Prescriptions

Interpreting Prescription Orders (Rx)

Sig Codes - Rx Abbreviations

The lingo "sig" refers to a string of

Prescription Abbreviations
found on a drug order.

When the sig is properly decoded, it becomes the directions for the preparation and use of the
medication.

This is important because it tells pharmacy technicians how to dispense it. The sig is also printed on the
container the prescription is dispensed in, but, translated into regular words for the patient to read.

Besides decoding a prescription's sig, there are several other concerns. There are refill limits, DEA laws,
PPPA requirements, patient requests and many other considerations. Pharmacy technicians must know
with certainty how to decode prescription orders.

Prescription order expiration dates

A prescription order must be dated, and it has an appropriate expiration date based on the type of drug
ordered. If it's not filled in time, the script expires.

No
DEA Sch II
Expiration

DEA Sch III thru V 6 Months

Legend Drugs 12 Months

Refills

If refills are allowed by the prescriber, it will be noted on the prescription. However, there
are boundaries and limitations. These are the guidelines:

DEA Schedule II NO REFILLS ALLOWED

DEA Schedule III thru V up to 5, but only 5 times*

Legend Drugs up to 12 Months worth

*If a patient has a Sch 3-5 prescription with 5 refills of 100, but can only afford 50 at a time,
they will only get 250 total. (not 500) Period. Each time a refill is redeemed, that refill is
then voided. So, if you are authorized a refill of 100, but only get 50, you then forfeit the
other 50.

Generic Substitutions

Generic drug substitutions may not be used unless the prescriber has authorized
it. Generic substitutions may only be used if the prescriber has requested or authorized
them.

DEA Controlled Drug Prescriptions

→ Must contain at least :

 Date of prescription issue

 Patient's name and address
 Practitioner's name, address, and phone number
 Drug name
 Drug strength
 Dosage form and instructions
 Exact quantity prescribed
 Complete directions for use
 Number of refills authorized
 Have a valid DEA Number

Schedule II drug prescriptions also:

→ Must be manually signed by the practitioner. No exceptions.
→ May not be Faxed or Called in, except for a valid emergency.
→ May not have any refills.

Common Pharmacy Abbreviations

These must be memorized (mandatory)

q - EVERY
qH - EVERY HOUR
qAM - EVERY MORNING
qPM - EVERY EVENING
qHS - EVERY BEDTIME
qD - EVERY DAY
qOD - EVERY OTHER DAY
qWK - EVERY WEEK
qMO - EVERY MONTH
q__° - EVERY___HOURS
q__H - EVERY___HOURS
BID - TWICE A DAY
TID - THREE A DAY
QID - FOUR A DAY
X_D - TIMES__DAYS
TDS - 3 TIMES A DAY
C - WITH
AC - BEFORE A MEAL
PC - AFTER A MEAL
HS - AT BEDTIME
PRN - AS NEEDED
UD - AS DIRECTED
AA - OF EACH
QS - QUANTITY SUFFICIENT
GTT - DROP

The most difficult pharmacy abbreviations to remember are the eyes and ears. They are
very easy to mix up, especially because they seem to make no sense.

Try this:
When you see the O, think of an EYE which is round.
For the A, remember it as "Audio" which is heard through yourEARS.
For S, think of "South" and Lef handed boxers being dubbed southpaw.
When you see U, imagine it as a face, needing both eyes or ears.

More Prescription Abbreviations

TBSP - TABLESPOON
TSP - TEASPOON
OZ - OUNCE
GM - GRAM
KG - KILOGRAM
LB - POUND
ML - MILLILITER
L - LITER
G - GALLON
OD - RIGHT EYE
OS - LEFT EYE
OU - BOTH EYES
AD - RIGHT EAR
AS - LEFT EAR
AU - BOTH EARS
PO - BY MOUTH / ORAL
SL - SUB-LINGUAL
NG - NASO GASTRIC
BUCCAL - CHEEK/GUM
PR - RECTALLY
PV - VAGINALLY
SUPP - SUPPOSITORY
TAB - TABLET
CAP - CAPSULE
IM - INTRA MUSCULAR
SQ - SUB-CUTANEOUS
IV - INTRAVENOUS
IC - INTRA CARDIAC
INJ - INJECTION
STAT - IMMEDIATELY

Generic Drug Suffix Chart

Suffix Drug Class

CHOLESTEROL
STATIN
(HMG CoA Reductase Inhibitor)
PROTON PUMP
RAZOLE
INHIBITOR
A2RB
ARTAN
(Angiotensin 2 receptor blocker)
BENZODIAZEPINES
PAM
(BENZOS)
OLOL BETA BLOCKER
ACE INHIBITOR
PRIL
(Angiotensin Converting Enzyme)
AZOSIN ALPHA BLOCKER
 ITIDINE H2 ANTAGONIST
PENICILLIN
CILLIN
ANTI-BIOTICS
FLUOROQUINOLONE
FLOXACIN
ANTIBIOTICS
TETRACYCLINE
CYCLINE
ANTIBIOTICS
MACROLIDE
ROMYCIN
ANTIBIOTICS
LAX LAXATIVE
VIR ANTI-VIRAL
Common dosage forms

Enteral medications are given orally and pass through the GI tract to be absorbed into the bloodstream
and metabolized by the liver. This includes oral, naso-gastric, and rectal routes.

