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Terminology and Abbreviations Every profession has its own unique language. In the world of finance, accounting and equity market, 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 idea 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/ microscope or in the metric system, 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 ROOTMEANINGEXAMPLE ArterArteryArterial ArthrJointArthritis BronchAirway in the lungBronchitis CarcinoCancerCarcinogen CardiHeartCardiac DermaSkinDermatits EnterIntestineEnteral nutrition GastrStomachGastric pain GlucoSugarGlucose meter HemoBloodHematology
Important Root words in Pharmacy continued ROOTMEANINGEXAMPLE HepatLiverHepatitis MyMuscleMyalgia NasaNoseNasal NephrKidneyNephrology NeurNerveNeurology OsteBoneOsteoporosis PneuLungpneumonia ProctoRectumProctotitis PulmoLungPulmonary RenKidneyRenal ThrombClotthrombosis
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.
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 MeaningAbbreviation Adverse drug reactionADR Average wholesale priceAWP Controlled releaseCR DiscontinueDC Dispense as writtenDAW Drug utilization reviewDUR Enteric coatedEC Extended releaseER FluidFl. Maximum allowable costMAC No known drug allergiesNKDA Nothing by mouthNPO
General Pharmacy Abbreviations Table 2 MEANINGABBREVIATION Over the counterOTC PediatricPed PrescriptionRx Schedule 1CI Schedule 2CII Schedule 3CIII Schedule 4CIV Schedule 5CV SolutionSoln SuppositorySupp Wholesame acquisition costWAC
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 organization (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 error, 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 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.www.ismp.org United States Pharmacopeia, www.medmarx.com collects medication errors and adverse events data.www.medmarx.com
Milan’s List of Must Know Drugs BRAND DRUGGENERIC NAMEMOST COMMON INDICATION ACTIVASE®ALTEPLASEPULMONARY EMBOLISM ACCUPRIL®QUINAPRILHYPERTENSION ACTONEL®RISEDRONATEOSTEOPOROSIS ADENOCARD®ADENOSINERAPID HEART RATE ALDACTONE®SPIRONOLACTONEHYPERTENSION ALLEGRA®FEXOFENADINEALLERGIES ALTACE®RAMIPRILHTN(?), HEART DISEASE
BRAND DRUGGENERIC NAMEMOST COMMON INDICATION KEFLEX®CEPHALEXINBACTERIAL INFECTIONS LASIX ®FUROSEMIDEHEART FAILURE, EDEMA LIPITOR®ATORVASTATINHIGH CHOLESTEROL LOPRESSOR®METOPROLOL TARTARATE HTN, CARDIAC FAILURE LOVENOX ®ENOXAPARINDVT, PE, AND MI MAALOX®ALUMINUM AND MAGNESIUM HYDROXIDE GASTROINTESTINAL UPSET/ACID REFLUX MARCAIN®BUPIVACAINE HCLLOCAL ANESTHETIC
I will add to this list as time goes on
Most commonly abbreviated medical conditions you will see Medical ConditionsAbbreviationCommon meaning Myocardial InfarctionMIHeart attack Congestive Heart failureCHFHeart muscle is dying AfibAtrial fibrillationA cardiac heart beat that is fast and abnormal Ventricular FibrillationVFA cardiac heart beat that is fast and almost always fatal Cerebral Vascular Accident CVAStroke/loss of blood flow to brain Diabetes MellitusDMA disorder of carbohydrate metabolism HypertensionHTNHigh blood pressure
Medical ConditionsAbbreviationCommon meaning CABGCoronary artery bypass graft Surgery to re-establish blood flow to the heart ATNAcute tubular necrosisA disorder of the kidney RARheumatoid ArthritisA joint disease that effects older people RIRenal InsufficiencyPoorly functioning kidneys PEPulmonary EmbolismA blood clot that travels to the lung DVTDeep vein ThrombosisA 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 AbbreviationDrugIndication ASAAspirinPain, post MI use APAPAcetaminophenPain, fever reducer in children 5FUFlurouracilAnti cancer drug SMX/TMPSulfamethoxazole/trimeth oprim Antibiotic HCTZHydrochlorothiazidediuretic INHIsoniazidAnti-TB (tuberculosis) drug 6-MP6 mercaptopurineImmune suppressant
Medication Abbreviations AbbreviationDrugIndication AZTZidoviduneHIV NSNormal SalineIV fluid D5WDextrose 5% in waterIV fluid D5WNSDextrose 5% in water with normal saline IV fluid MVIMultiple vitaminsVitamin replacement ISDNIsosorbide dinitrateChest pain MTXMethotrexateCancer drug
Major Class of Drugs Beta Blockers Class of drugs used to treat HTN, CHF, MI Slow down the rate at which the heart beats Very important class to known Examples: propranolol (Inderal®), Metoprolol (Lopressor®, Toprol XL®) Usually generic name ends in “lol”
Calcium Channel Blockers Important drugs for HTN and for Afib Blocks the inflow of calcium in the heart Effects is to slow down the heart and to relax artery muscles Examples: verapamil (Calan®), diltiazem (Cardizem®), amlodipine (Norvasc®)
ACE inhibitors Used to treat HTN, CHF, MI and to stop the progression of kidney damage in DM. Blocks the conversion of a inactive hormone to an active one in the blood Example: Enalapril (Vasotec®), lisinopril (Prinivil®), ramipril (Altace®), and captopril (capoten®) Usually ends in “pril”
I will add to this list as we proceed in the class