Dosage Forms Abbreviations

Dosage Forms
amp	ampule
buccal	buccal tablet
cap	capsule
Cm	cream
el or elix	Elixir
EC tab	Enteric-coated tablet
expect	expectorant
gtt	drops
inj	injection
lot	Lotion
loz	Lozenge
MDI	Metered Dose inhaler
sol	solution
spry	Spray
supp	suppository
susp	suspension
syr	syrup
tab	tablet
tbsp	Tablespoon
TDS	transdermal delivery system
tsp	Teaspoon
TPN	total parenteral nutrition
pulv	poweder
Ung or oint	ointment

Route of Administration Abbreviations

Route of Administration
OD	Right Eye
OS	Left Eye
OU	Both Eyes
AD	Right Ear
AS	Left Ear
AU	Both Ears
PO	By Mouth
SL	Sublingual
NG or NGT	Feeding Tube through the nose into stomach
IEN or NAS	by Nostril
Bucc	Held Inside the Cheek
S&S	Swish & Swallow
HHN	Hand Held Nebulizer
PR	Into the Rectum
PV	Into the Vagina
SubQ, SC, SQ	Immediately under the skin
Top	Topical
GT or PGT	Feeding Tube through the abdominal wall into stomach
JT	Feeding Tube through the small Intestine
IA	Into a(n) artery or joint
IC	Into the heart muscle
ID	Into the top layer of the skin
IT	Into the Trachea
IM	Into a muscle
IV	Into a vein
INH	Inhalant

The most difficult pharmacy abbreviations to remember are the eyes and ears. They are very easy to mix up. Try this: When you see the O, think of "OCULAR". For the A, remember it as "AUDIO". For the letter U, think of "UNITED" - all parts.

Frequency of Dosage Abbreviations

Also known as "Sig Codes", Prescription abbreviations are basically coded instructions from a health-care professional. The code is used to supply the words while Roman Numerals are sometimes used for the numbers. These should be memorized to prepare for the PTCB or ExCPT exams.

Frequency of Dosage
q	Every
qH	Every Hour
qAM	Every Morning
qPM	Every Night
qHs	Every Bedtime
qD	Everyday
qOD	Every Other Day
qWK	Every Week
qMO	Every Month
q__o	(Q) 1°, 2°, 3°, 4°, (Every 4 Hours)
q__H	Every__Hour (Every 4 Hours)
BID	Twice a day
TID	Three times a day
QID	Four times a day
X_D	Times_Day (3x a day)
C	With
AC	Before Meal
PC	After Meal
HS	At Bedtime
PRN	As Needed
UD	As Directed
AA	Of Each
QS	Quantity Sufficient
ATC	Around the clock
ad lib.	as desired
STAT	Immediately
	Half Strength

Generic Medication Prefixes, Roots, & Suffixes Chart

Recognizing Generic Drug Names by Prefixes, Roots, and Suffixes:
Memorizing the top 200 drug names is one of the most challenging parts of studying for the PTCB of ExCPT exams.

In generic names, there are several prefix, root and suffixes that will help you to remember what the medication does.

The chart below lists some of the prefix, root and suffixes you will see when studying the top 200 drugs.

A prefix is placed at the beginning of a word to modify or change its meaning to "before." A Root is the central part of a word. Suffix is the ending part of a word that modifies the meaning of the word. Example: homeless. Root = 'home' and the suffix is 'less'.