Parenteral medications are injected or placed into the body tissues and do not pass through the liver
before entering the bloodstream. This can include injections, topical and inhalation routes. Generally in
pharmacy, parenteral refers to injection. Topical and inhalation routes are separated into their own
routes of administration.

Injectable drugs are usually in the form of solutions or powders, which are mixed with a sterile diluent to
render an injectable solution.

Inhalation routes of administration are inhaled through the mouth or the nose and usually act directly
on the respiratory system before entering into the bloodstream. They are often used to treat respiratory
diseases, but gases are inhaled for general anesthesia as well.

Topical dosages are applied to the skin surface or a mucous membrane.

Dosage Form Table:

Enteral Oral Preparations

To form a Tablet the drug is combined with fillers and is then compressed into a hard
pellet. There are various shapes, sizes and colors of tablets. Tablets are available in fast
acting, slow release, controlled release, enteric coated, film coated, sublingual, chewable
Tablets
and other formulations. Not all oral Dosage Forms / tablets are swallowed.
Sublingual (SL) tablets are placed under the tongue, wafers are placed on the tongue
and BUCCAL tablets are placed between the cheek and the gum.

Capsules To form a Capsule the drug is contained in a cylindrically shaped shell, which breaks open
 and the drug is released. This includes gelatin capsules.

Caplet A Caplet is an oval-shaped tablet.

Oral Solutions The drug is dissolved completely into a liquid form.

Oral The drug is mixed with, but not completely dissolved into a liquid. It needs to be shaken
Suspensions before administration in order to suspend the drug particles evenly.

Syrups Contain a high concentration of sucrose or sugar to sweeten, for ease of use.

Elixirs Elixirs contain between 5% and 40% alcohol.

Tinctures May contain as little as 17% alcohol or as much as 80% alcohol.

An Emulsion is a suspension involving one liquid in a second liquid with which the first will
Emulsions
not mix. (oil in water or water in oil)

Drugs which are in a powder form and are usually dissolved in juice or water before
Oral powders
administration

Lozenge and Lozenges and Troches are meant to be dissolved slowly in the mouth and generally have a
Troche local effect.

Rectal Solid or semi-solid bullet shaped dosage forms. They melt at body temperature, dispersing
Suppositories the medication.

Enemas Drug is suspended in a solution and infused into the rectum.

Transdermal A medicated adhesive patch applied directly on the skin to deliver a specific dosage of a
patch drug. They have systemic effects and should be rotated to different sites on the body.

Inhaled through the mouth or nose and usually act directly on the respiratory system
Inhalation before entering into the bloodstream. They are often used to treat respiratory diseases, but
gases are inhaled for general anesthesia as well.

Dosage Form Table:

Parenteral Injectable Preparations

Epidural Injected into the dura matter (epidural space) of the spinal cord.

Injected into the vein. This allows for immediate adsorption. Intravenous includes IV
Intravenous
push, IV piggyback and IV infusion or drip.

Intramuscular Injected into the muscle.

Subcutaneous Injected into the fatty layer under the skin.

Intradermal Injected into the top layer of the skin at a slight angle.

Intracardiac Injected into the heart.

Intraocular Injected within the eye.

Intrathecal Injected into the space surrounding the spinal cord.

Intra-articular Injected into the joint.

Drug Class Definitions

A.C.E. Inhibitors - Angiotensin Converting Enzyme Inhibitors block the conversion of angiotensin I to
angiotensin II. Avoiding Angiotensin II may avoid increased blood pressure and vasoconstriction. They
usually have the suffix "PRIL"

A.2.R.B. - Angiotensin 2 Receptor Blockers block Angiotensin 2 enzymes from specific

receptor sites. Avoiding Angiotensin 2 activity helps prohibit vasoconstriction. They usually
have the suffix "ARTAN"

Anti-Biotics - Anti-Biotics inhibit the reproduction of new Bacteria cells. There are several
varieties and Drug Class Definitions of Anti-Biotics.

Anti-Convulsants - Anti-Convulsants suppress the rapid firing of neurons in the nervous

system (brain). Also known as Anti-epileptic drugs and Anti-Seizure drugs.

Anti-Diabetics / Sulfonylureas - lower glucose levels in the blood. They are only used to
treat Type II Diabetes.

Benzodiazepines - Also know as "Benzos". Benzos are used as anti-anxiety agents, muscle
relaxants, sedatives, and hypnotics. They usually have the suffix "PAM".

