage form)
 Route of administration
 Time Frequency
 Day supply or total quantity
 Refills
 Example:
 Vasotec 5 mg



Sig: take 1 tab qd
30 tablets
Refills: 2
 A tougher example:
 Humulin N


Sig: inject 25 units qam and 25 units qhs
Refills: 11
 Example 3
 Amoxicillin Susp 400 mg/5 ml




Sig: 1 ½ tsp TID
For 14 days
Refills: 2
Total amount to dispense for 14 days?
JCAHO’s Minimum Do not use List
 In 2004, JCAHO published its minimum do not use
list which the joint commission encourages health care
institutions it accredits to use (at a minimum)
Abbreviation
Problem
Preferred
IU
Mistaken as IV or 10
International units
MS, MSO4 or MgSO4
Confused for each other
Morphine
sulfate/magnesium
sulfate
Q.D. and QOD
Confused for each other
Daily and every other
day
Trailing zero and no
preceding zero (3.0 or .3)
10 fold overdose
possible
3 or 0.3
U
Look like 0
Use “units”
Mistake for mg
Write microgram
Mistaken for every hour
Write at bedtime
g
HS or qHS
Abbreviation
Problem
Preferred
AS, AD, AU and OS, OD,
OU
Mistaken for each other
Use “left eye”, “left ear”,
etc
DC or D/C
Mistaken for discontinue
meds
Write discharge
Cc
Mistaken for zero’s
Write mls
SC or SQ
Mistaken for SL or 5 every Use subQ or write
subcutaneously
TIW
Mistaken for three times a Write three times a week
day
Less commonly known pharmacy
terminology
Term
Meaning
Analgesic
A drug for pain
Anorectic
A drug for appetite suppression
Analeptic
A drug that stimulates the CNS
IV Admixture
A drug product made by adding the
drug to an IV bag
Anesthetic
A drug that block sensations of pain or
feeling in general
Anaphylactic Shock
A severe allergic reaction to a drug
Anticoagulant
A drug that blocks blood clotting
Antitussive
A drug that blocks coughing
Antiemetic
A drug that stop N/V
Antipruritic
A drug that stop itching
Term
Meaning
Aseptic Techniques
Techniques used in making parenteral
drug products that minimizes
microrganism contamination
Clinical Trials
Mandated by the FDA for the marketing
of new drugs in the US
Contraindication
An aspect of a patient’s condition that is
not compatable with the treatment
Emulsion
A pharmaceutic dosage form where two
immiscible liquid drugs are mixed
together
NSAID
Non steroidal anti-inflammatory drugs
Corticosteroids
Steroid drugs used in autoimmune
conditions
Glucocorticoids
Same as above. Two terms are used
interchangeable
Neuroleptics
Drugs that cause an effect on the CNS
used to refer to old type of anti
psychotic drugs like Haldol®
Term
Meaning
Narcotic
A drug that induces sleep (from the
greek word for “stupor”)
Antisialagogue
A drug that dry mucus and saliva
secretion. Used before anesthesia to dry
secretions.
NMB
Neuromuscular blocker
Suspension
A drug dosage form that consists of
suspended drug particles in aqueous
solution
Solution
A uniform homogenous mixture of a
drug in water
Ointment
A semisolid mixture of drug in oily solid
base
Troche
A drug made into a lozenge dose form
Tincture
An alcoholic mixture of a drug with at
25% V/V alcohol
Enema
A drug in a fluid vehicle delivered into
the rectum