Prefix, Root, Suffix	Drug Class
-artan	A2RB (Angiotensin 2 receptor blocker)
-asone	Corticosteroid
-azosin	Alpha Blocker
-bital	Barbiturate (sedative)
-caine	Local Anesthetic
-cillin	Penicillin Antibiotic
-cort-	Corticosteroid
-cycline	Tetracycline Antibiotic
-dipine	Calcium Channel Blocker
-floxacin	Fluoroquinolone Antibiotic
-itidine	H2Antagonist
-lax	Laxative
-mycin	Antibiotic; Antibacterial
-nazole	Antifungal
-olol	Beta Blocker
-pril	Ace Inhibitor Angiotensin (Angiotensin Converting Enzyme)
-pam	Benzodiazepines (Benzos)
-profen	NSAID
pred-	corticosteroid
-razole	PPI = Proton Pump Inhibitor
-romycin	Macrolide Antibiotic
-semide	Loop Diuretic (water pill)
-statin	Cholesterol (HG CoA Reductase Inhibitor)
-thiazide	Thiazide Diuretic (water pill)
-vir	Anti-Viral
-zodone	Antidepressant
-zolam	Benzodiazepines (Benzos)

Unfortunately, only a fraction of the top 200 drugs end in a common Generic Drug suffix. However, learning them may help you immensely to memorize the top 200 drugs.

There are plenty more common suffixes and prefixes in generic drug names. The above list is geared to apply to the Top 200 Drug name suffixes.

Extended-Release Medications

These medication dosage forms are called extended-release, sustained release, long-acting, or controlled release. Although the exact meaning of these terms differ in some respects, each of these terms implies a gradual release of medication over a long period time.

CD	Controlled-diffusion
CR	Controlled-release, continuous-release
CRT	Controlled-release tablet
LA	Long-acting
SA	Sustained-action
SR	Sustained-release, slow-relaese
TD	Time-delay
TR	Time-release
XL	Extra-long
XR	Extended-release

Top 20 Most Commonly Diagnosed Conditions

Research data shows the top 20 most common conditions diagnosed by primary care and specialist physicians. Treatment and indications are also listed.

