MEDICAL ABBREVIATIONS

Abbreviations for disease states and physiologic states relevant to dosing

Term                                       Meaning                                    
ADD                                        Attention Deficit Disorder                 
ASHD                                       Arteriosclerotic Heart Disease             
BM                                         Bowel movement                             
BP                                         Blood Pressure                             
BPM                                        Beats per Minute                           
BS                                         Blood Sugar                                
Ca                                         Cancer, carcinoma                          
CHD                                        Coronary Heart Disease                     
CHF                                        Congestive Heart Failure                   
CVA                                        Cerebral Vascular Accident, stroke         
DM                                         Diabetes Mellitus                          
GERD                                       Gastro-esophageal Reflux Disease           
GI                                         Gastro-intestinal                          
ERD                                        End Stage Renal Disease                    
HA                                         Headache                                   
HBP, HTN                                   High Blood Pressure, Hypertension          
HR                                         Heart Rate                                 
IDD                                        Insulin Dependent Diabetes                 
MAP                                        Mean Arterial Pressure                     
N&V, N/V                                   Nausea and Vomiting                        
NIDD                                       Non Insulin Dependent Diabetes             
PA wedge Pressure, wedge pressure          Pulmonary artery wedge pressure            
SOB                                        Shortness of Breath                        
Temp                                       Body Temperature                           
URI                                        Upper Respiratory Infection                
UTI                                        Urinary Tract Infection                    

Abbreviations for Dosage Forms Found in Inscription, Subscription or Signa

Term       Meaning                                                                           
amp.       Ampule. A hermetically sealed glass vessel containing a sterile drug solution     
           usually used parenteral administration.  The ampule is broken and the solution    
           drawn into a syringe under aseptic conditions just prior to administration.       
           Ampules are always single dose units.  Vials are glass containers with a rubber   
           stopper through which a hypodermic needle can be inserted to remove its           
           contents.  Vials can be either single use or multiple use depending on whether    
           a bacteriostatic preservative is present in the solution.                         
cap.       Capsule.   A shell usually made of gelatin that contains the active ingredients   
           in powder or liquid form.  When the capsule is swallowed, the gelatin dissolves   
           in the acid environment of the stomach releasing the material inside.             
chart.     A divided powder, powder in a paper.  The drug or drug mixture is wrapped in      
           folded paper.  The patient unfolds the paper and transfers the contents to a      
           tablespoon or a glass and dissolves the contents in water.  This solution is      
           swallowed and washed down with water.  Archaic dosage form.                       
cr., crm.  Cream.  A semisolid preparation containing drug intended  for application to      
           body surfaces like the skin.  Creams are heterogenous systems (an oil in water    
           mixture) whose continuous phase is either aqueous or water soluble.  Creams       
           absorb into the skin leaving little oily residue.                                 
elix.      Elixir.  An oral solution containing drug, water, and some alcohol.  When the     
           active ingredients are dissolved exclusively in alcohol the dosage form is        
           called a Spirit.                                                                  
emul.      Emulsion.  A liquid, heterogenous dosage form in which a liquid oil is usually    
           dispersed in a continuous aqueous phase.  Usually the drug is dissolved in the    
           internal oil phase.  When an emulsion is used topically it is frequently called   
           a lotion.  (Topical lotions may also be called suspensions)                       
Liq.       A solution                                                                        
Lot.       A lotion.                                                                         
pulv.,     A bulk powder.  Applied directly to the skin from the container.                  
pulvis                                                                                       
sol.       Solution.  A solution of drug usually in water.  May be taken by mouth or         
           applied to skin depending on indication.                                          
supp.,     Suppository.  Firm semisolid dosage forms that are designed to be inserted into   
sup.,      a particular body opening.  The semisolid vehicle melts at body temperature       
suppos     releasing the incorporated drug into the local body fluids.  Rectal and vaginal   
           suppositories are most common.                                                    
susp.      Suspension.  A liquid, heterogenous dosage form in which a solid is dispersed     
           in the liquid.  Usually the drug is not dissolved in the dosage form.   When      
           the suspension is used topically it is frequently called a lotion.                
syr.       Syrup.  A solution that is sweet and highly viscous.                              
tab.       Tablet.  A compressed tablet of drug and other excipients which can only be       
           manufactured on an industrial scale.  Tablets are designed to break up into       
           fragments when they enter the stomach or other body fluid allowing the drug to    
           come into contact with the fluid, and dissolve.  Tablets are not pills.  Pills    
           are an older type of preparation not commonly used anymore, and have a round      
           shape  (exception - colchicine is dispensed as pills).  A Sublingual Tablet       
           (tab SL. or SL) is designed to be dissolved under the tongue.  A sublingually     
           administered drug is intended to be absorbed across the oral mucosa avoiding      
           gastrointestinal-hepatic degradation prior to entry into general circulation      
           (Example Nitroglycerine Sublingual Tablet).  Sublingual tablets should not be     
           swallowed.                                                                        
tinc.,     Tincture.  A solution containing a lot of alcohol, although other solvents may    
tr.,       be present.  Tinctures usually contain drug at high concentrations.               
tinct.                                                                                       
ung,       Ointment.  A semisolid preparation containing drug intended for application to    
unguetum,  body surfaces like the skin.  Ointments unlike creams are continuous oil based    
oint.      systems.  Ointments generally leave an oily residue on the applied surface for    
           a longer time than creams.                                                        

