Dosage Forms, Abbreviations, and Routes of Administration

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Dosage Forms, Abbreviations, and Routes of
Administration

• Pharmacology
• Chapter 3

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Introduction

• To be a successful technician it is necessary to
  interpret orders correctly
• Dr.s writing may look like chicken scratch
• It is the responsibility of the pharmacy to
  interpret and clarify orders if necessary
• abbreviations can look alike
• Technicians should know common dosages to help
  verify sig is correct.

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Where Do Pharmacy Abbreviations Originate?

• Terminology comes from the Latin and Greek
• abbreviations have their origins in a foreign
  language
• Latin and Greek serve as the universal language
  that all medical personnel can understand

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The Prescription
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The Prescription
Abbreviation Translation
ac before meals
bid twice a day
c with
cap capsule
DAW dispense as written
D/C discontinue
g gram
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The Prescription
Abbreviation Translation
gr grain
gtt drop
hs at bedtime
IM intramuscular
IV intravenously
L liter
mcg microgram
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The Prescription
Abbreviation Translation
mEq milliequivalent
mL milliliter
NKA no known allergy
NKDA no known drug allergy
npo nothing by mouth
pc after meals
PO by mouth
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The Prescription
Abbreviation Translation
prn as needed
q every
qh every hour
q2h every two hours
qid four times a day
qs a sufficient quantity
stat immediately
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The Prescription
Abbreviation Translation
tab tablet
tid three times daily
ud as directed
wk week
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Discussion

• What makes an abbreviation dangerous?
• What is the role of the pharmacy technician when
  a prescription arrives with a dangerous
  abbreviation?

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Problematic Abbreviations
Dangerous Abbreviation Correct Form to Use
µg Microgram or mcg
qd every day
qod every other day
U units
MgSO4 magnesium sulfate
MSO4 morphine sulfate
.2 0.2
2.0 2
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Problematic Abbreviations

• Institute for Safe Medication Practices (ISMP)
• Lists dangerous abbreviations and other safety
  tips.
• Check out the site at www.ismp.org.

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Pharmaceuticals

• A drug is any substance taken into or applied to
  the body for the purpose of altering the bodys
  biochemical functions and thus its physiological
  processes.
• Active ingredient.

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Uses of Drugs

• Treat and cure illness
• Diagnose
• Prevention
•  Therapeutic Agents
• Help maintain heath, relieve symptoms, combat
  illness and reverse disease process.
• Pharmacodynamic Agents
• Alters body function in a desired way.
• Diagnostic Agents
• Used in diagnosing illnesses
• Prophylactic Agents
• Prevent illness or disease from occurring
• Destructive Agents

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Dosage Forms

• Dose refers to the amount of medication given at
  one time.
• Dosage form refers to the physical manifestation
  (shape) of a drug
• i.e. tablet or capsule
• Dosage form is determined by the drugs
  effectiveness

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Types of Dosage Forms

• Three major categories of dosage forms
• Solids
• Liquids
• Semisolids

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Solid Dosage Forms

• contained in various packages
• administered by almost all routes except
  parenterally
• contain fillers (inert substancesno active
  ingredient), sugar coatings, and certain additives

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SOLID DOSAGE FORMS

• Tablets
• More than one type of tablet or capsule
• variety of shapes and sizes
• Caplets
• Chewable
• scored or unscored
• coated or uncoated
• Extended release
• ability to release the active ingredient over an
  extended period

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• A. Unscored tablet
• B. Scored tablet

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Plain tablets
Scored tablets
Enteric-coatedtablets
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SOLID DOSAGE FORMS

• Capsules
• Capsule and caplet dosage forms are closely
  related to tablets
• Capsules can have either a hard or soft outer
  shell
• Hard capsules are composed of sugar, gelatin, and
  water
• Pulvuletype of capsule that is shaped
  differently for identification purposes
• Spansulescan be pulled apart to sprinkle the
  medication onto food for children
• The main difference between capsules and caplets
  is that capsules can be pulled apart

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Types of Capsules
Capsules
Extended-releasecapsules
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Solid Dosage Forms Cont.