Condition	Indications	Treatment
High blood pressure (hypertension)	Blood pressure is a measurement of the force against the walls of your arteries as your heart pumps blood through your body. Hypertension is another term used to describe high blood pressure.	ACE Inhibitor: Benazepril, Lisinopril (Prinivil), Hydrochlorothiazide/lisinopril (Zestoretic) Channel blocker: Felodipine (Plendil), Amlodipine (Norvasc), Nifedipine (Procardia) Diuretic: Triamterene, Chlorothiazide, Hydrochlorothiazide​/​losartan (Hyzaar), Chlorthalidone (Thalitone), Furosemide, Hydrochlorothiazide (Microzide) Heart medication: Nitroglycerin through the skin (Nitro-Dur) Other treatments: Irbesartan (Avapro), Metoprolol, Nadolol (Corgard), Candesartan (Atacand), Telmisartan (Micardis), Losartan (Cozaar), Valsartan (Diovan), Labetalol (Trandate), Bisoprolol (Zebeta), Carvedilol (Coreg), Spironolactone (Aldactone), Atenolol (Tenormin)
Cholesterol, HDL, Hypercholesterolemia, Hyperlipidemia, Hyperlipoproteinemia, LDL	High amounts of cholesterol in the blood. High cholesterol can limit blood flow, increasing risk of heart attack or stroke. It's detected by a blood test.	Diabetes medication: Fenofibrate (Tricor), Gemfibrozil (Lopid) Statin: Ezetimibe/simvastatin (Vytorin), Lovastatin (Mevacor), Pravastatin (Pravachol), Fluvastatin (Lescol), Simvastatin (Zocor), Atorvastatin (Lipitor) Other treatments: Niacin (Niacor), Ezetimibe (Zetia), Colestipol (Colestid)
Type 2 diabetes Also called: adult onset diabetes	Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well.	Diabetes medication: Metformin​/​saxagliptin monohydrate, Metformin​/​rosiglitazone, Metformin​/​pioglitazone, Acarbose (Precose), Glyburide​/​metformin (Glucovance), Glipizide​/​metformin, Sitagliptin/metformin (Janumet), Glyburide (Micronase), Sitagliptin (Januvia), Glipizide (Glucotrol), Glimepiride (Amaryl), Metformin (Glucophage), Saxagliptin (Onglyza), Insulin aspart, Rosiglitazone (Avandia), Pioglitazone (Actos) Diabetes medication by injection: Insulin lispro (Humalog), Insulin, Insulin glargine (Lantus), Exenatide (Byetta), Insulin detemir (Levemir) Statin: Atorvastatin (Lipitor)
Back pain	A common, painful condition affecting the lower portion of the spine. Pain: in the back, hip, leg, tailbone, or muscle and bone. Sensory: pins and needles or sensitivity to pain. Also common: leg numbness or muscle spasms	Anti-inflammatory: Ketorolac by injection or by mouth (Toradol) Muscle relaxant: Metaxalone (Skelaxin), Methocarbamol (Robaxin), Cyclobenzaprine (Flexeril ), Carisoprodol Pain reliever: Tramadol (Ultram)
Anxiety	Severe anxiety that lasts at least six months is generally considered to be problem that might benefit from evaluation and treatment. Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive, irrational fear and dread.	Antidepressants: (Prozac, Sarafem), imipramine (Tofranil), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and venlafaxine (Effexor XR). Citalopram (Celexa) and escitalopram (Lexapro) Buspirone. Benzodiazepines: Alprazolam (Niravam, Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), diazepam (Valium), and lorazepam (Ativan).
Obesity	A disorder involving excessive body fat that increases the risk of health problems.	The mainstay of treatment is lifestyle changes such as diet and exercise.
Allergic rhinitis/ Seasonal allergies	An allergic response causing itchy, watery eyes, sneezing, and other similar symptoms.	Antihistamine: Levocetirizine (Xyzal), Azelastine nasally (Astelin), Desloratadine (Clarinex) Steroids: Triamcinolone, Budesonide by inhaling Steroids nasally: Budesonide, Beclomethasone (Beconase), Flunisolide, Mometasone (Nasonex), Triamcinolone acetonide (Nasacort), Fluticasone (Flonase) Other treatments: Ciclesonide nasally (Omnaris), Ipratropium nasally (Atrovent)
Reflux esophagitis/ Acid reflux	Digestive disease in which stomach acid or bile irritates the food pipe lining.	Stomach acid supressant: Pantoprazole (Protonix), Dexlansoprazole (Dexilant), Rabeprazole (Aciphex) Other treatments: Sucralfate (Carafate)
