3 Terminology, Abbreviations, and Dispensing Prescriptions

Medical Terminology Medical terminology originated primarily from Greek and Latin prefixes, roots, and suffixes, known as word parts. Health-care professionals involved with pharmacology must be familiar with word building, common medical terms, and abbreviations.

Medical Terminology A root is the main part of a word that gives the word its central meaning. A prefix is a structure at the beginning of a word that modifies the meaning of the root. A suffix is similar in function to a prefix, but appears at the end of a word.

Table 3-1 Some Common General Prefixes

Table 3-2 Some Common General Suffixes

Combining Vowels Medical terms are formed from many different word parts. These parts are often joined by combining vowels. The most common combining vowels are the letters o and i.

Table 3-3 Abbreviations Commonly Used in Prescriptions

Table 3-3 (continued) Abbreviations Commonly Used in Prescriptions

Table 3-3 (continued) Abbreviations Commonly Used in Prescriptions

Table 3-4 Abbreviations Commonly Used for Measurements

Table 3-5 General Medical Abbreviations

Table 3-5 (continued) General Medical Abbreviations

Table 3-5 (continued) General Medical Abbreviations

Table 3-5 (continued) General Medical Abbreviations

Drug Names Chemical name: chemical makeup of a drug; often very complicated Generic name: also official, approved, or nonproprietary name; not protected by copyright Proprietary name: also brand or trade name; assigned by manufacturers and protected by copyright

Sources of Drug Derivation Plants (e.g., alkaloids) Humans/animals (e.g., hormones) Minerals (e.g., sodium, iodine, etc.) Synthetics: manufactured (e.g., oral contraceptives) Engineered: genetically engineered; (e.g., some insulins)

Drug Forms Classified by physical state (liquid, solid) and chemical composition Determine whether action is local or systemic Allow for oral, topical, mucosal, or parenteral (injectable) use

Preparations for Oral Use Oral drugs: solid or liquid forms Form influences rate of dissolution and absorption Liquids are more readily available for GI absorption than solids.

Solid Drugs Pills: powdered drug mixed with liquid and rolled into round or oval shape Tablets: powdered form of drug and bulk-filling material compressed under high pressure; various types include: Chewable, sublingual, buccal, enteric-coated, buffered, and sustained-release

Figure 3-1 Solid drug forms. Al Dodge Figure 3-1 Solid drug forms.

Solid Drugs Capsules: external shell usually made of gelatin contains drug in powder, granule, liquid, or combination form Enteric-coating: prevents capsule or tablet from being dissolved in stomach where it may cause irritation; absorption occurs in intestines

Solid Drugs Caplets: shaped like capsules with form of tablets; film-coated for easy swallowing Gelcaps: oil-based drug in soft gelatin capsules

Figure 3-2 Examples of tablets. Al Dodge Figure 3-2 Examples of tablets.

Figure 3-3 Examples of capsules. Al Dodge Figure 3-3 Examples of capsules.

Figure 3-4 Examples of gelcaps. Al Dodge Figure 3-4 Examples of gelcaps.

Solid Drugs Powders: dried and finely ground drugs Granules: tiny pills usually in gelatin capsules; usually intended for gradual release Troches or lozenges: flattened disks that may be hard or semisolid (e.g., cough suppressants)

Liquid Drugs Syrups and linctuses: aqueous solutions containing high concentrations of sugars Solutions: drugs dissolved in appropriate solvent Elixirs: solutions of water, alcohol, and sugar

Liquid Drugs Infants and young children are not able to take solid drug forms such as tablets or capsules. Liquid drugs should be used.

Liquid Drugs Fluid extracts: concentrated drug solutions from plant source mixed with suitable solvent, usually alcohol Mixtures or suspensions: drug agent mixed with liquid but not dissolved; must be shaken before administration

Liquid Drugs Tinctures: alcoholic preparations of soluble drugs, usually from plant source Emulsions: preparations combining two elements (such as oil and water) that cannot ordinarily be mixed Spirits or essences: alcoholic liquids that may be used pharmaceutically as solvents

Storing Drugs That Contain Alcohol Elixirs, spirits, tinctures, and fluidextracts contain alcohol. Keep them tightly sealed so that the alcohol cannot evaporate. Store them in a dark place as specified on label.

Liquid Drugs Aerosols: frequently delivered by oral inhalers or nebulizers for rapid absorption into blood circulation Magmas: particles suspended in liquid; more pasty in consistency than other suspensions

Topical Drugs: Semisolids Creams: semisolids in both aqueous and oily base (e.g., benzoyl peroxide) Ointments: similar to creams; used for local protective, soothing, astringent, or transdermal systemic effects (e.g., zinc oxide) Plasters: combination liquids and powders that harden when dry (e.g., salicylic acid)

Topical Drugs: Liquids Liniments: liquid suspensions for external application to skin Gels or jellies: jellylike substances used for topical application Lotions: suspensions of drugs in water base for external use

Injectable Drugs Provide rapid response; also called parenteral Available as powders or solutions Administered by following methods: Intra-articular Intradermal Intramuscular (IM) Epidural Subcutaneous Intravenous (IV)

Other Forms of Medications Ophthalmic: eye drops and ointments Otic: ear medications Nasal: nose drops or sprays Vaginal: solutions, creams, tablets, suppositories Rectal: suppositories or enemas Inhalation: anesthetic gases, compressed gases, bronchodilators

Figure 3-5A Examples of otic drops. © Elena Dorfman. Dorling Kindersley, Ltd Figure 3-5A Examples of otic drops. © Elena Dorfman.

Figure 3-5B Examples of ophthalmic drops. Captured by Sarah Hill / Flickr / Getty Images Figure 3-5B Examples of ophthalmic drops.

Figure 3-5C Examples of nasal drops.

Safe Storage of Drugs Do not expose medicines to sunlight, bright light, moisture, or extremes in temperatures. Store insulin and vaccine preparations in a refrigerator according to the manufacturer’s directions.

Dispensing Drugs Over-the-counter (OTC) drugs: available for self-medication; do not require prescription Legend drugs: require prescription from licensed practitioner (physicians, dentists, veterinarians, etc.)

Contents of Prescriptions Name and address of patient and Date Address of prescriber’s office Medication prescribed (inscription) Rx symbol (superscription) Dispensing directions (subscription) Directions for patient (signa)

Contents of Prescriptions Refill and special labeling Prescriber’s signature, license or DEA number

Figure 3-6 Example of a physician’s prescription Figure 3-6 Example of a physician’s prescription. (A) The prescriber’s office name, address, and phone number. (B) The patient’s name, address, and date of prescription. (C) The super-scription (“Rx” symbol). (D) The inscription (names and quantities of ingredients). (E) The subscription (tells the pharmacist how many units of medication are needed). (F) The signature (Sig), which tells the patient how to take the medication. (G) Signature blank(s), where the prescriber signs. (H) The repetatur (which tells how many refills are allowed).

Telephone Orders and Standing Orders Prescribed by physicians who cannot be present at time of administration Telephone orders: must be followed up with written drug order Standing orders: ongoing prescriptions in hospitals, nursing homes, or residential care settings; must be signed and dated

Hospital Drug Charts Also known as physician order sheets; must be transcribed onto medication administration record (MAR) and include: Approved drug names All instances when drugs are administered or not administered (including reasons) Nurse-initiated therapy (with physician countersignature)

Figure 3-7 Medical administration record as used in many hospitals.