Abbreviations Related to the Directions for the Pharmacist - The Subscription Verbs

disp.          Dispense. Provide to the patient.                                              
div. #         Divide. The formula refers to the total amount to be made.  Divide the         
               formula into the specified number of dosage units.                             
d.t.d. #       Give such doses.  The formula refers to a single dose.  Prepare and dispense   
               a specified number of doses.                                                   
ex. aqua       in water                                                                       
f., ft.        Make.  Prepare                                                                 
M              Mix the contents of the formula                                                
N.B.           Note Well!!!  Pay attention to this.                                           
No., #         Number of units to be prepared or dispensed.                                   
S.A.,          According to the art.  A vague phrase meaning roughly "use your skill and      
Secundum       judgement"                                                                     
artem                                                                                         
tal. dos.      such doses                                                                     

Abbreviations used in the directions to the patient or instructions to care providers - The Signa

Term         Meaning                                                                          
Sig.         write the following directions on the label                                      
ad           up to, don't confuse with right ear (a.d.)                                       
appl.        apply                                                                            
c, cum       with                                                                             
dil.         dilute,  for example: dil. 5 ml in 6 oz. OJ (orange juice)                       
D/C, D.C.    Discontinue                                                                      
e.m.p., ut   as directed, in the manner prescribed                                            
dict, u.d.                                                                                    
et           and                                                                              
NMT          not more than                                                                    
NPO          Nothing by Mouth.  The patient is to receive nothing orally                      
non rep,     do not repeat, (also, no refills when not in Sig.)                               
N.R.                                                                                          
rep          repeat, (also, refill when not in Sig.)                                          
s, sine, s   without                                                                          

Abbreviations frequently used in the Prescription Formula - The Inscription

Term           Meaning                                                                        
aa., or aa     of each.  Used when two or more ingredients are present in the same amount.    
               They are listed sequentially with the symbol placed next to the last item of   
               the group which it refers.                                                     
ad             to, up to.  don't confuse with a.d. - right ear                                
Agit.          Shake.                                                                         
Alb.           White.                                                                         
ASA            aspirin.  an analgesic.                                                        
aq., aqua.     water, drinking water.  Never used in making prescriptions.                    
aq. dest.      distilled water, deionized water used in prescriptions.  Prepared by           
               distillation.                                                                  
aq. pur.       purified water USP, An official deionized water used in prescription           
               compounding.                                                                   
q.s.           a sufficient quantity.  Calculate and add the appropriate quantity to make     
               the prescription.  Example:  the amount of lactose needed to fill capsules.    
q.s. ad        a sufficient quantity up to.  Add sufficient quantity to achieve a specified   
               total weight  or volume.  Example:  amount of water needed to make 240 ml of   
               total solution.                                                                
aa q.s. ad     a sufficient quantity of each up to.  Used when more than one substance is     
               to be added in equal quantities to achieve a specified total weight or         
               volume.  For example calculate the amount of Lanolin and Petrolatum to make    
               60 g of ointment.                                                              
D5W            Dextrose Injection USP, a sterile isotonic IV Fluid (5% dextrose in water)     
HC             Hydrocortisone, a steroid hormone                                              
inj.           Injection, indicating that the injection dosage form is to be used.            
MS             Morphine Sulfate.  A narcotic analgesic                                        
NF             Natural Formulary, Indicates the ingredient should conform standards           
               prescribed in the official NF compendium                                       
NS, N.S.       Sodium Chloride Solution USP, a sterile, isotonic IV fluid (0.9% NaCl in       
               Water)                                                                         
1/2NS          0.45% Sodium Chloride for Injection, a sterile IV fluid                        
NTG            Nitroglycerine, a drug to treat angina pectoris, and other cardiovascular      
               disturbances                                                                   
TPN            Total Parental Nutrition, an intravenous feeding fluid containing              
               carbohydrates, amino acids, electrolytes, and sometimes lipids.                
USP            United States Pharmacopeia, Indicates the ingredient should conform            
               standards prescribed in the official USP compendium.                           