Respiratory Diseases	A group of lung diseases that block airflow and make it difficult to breathe.	Steroids: Fluticasone/salmeterol by mouth Steroids by inhaling: Budesonide​/​formoterol (Symbicort), Budesonide, Fluticasone/salmeterol, Fluticasone, Beclomethasone Other treatments: Arformoterol by inhaling (Brovana), Formoterol by inhaling (Foradil), Ipratropium by inhaling (Atrovent), Salmeterol by inhaling or by mouth, Acetylcysteine, Indacaterol by inhaling, Albuterol​/​ipratropium by inhaling (Duoneb), Tiotropium bromide by inhaling (Spiriva), Albuterol by inhaling (Accuneb) or into the windpipe, Levalbuterol by inhaling (Xopenex)
Hypothyroidism /Underactive thyroid	A condition in which the thyroid gland doesn't produce enough thyroid hormone.	Levothyroxine (Synthroid)
Visual Refractive Errors/ Farsightedness, Hyperopia, Myopia, Nearsightedness	Refractive errors are vision problems that happen when the shape of the eye keeps you from focusing well.	Eyeglasses, Contact Lenses, Refractive Surgery
Osteoarthritis/ OA, degenerative joint diseas	A type of arthritis that occurs when flexible tissue at the ends of bones wears down.	Anti-inflammatory: Indometacin (Indocin), Etodolac (Lodine), Meloxicam (Mobic), Piroxicam (Feldene), Diclofenac by mouth or to the affected area (Voltaren), Celecoxib (Celebrex) Pain reliever: Tramadol (Ultram) Steroids: Cortisone
Fibromyalgia/myositis, neuritis, fibrositis	Widespread muscle pain and tenderness.	Muscle relaxant: Cyclobenzaprine (Flexeril ) Other treatments: Paroxetine (Paxil), Fluoxetine (Prozac), Milnacipran (Savella), Pregabalin (Lyrica), Duloxetine (Cymbalta), Venlafaxine (Effexor), Gabapentin (Neurontin), Sertraline (Zoloft), Amitriptyline
Malaise and fatigue	Malaise is a generalized feeling of discomfort, illness, or lack of well-being. Fatigue (feeling tired) occurs with malaise in many diseases. Along with malaise, you can have a feeling of not having enough energy to do usual activities.
Joint Pain	Conditions that can lead to painful joints, include osteoarthritis, rheumatoid arthritis, bursitis, gout, strains, sprains, and other injuries.	Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen or naproxen may help relieve pain and swelling.
Acute laryngopharyngitis/ Laryngitis	An inflammation of the voice box from overuse, irritation, or infection.	Anti-inflammatory: Ibuprofen (Advil) Pain reliever: Acetaminophen (Tylenol) Stomach acid supressant: Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Prevacid) Other treatments: Calcium carbonate (Tums)
Acute maxillary sinusitis/ sinus infection	A condition in which the cavities around the nasal passages become inflamed.	Antibiotics: Amoxicillin​/​clavulanic acid (Augmentin), Cefuroxime, Amoxicillin (Amoxil), Cefprozil, Moxifloxacin, Cefdinir, Levofloxacin, Ciprofloxacin, Azithromycin (Zithromax), Clarithromycin (Biaxin) Steroids nasally: Budesonide, Beclomethasone (Beconase), Flunisolide, Mometasone (Nasonex), Fluticasone (Flonase)
Major depression/ clinical depression	A mood disorder causing a persistent feeling of sadness and loss of interest.	Escitalopram (Lexapro), Selegiline (Eldepryl), Aripiprazole (Abilify), Bupropion (Wellbutrin), Imipramine (Tofranil-PM), Paroxetine (Paxil), Desvenlafaxine, Fluoxetine (Prozac), Trazodone (Desyrel), Nortriptyline (Pamelor), Buspirone, Amitriptyline, Fluvoxamine, Citalopram (Celexa), Venlafaxine (Effexor), Mirtazapine (Remeron), Sertraline (Zoloft), Duloxetine (Cymbalta)
Acute bronchitis/ bronchial infection	Inflammation of the lining of bronchial tubes, which carry air to and from the lungs.	Antibiotics: Amoxicillin (Amoxil), Azithromycin (Zithromax), Amoxicillin​/​clavulanic acid (Augmentin) Pain reliever: Codeine Steroids: Fluticasone by inhaling Other treatments: Prednisone (Deltasone), Albuterol by inhaling (Accuneb)
Asthma	A condition in which a person's airways become inflamed, narrow and swell, and produce extra mucus.	Steroids: Methylprednisolone by injection Steroids by inhaling: Beclomethasone, Fluticasone, Fluticasone/salmeterol, Budesonide, Flunisolide (Aerospan), Budesonide​/​formoterol (Symbicort) Other treatments: Levalbuterol, Tiotropium bromide, Albuterol​/​ipratropium by inhaling (Duoneb), Zileuton (Zyflo), Zafirlukast (Accolate), Pirbuterol, Salmeterol by inhaling, Prednisone (Deltasone), Albuterol, Ipratropium by inhaling (Atrovent)