Beta Blockers (B1) - Also known as Beta-adrenergic blocking agents. Block adrenaline
receptors, which are part of the central nervous system and mediate a "Fight or flight"
response, which would cause actions in the heart. They usually have the suffix "OLOL".

Calcium Channel Blockers - Calcium channel blockers work by blocking calcium channels
in cardiac muscle and blood vessels, thereby slowing down activity in the heart.

Diuretics - Diuretics are primarily used to treat hypertension. They promote evacuation of
water from the body, which decreases the load on the cardiovascular system.

HMG-CoA Reductase Inhibitors - Also known as Statins, They inhibit the body's
cholesterol production and usually have the suffix "STATIN".
NSAID - Non Steroidal Anti-Inflammatory Drugs are commonly used as pain killers and
Fever Reducers. They are non-narcotic and can be sold OTC.

Opioid - Opioids provide an analgesic effect by decreasing the perception of pain and
increase pain tolerance.

Proton Pump Inhibitors - Inhibit the action of the gastric proton pump, thereby reducing
gastric acid production. They usually have the suffix "PRAZOLE".

S.S.R.I - Selective Seratonin Re-Uptake Inhibitors increase the body's Seratonin level by
inhibiting its re-uptake into the Presynaptic cell. Commonly indicated as an Anti-Depressant.

Pharmacy Temperature Conversions

In the U.S. we mostly use the (F°) Fahrenheit system in our everyday lives. If you turn on the news
tonight the weather will likely be forecast inFahrenheit. In the field of science, however, (C°) Celsius is
more commonly used.

There is a very good reason for this; Celsius is shaped around when a reaction will take place. For
example, in Celsius water will freeze at 0° and boil at 100°. Compare that with 32° and 212°
in Fahrenheit. Based on that example, surely you can understand why Celsius is predominantly used in
science/Pharmacy.

1) Traditional way, as taught in Pharm Tech School:

C = (F - 32) x (5/9)
F = C x (9/5) + 32
IMPORTANT- Remember that Fahrenheit will always be greater than Celsius. The most simple way to
remember that water freezes at 0° Celsius / 32° Fahrenheit.

I would recommend writing down some numbers and converting them for practice until you are
comfortably converting without referring to your notes

2) Algebra Shortcut:
5F = 9C + 160

3) Ballparking Temperature Conversions:

While studying temperature conversions, my study partner and I discovered a way to Ballpark a
temperature conversion in a matter of a few seconds. The link just below will show you how.

FDA Recall Definitions

 According to the
Official FDA website
"Recalls are actions taken by a firm to remove a product from the market. They
may be conducted on a firm's own initiative, by FDA request, or by FDA order under
statutory authority."

The urgency and severity of an

FDA Recall is what determines the "class" of the recall. Very similar to the DEA
Sch., the FDA recall class schedule uses "1" as the most dangerous. However,
unlike the DEA's schedule, the FDA Class schedule only goes to "3". The severity of
the recall is less as the number increases.

Other Actions

Is appropriate when a product has a minor violation that would

not be subject to FDA legal action. The manufacturer must
remove the product from distribution markets or correct the
FDA Market
violation. An example from the FDA Official website says, "A
Withdrawal
product removed from the market due to tampering, without
evidence of manufacturing or distribution problems, would be a
market withdrawal."

FDA Medical Used only for medical apparatus equipment. This is when a
Device medical device may present an unreasonable risk of substantial
Safety Alert harm. In some cases, these situations also are considered recalls.

Pharmacy Measurement Conversions

In pharmacy, measurement conversions

of units from one system to another is very common.
You'll want to study all of the different pharmacy conversions to prepare for the PTCB or ExCPT exams.
However, I would recommend committing what you would consider the most commonly used to
memory first. If you can eventually memorize them all, that's great too.

Liquids

1cc = 1 mL

5mL = 1 tsp
 15mL = 1 tbsp

30mL = 1 oz

480 mL = 1 pt

3785 mL = 1 gal

Look at the above conversions, notice the progression of the measurements. Now look at the next
conversions and hopefully you will start to see the patterns.

3 tsp = 1 tbsp

2 tbsp = 1 oz

16 oz = 1 pt

2 pt = 1 qt

4 qt = 1 gal

1 Liter = 1000 ml (metric)

Mass / Dry / Solids

1 Kilogram = 1000 Grams

1 Gram = 1000 Milligram

1 Milligram = 1000 Micrograms

1 kg = 2.2 lbs

1 lbs = 454 gm

1 oz = 30 gm

16 oz = 1 lb

The Metric system is the most commonly used in pharmacy and all that is used in Chemistry.
Surprisingly, the U.S. has never standardized to it with the rest of the world.

Microgram mcg

Milligram mg

Gram gm or G

Kilogram kg

Insulin units

100 IU per/mL

(100 int'l units) (per milliliter)