Units of Measure used in the Inscription-Subscription1

cc., cc        cubic centimeter, USP states 1 cc is equivalent to 1 ml                        
fl, fld.       specifies that the measure is a fluid measure                                  
g., Gm.        Gram, NB don't confuse with gr.                                                
gr., gr        Grain, NB don't confuse with g.                                                
gtt.           Drop, In general not a rigidly standardized measure.  Modern preparations      
               are dispensed with the calibrated dropper included with the manufactured       
               product.                                                                       
               Minum, NB Don't confuse with ml                                                
mcg., mcg      Microgram, NB don't confuse with mg.                                           
mEq            Milliequivalent                                                                
mg., mg        Milligram, NB don't confuse with mcg                                           
ml., mL.       Milliliter, USP states that 1 cc is equivalent to 1 ml, NB, don't confuse      
               with minum.                                                                    
mOsm, mOsmol   Milliosmole                                                                    
O.             Apothecary pint                                                                
oz.            ounce                                                                          
parts          Some formulas indicate the ratio of ingredient quantities to each other.  In   
               a formula given in terms of parts by weight, any unit of weight may be used,   
               but it must be applied to all components.  In a formula given in parts by      
               volume, any unit of volume may be used, provide that all components have the   
               same units.                                                                    
Ratio          Ratio strength is a way of representing the concentration of a formula         
Strength       component.  It is denoted in terms of total amount of solution or mixture      
               that contains one unit of solute.  A 1:25 solution of cinnamon oil means       
               that 1 ml of cinnamon oil is contained in each 25 ml of solution.  N.B. the    
               second number in the ratio does not describe the quantity of solvent, but      
               the total quantity of solution.  If the solute is a liquid the solution is     
               assumed to be a v/v mixture.  For solid solutes its assumed to be a w/v        
               mixture.  When the denominator of the ratio is 100, the concentration is       
               denoted as Percentage Strength.                                                
ss., ss        one half                                                                       
tbl.           tablespoonful, a household measure, nominal value 15 ml.                       
tsp.           teaspoonful, a household measure, nominal value, 5 ml                          
U, u, I.U.     Unit, International Unit.  potency of many antibiotics and endocrine           
               preparations are expressed in terms of official USP units.  These units are    
               specific for each substance and determined by an official USP biological       
               activity test                                                                  
1.  NB.  Sometimes the unit abbreviations for quantities are absent in the formula.  When    
absent, units for weight are presumed to be gram, g, and for volume presumed to be           
milliliter, mL                                                                               

Abbreviations used in the directions to the patient or instructions to care providers concerning Dose and Dosing Frequency - The Signa