Guidelines for Filling Prescription Orders

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

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

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: 

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

In addition Schedule II drug prescriptions:

• 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.

New York State VALID PRESCRIPTION REQUIREMENTS

	Prescription order expiration dates		Refills
	Federal	State Ex. NY	Federal	State Ex. NY
DEA Sch II	No Expiration	30 days	NO REFILLS ALLOWED	NO REFILLS ALLOWED
DEA Sch III thru V	6 Months	6 Months	up to 5 times, but only 5 times	up to 5 times within 6 months
Legend Drugs	12 Months	No Expiration	up to 12 Months worth	up to 3 Months worth

Routes of Medication Administration

A route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration. Routes can also be classified based on where the target of action is. Action may be topical (local), enteral (system-wide effect, but delivered through the gastrointestinal tract), or parenteral (systemic action, but delivered by routes other than the GI tract).

Route	Methods	Description	Advantages	Disadvantages
Oral	Oral	Through the mouth	It is convenient. It is the cheapest available route. It is easy to use. It is safe and acceptable.	Less amount of drug reaches the target tissue. Some of the drug is destroyed by gastric juices. Absorption has to take place which is slow, so is not preferred during emergencies. It might cause gastric irritation. It might be objectionable in taste. It might cause discoloration of teeth.
	Buccal	Inside the cheek
	Lingual	On the tongue
	Sublingual	Under gums	Rapid absorption takes place. Drug is dissolved easily. Drug enters the blood directly. Less first pass effect. Spitting out of the drug removes its effect.	This method is inconvenient. Irritation of the mucous membrane might occur. Person may swallow the drug. Might be unpleasant in taste.
	Transmucosal	Across mucous membrane
Enteral	Enteral	By way of the intestine
	Nasogastric (Tube)	A feeding tube inserted through the nose into the stomach (NG or NGT)
	Gastrostomy (tube), percutaneous endoscopic gastrostomy (tube)	A feeding tube inserted through the abdominal wall into the stomach (GT or PEG)
	Jejunostomy (tube)	A feeding tube inserted through the jejunum (small intestine) (JT)
Inhalation	Inhalation	Drawn through the mouth into the lungs	Rapid absorption takes place. Rapid onset of action takes place. This route has minimum side effects. No first pass effect takes place. This method is easy. Fewer doses is required.	Special apparatus is required. Irritation of the respiratory tract may take place. Cooperation of the patient is required. Airway must be patent.
Parenteral	Parenteral	By passing the gastrointestinal tract. Not delivered via the intestinal tract.	Parenteral route is rapid. It is useful for uncooperative patients. It is useful for unconscious patients. Inactivation by GIT enzymes is avoided. First pass effect is avoided*. Bioavailability is 100%.	Skill is required. It is painful. This method is expensive. It is less safe.
	Implant	A device inserted into or under the skin
	Intra-arterial	Into an artery (AI)
	Intra-articular	Into a joint (AI)
	Intracardiac	Into the heart muscle (IC)
	Intradermal	Into the top lay of the skin (ID)
	Intratracheal, endotrcheal	Into the trachea (IT)
	intramuscular	Into a muscle (IM)	Absorption is rapid than subcutaneous route. Oily preparations can be used. Irritative substances might be given Slow releasing drugs can be given by this route.	Using this route might cause nerve or vein damage.
	Intraosseous	Into the marrow of a bone
	intraperitoneal	Into the peritoneal (abdominal) cavity
	Intrapleural	Into the pleura (sac that surround the lungs)
	intrathecal	Into space around the spinal cord
	intrauterine	Into the uterus
	intravenous	Into a vein (IV)	Immediate action takes place. This route is preferred in emergency situations. This route is preferred for unconscious patients. Titration of dose is possible. Large volume of fluids might be injected by this route. Diluted irritant might be injected. Absorption is not required. No first pass effect takes place.* Blood plasma or fluids might be injected.	There is no retreat. This method is more risky. Sepsis-Infection might occur. Phlebitis(Inflammation of the blood vessel) might occur. Infiltration of surrounding tissues might result. This method is not suitable for oily preparations. This method is not suitable for insoluble preparations.
	intraventricular	Into the ventricles, or cavities, of the brain
	intravesicular	Into the urinary bladder
	intravitreal or intravitreous	Into the eye
	Subcutaneous	Immediately under the skin (SubQ, SC, SQ)	Absorption is slow and constant. It is hygienic.	It might lead to abscess formation. Absorption is limited by blood flow.
Nasal		Into the nose
Ophthalmic		Into the eye
Otic, aural		Into the ear
Percutaneous		Through the skin
Rectal		Through the anus into the retum	This route is preferred in unconscious or uncooperative patients. This route avoids nausea or vomiting. Drug cannot be destroyed by enzymes. This route is preferred if drug is irritant.	This route is generally not acceptable by the patients. Locally acting drugs include glycerin and Bisacodyl suppository. Systemic acting drugs include Indomethacin (anti inflammatory) and aminophyllin (bronchodilator). Retention enema is diagnostic and is used for finding the pathology of lower intestines. Drugs given by rectal route have 50% first pass metabolism.*
Topical		Applied to the skin or mucous membranes
Transdermal		Through the skin
Vaginal		Into the vagina