• Lozenges / Troches
• forms of tablets that are meant to dissolve in
  the mouth
• Cough drops
• Troches are larger than normal-sized tablets and
  are flat chalky consistency
• Implants / Pellets
• A special type of capsule can be implanted under
  the skin and left in place for up to 5 years
• Contraceptives containing progestin
• Medication is released in a stair-step method

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Solid Dosage Forms Cont.

• Patches
• medication to be released into the skin over time
• Easily administered and eliminate a possible
  upset stomach
• Uses Angina-Nitroglycerin chronic pain-
  Duragesic
• Motion sickness-Scopolamine
• Powders
• main uses-to decrease moisture
• Antifungal foot agents
• They can also be spread over a wide area
• Effervescent Salts

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Solid Dosage Forms Cont.

• Extended release dosage forms
• Medications that slowly and consistently release
  over time
• CD- Controlled Diffusion
• CR- Controlled Release, Continuous release
• CRT- Controlled release tablet
• LA- Long Acting
• SA- Sustained action
• SR -Sustained-Release, Slow Release
• TD- Time Delay
• TR- Time Release
• XL- Extra Long
• XR- Extended Release

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LIQUID DOSAGE FORMS

• consist of one or more active ingredients in a
  liquid vehicle.
• Administered by all routes
• 2 major categories
• Solutions
• ingredient is dissolved in a liquid vehicle
• Dispersions.
• undissolved ingredients are dispersed throughout
  a liquid vehicle

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Solutions

• Solvent
• The vehicle that makes up the greater part of a
  solution.
• Solute
• The ingredient dissolved in a soln
• Solutions may be classified by vehicle
• as aqueous
• or alcoholic
• hydroalcoholic
• By site or method of administration
• By contents

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Solutions Cont

• Elixir
• Alcoholic or hydroalcoholic solution
• Used to cover up bad taste
• Same consistency as water
• Syrups
• aqueous sugar based solution to improve taste,
• tend to be thicker than water

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Solutions Cont

• Aromatic Waters
• Solutions of water containing oils that have a
  pleasing smell and are easily released into the
  air (Rose Water).
• Enema
• Solutions administered rectally for cleansing or
  drug administration.
• Extract
• Potent forms from animal or plant sources from
  which the solvent has been evaporated.
• Irrigating Solutions / Douches
• Solutions for cleansing or bathing an area of the
  body
• Spirits
• Alcoholic solutions containing aromatic
  ingredients, used as medicines or as flavorings
• Tinctures
• Alcoholic solutions of pure chemicals or of
  extractions from plants.

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Dispersions

• Suspensions
• liquids that have very small, solid particles
  suspended in the base solution
• used orally by children and seniors
• shake well sticker
• Emulsions
• mixture of water and oil when used with an
  emulsifier binds the two together
• Most are used topically.
• Some are used parenterally, such as lipids (fats)
  in nutritional parenteral feedings

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Sprays

• Sprays
• Fine dispersion can be liquid, solid or gaseous
• Aerosol
• Spray in a pressurized container that contains a
  propellant
• Sprays and Aerosols are usually meant for topical
  application but some can be used inhalants.
• Nasal decongestants or sunscreens
• Nitroglycerin translingual spray

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Inhalants and Aerosols

• Inhaler agents come in a variety of forms but all
  must be easily inhaled into the lungs
• Common devices available OTC are vaporizers,
  humidifiers, nebulizers
• MDIs dispense a specific amount of drug with
  each puff or inhalation
• May be powder, soln, susp.
• Anesthetics inhaled solutions

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Semisolids

• Semisolids contain both liquids and solids
• They are meant for topical application

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Semi Solids- Dispersions

• Creams
• like ointments but are smoother, most are
  considered vanishing
• Part oil and water
• Lotions
• thinner than creams, base contains more water
• Ointments
• Glycol or oil base
• Cover and keep out moisture
• Pastes
• Are like ointments but contain more solid
  materials and are stiffer and thicker.
• Gels / Jellies
• solid fine particles in viscous liquid

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Suppositories

• Can be used both rectally and vaginally
• Rectal suppositories bypass the stomach, which is
  important if the patient has nausea and vomiting
• Vaginal suppositories are used mainly to treat
  vaginal infections

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Critical Thinking

• Which dosage form is easiest for patient to take?