Term           Meaning                                                                        
ad lib., prn   use when or as needed. Ex. 1 cap hs prn sleep      
a.             before                                                                         
a.c.           before meals.  Take before meals.  Usually  used in conjunction with q.d.,     
               tid etc.                                                                       
a.m.           morning, before midday                                                         
h.             hour                                                                           
d.             day                                                                            
q.             every                                                                          
q4h            every 4 hours, Also specified by the degree symbol. Ex. q 4deg.                
q.d.           every day, take one dose a day                                                 
q.o.d.         every other day, Take one dose every other day                                 
bid            twice a day, Take one dose twice a day.  N.B. does not mean every 12 hours.    
               Loosely means morning and evening.                                             
tid            three times a day,  NB. Take one dose three times a day.  N.B. does not mean   
               very 8 hours.  Loosely means morning, evening, and night.                      
qid            four times a day.  NB.  Take one dose four times a day.  N.B. does not mean    
               every 6 hours.  Loosely means morning, afternoon, evening, and night.          
t.i.w.         three times a week,  Take a dose three times a week.  For example M, W, F      
h.s.           at bed time.  Take at bedtime                                                  
ATC            around the clock,  Doses administered at equal time intervals.  Ex: q. 6 h.    
               ATC.                                                                           
m2, M2         square meter                                                                   
BSA            body surface area                                                              
p.             after                                                                          
p.c.           after meals.  Take after meals.  Usually used in conjunction with q.d., bid,   
               tid etc.                                                                       
p.m.           evening, afternoon, after midday                                               
noct.          night                                                                          
STAT           immediately, give at once                                                      
s.o.s.         if there is need.  Administer again if required.  Example:  MS 2 mg IV STAT    
               and q 30 min s.o.s. bucking ventilator                                         

Abbreviations used to indicate Route of Administration or Administration Site1.

Term            Meaning                                                                      
a.d.            right ear, (the dexter ear)                                                  
a.s.            left ear, (the sinister ear)                                                 
a.u.            both ears                                                                    
Aur             ear, ears                                                                    
D.              Right                                                                        
IA              intraarterially, inject into artery                                          
ID              intradermal, inject into skin                                                
IM              intramuscular, inject into muscle                                            
IV              intravenous, inject or infuse into vein, rate specified.  For intravenous    
                fluid therapy IV also refers to the infusion fluid.  IV bottles are          
                consecutively numbered.  Ex: IV #10 NS 1000 mL @ 125 cc/h, IV #11 D5W        
                1000 mL @ 125/hr                                                             
IMP, IV bolus   intravenous push, a rapid injection into vein                                
IVPB            intravenous piggy back. infuse solution into primary intravenous infusion,   
                rate specified   Ex:  Ampicillin 250 mg IVPB over 30 min q 6 h               
KVO             keep vein open.  A slow infusion.  The rate is set by institution policy     
                or specified used to maintain an intravenous catheter patent.                
via Hep Loc     Inject through heparin lock.  A small indwelling intravenous cannula         
                filled with a dilute heparin solution to maintain patency.  After            
                injection, the heparin lock needs to be flushed and refilled with a dilute   
                heparin solution.                                                            
Ocul            eye                                                                          
o.d.            right eye (the dexter eye)  in the right eye                                 
o.l., o.s.      left eye, (the sinister eye) in the left eye                                 
o.u.            both eyes, in each eye                                                       
p.o., per os    by mouth, take orally                                                        
R, pro rect.    rectal                                                                       
S.              left                                                                         
SL              sublingual, Place under tongue and allow to dissolve                         
subq., s.c.     subcutaneously,  inject below the skin                                       
top             topically,  apply locally to affected area                                   
vag.            vaginally                                                                    
1.  NB.  The oral route is always assumed if no route is specified for a drugs which can     
be administered orally.  If it is not possible to give the drug orally, (i.e. NPO), the      
alternative route must be explicitly specified by the prescriber.                            

THE ANATOMY OF A PRESCRIPTION

CHECKING THE DEA NUMBER

* All physician DEA bumbers begin with TWO LETTERS.

* The FIRST LETTER is always A or B.

* The SECOND LETTER is the first letter of the physicians LAST NAME.

* Add digits 1, 3, 5

* Add digits 2, 4, 6 and multiply by 2.

* Add the two totals.

* The LAST digit of the sum is the same as the last digit of the DEA number

Example:

Take DEA #                                                   AH0354213 from Dr. Alfred K.      
                                                             Hall                              
Is the 1st letter A or B?                                    Yes, it's A                       
Does the 2nd letter the same as 1st letter of the            Yes, it's H                       
physician's last name?                                                                         
Add 1st, 3rd and 5th digit:                                  0 + 5 + 2 = 7                     
Add 2nd, 4th and 6th digits and multiply by two              (3 + 4 + 1) x 2 = 16              
Add the two totals                                           7 + 16 = 23                       
Is the last digit of the sum the same as the last digit of   Yes                               
the DEA #