*First Pass Effect: First pass effect is the term used for hepatic metabolism of drug when absorbed and delivered through portal blood. Greater the first pass effect, less amounts of the drug reach the systemic circulation.

Time of Action using Different Routes of Administration

Route of Administration	Delay time for Action
Intravenous route	30-60 seconds
Intraosseous route	30-60 seconds
Endotracheal inhalation	2-3 minutes
Sublingual route	3-5 minutes
Intramuscular route	10-20 minutes
Rectal route	5-30 minutes
Ingestion	30-90 minutes

Medication Dosage Forms

The term dosage form can also sometimes refer only to the chemical formulation of a drug product's constituent drug substance(s) and any blends involved, without considering matters beyond that (like how it's ultimately configured as a consumable product such as a capsule, patch, etc.). Because of the somewhat vague boundaries and unclear overlap of these terms and certain variants and qualifiers thereof within the pharmaceutical industry, caution is often advisable when conversing with someone who may be unfamiliar with another person's use of the term.

Depending on the method/route of administration, dosage forms come in several types. These include many kinds of liquid, solid, and semisolid dosage forms. Common dosage forms include pill, tablet, or capsule, drink or syrup, and natural or herbal form such as plant or food of sorts, among many others. Notably, the route of administration (ROA) for drug delivery is dependent on the dosage form of the substance in question. A liquid dosage form is the liquid form of a dose of a chemical compound used as a drug or medication intended for administration or consumption.

A 1999 Food and Drug Administration Draft Guidance for Industry states: "A dosage form is the way of identifying the drug in its physical form. In determining dosage form, FDA examines such factors as (1) physical appearance of the drug product, (2) physical form of the drug product prior to dispensing to the patient, (3) the way the product is administered, (4) frequency of dosing, and (5) how pharmacists and other health professionals might recognize and handle the product."

Liquid Medication Dosage Forms
Solutions	Aqueous (water-based)
	Gargles
	Oral Rinses
	Washes & Mouthwashes
	Douches
	Irrigants
	Enemas
	Sprays
Viscous (thick) aqueous	Syrups
	Jellies
Hydroalcoholic	Elixirs
	Spirits
Alcoholic	Collodions
	Spirits
Glycerites
Extractives	Extracts
	Tinctures
Emulsions	Fluidextracts
	Oil-in-Water
Suspensions	Magmas & Milks
	Gels
	Mucilages

Solid Medication Dosage Forms
Tablets
Compressed	Suger-coated
	Film-coated
	Enteric-coated
Sublingual
Buccal
Effervascent
Chewable
Vaginal
Capsules	Hard gelatin
	Soft gelatin
Lozenges
Supporites	Rectal
	Vaginal
	Urethral
Semisolids	Oinments
	Creams
	Pastes

Miscellaneous Medication Dosage Forms
Poweders
Granules
Inhalants
Aerosols
Shampoos & crème rinses
Wipes & scrubs
Transdermal patches
Implants

Dosage Forms	Description
Capsules	Capsules are composed of a gelatin container. Caplet dosage forms are related closely to tablets, but they are smooth sided and are therefore easier to swallow.
Lozenges & Troche	Lozenges and troches are other forms of tablets that are not meant to be swallowed but to dissolve in the mouth, which releases the medication more slowly. Troches are larger than normal-size tablets and are flat: they usually have a chalky consistency in order to dissolve in the mouth.
Patches	Patches are solid pieces of material that hold a specific amount of medication to be released into the skin over time.
Liquids	Liquids are composed of various solutions.
	Syrups are sugar-based solutions that have medication dissolved into them.
	Elixirs contain dissolved medication in an alcohol base or water and alcohol base.
	Sprays are composed of various bases such as alcohol or water in a pump dispenser.
	Inhalants and aerosols need to be able to get medication directly to the source of inflammation.
	Emulsions are a mixture of water and oil may be used with an emulsifier to bind the two together.
	Suspensions are liquids that have very small, solid particles suspended in the base solution.
	Enemas may be administered for two different reasons-retention or evacuation.
Semisolids	Semisolids contain solids and liquids, they normally are meant for topical application.
	Creams usually have medications in a base that is part oil and part water and is meant for topical or local use.
	Lotions are thinner than creams because their base contains more water. They penetrate well into the skin and do not leave an oily residue after application.
	Ointments contain medication in a glycol or oil base. Ointments can be used rectally, topically and as an ophthalmic agent.
	Gels contain medication in a viscous liquid that easily penetrates the skin and does not leave a residue.
	Pastes contain a lesser amount of liquid base than solids. They are used for topical application and are able to ab sorb skin secretions, unlike other topical agents.
	Suppositories can be used rectally and vaginally.
	Powders do not fit neatly into semisolids. Powders are solids, yet they are packaged in some forms that allow them to be sprayed similar to liquid dosage forms.
	Injectables are used for rapid response. The onset of an injectable drug only takes a few minutes as opposed to the 45 minutes that oral medications can take to work.

Roman Numerals

Roman numerals are used in Pharmacy by practitioners on prescription drug orders and on packaging to designate DEA schedules for controlled substances. 

The Basics
A smaller number in front of a larger number means subtraction, all else means addition. For example, IV means 4, VI means 6.

You would not put more than one smaller number in front of a larger number to subtract. For example, IIV would not mean 3.

You must separate ones, tens, hundreds, and thousands as separate items. That means that 99 is XCIX, 90 + 9, but never should be written as IC. Similarly, 999 cannot be IM and 1999 cannot be MIM.

Sometimes you will see a numeral with a line over it. That means to multiply it by 1000. A numeral V with a line over it means 5000. This usage is no longer current, because the largest numbers usually expressed in the Roman system are dates.

Symbols
I	The numeral one. II is two, III is three. You seldom see IIII as 4, since IV can also mean 4, plus its shorter to write.
V	The numeral 5. IV is 4, VI is 6, VII is 7, VIII is 8.
X	The numeral 10. IX is 9, XI is 11, etc.
L	The numeral 50. XL would be 40.
C	The numeral 100. Think of Century having a hundred years. C is short for the Latin word Centum, but that's not very easy to remember.
D	The numeral 500.
M	The numeral 1000.

Roman Numerals Chart 1-100
1	I
2	II
3	III
4	IV
5	V
6	VI
7	VII
8	VIII
9	IX
10	X
15	XV
20	XX
25	XXV
30	XXX
35	XXXV
40	XL
45	XLV
50	L
55	LV
60	LX
65	LXV
70	LXX
75	LXXV
80	LXXX
85	LXXXV
90	XC
95	XCV
100	C

Brand Name Drugs and Generic Drugs

The FDA approves all drugs that are available for distribution in the U.S. to assure that they are safe and effective.

Before a new drug is approved, the manufacturer must submit a New Drug Application (NDA) to the FDA. The NDA includes:

1. Info about the drug
2. Results from human clinical trials
3. Results from animal clinical trials
4. How drugs acts in the body
5. How it is manufactured, processed and packaged

Most companies market new drugs with a trade or brand name. Lipitor is an example of a brand name for a drug that is produced and distributed by the manufacturer Pfizer.

1. The generic name for Lipitor is atrovastatin
2. Pfizer developed atrovastatin
3. Pfizer submitted a NDA to the FDA
4. FDA approved atrovastatin
5. Pfizer is granted patents for an average of 11 years.
6. Once the patent expires other drugs companies may apply for approval of generic or copies of the drug.

Generic equivalents contain the same active ingredients and have the same dosage form, strength and formulations as their brand name counterparts.

Generic drug companies must submit an Abbreviated New Drug application (ANDA). Generic manufactures must meet the same standards for:

1. Manufacturing
2. Quality
3. Labeling
4. They do not need to repeat the original research.
5. Must show bioequivalence to the brand name drug.

Generic Drug Substitution
Pharmacists are permitted to substitute the generic equivalent drug for the brand name unless the prescriber prohibits generic substitution.

Generic substitution is regulated by state laws. These laws and regulations set requirements for when pharmacists may or may not substitute therapeutically equivalent generic drugs for brand name drugs.
Indications of no substitution include:

1. “Dispense as written”
2. “DAW”
3. “no substitution”
4. “do not substitute”
5. “DNS”

Pharmacists use the “Orange Book” to find the FDA’s decision on whether or not a generic drug is therapeutically equivalent to the brand name.

Controlled Substances

Controlled substances are subject to stricter controls through Federal and State laws and regulations due to their potential for misuse, abuse, diversion, and addiction.

The Federal law regulating controlled substances is the Controlled Substance Act.

The Law and its regulations controls over the manufacture, import, export, distribution, ordering, dispensing and prescribing of controlled substances.
Pharmacies must comply with both State and Federal controlled substance laws.

Schedules of Controlled Substances
The Federal Controlled Substance Law created five classifications for controlled substances numbering I, II, III, IV, and V.

A drug is placed into a controlled Schedule based on certain criteria, such as it’s potential for abuse or addiction and its medical use.

Schedule I is the most restrictive and Schedule V is the least restrictive of the controlled substances.

Labeling Controlled Substances
The symbol that indicates a controlled substance is the capital letter “C” with the appropriate roman numeral placed inside the “C” symbol.

Dispensing Controlled Substances
For a controlled substance prescription to be valid, it must be prescribed by a licensed prescriber for a legitimate medical purpose in the normal course of the prescriber’s professional practice.

The prescribing practice must be registered with the DEA and be licensed to prescribe controlled substances by the state. Controlled substances prescription must contain:

1. The date issued
2. The patients full name & address
3. The practitioners name, address & DEA registration number
4. The drug name
5. Strength
6. Dosage form
7. Quantity prescribed
8. Direction of use
9. Number of authorized refills
10. Signature of prescriber

Federal law allows Schedule III and IV prescriptions to be refilled up to five times within six months after the issuing date.

Schedule V prescriptions may be refilled more than five times, but have a six-month the limit on refills.

Schedule II prescriptions may not be refilled and are not transferable between pharmacies.
Federal law allows schedule III, IV, and V prescriptions to be transferred from one pharmacy to another for refill (if the state permits).

Pharmacies are required to maintain complete and accurate records for all controlled substances that they purchase , receive, distribute or dispense.

Federal law requires that pharmacy to keep controlled substance records for two years and have them readily available for DEA inspection if requested. Examples of records include:

1. Invoices
2. Receipts of purchases
3. Inventory of records
4. Records of transfer

State Prescription Monitoring Programs, require pharmacies to report information on controlled substance prescriptions dispensed for drugs in Schedules II, III, IV and V. (varies from state to state.) The programs help states identify potential diversion and abuse. Required information includes:

1. Patient info
2. Prescriber info
3. Pharmacy ID
4. Prescription info