Dosage Forms, Abbreviations,
Routes of Administration, Drug
Abbreviations, and Medical Terminology
Chapter 5
Copyright © 2012, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
1
Introduction
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
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For a technician to become proficient,
it is necessary to interpret orders correctly.
Many doctors’ handwriting is referred
to as “chicken scratch,” and it is the
responsibility of the pharmacy to interpret and
clarify orders if necessary.
Many abbreviations used in prescribing
medication look very much alike.
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2
Where Did Pharmacy Abbreviations
Originate?
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Terminology in pharmacy and medicine comes
from the Latin and Greek languages.
Because pharmacy began in Europe, most of
the 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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3
Interpreting Doctors’ Orders
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It is very important for the pharmacy staff to
interpret doctors’ orders correctly.
When writing out the various abbreviations, be
sure to write as neatly as possible because other
technicians and pharmacists will be reading your
handwriting.
Technicians must learn all of the dosage forms
and abbreviations to decipher doctors’ orders.
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4
Do Not Use List

Drug errors that have occurred from the
misinterpretation of medication orders led to
the creation of the do not use list.



The list outlines the most common misread
abbreviations.
These abbreviations should be avoided.
See Box 5-1.
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5
Dosing Instructions
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Dosing times are abbreviated on
prescriptions.
Many pharmacy computers are programmed
to accept these abbreviations.
See Table 5-1.
Computerized Doctor Order Entry
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6
Classification of Medications
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Each drug can be broken down into
groupings based on:
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Pharmacology
Intent of use
Route of use
How the drug affects the body-by-body system
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7
Dosage Forms
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A dosage form refers to the package or
container of which the drug has taken the
shape.
For example, it might be a tablet or a capsule.
There is more than one type of tablet or
capsule.
Tablets come in a wide variety of shapes and
sizes.
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8
Dosage Forms (cont’d)


Much of what determines the dosage form of a
medication is determined by the drug’s
effectiveness.
Manufacturers prepare certain medications with
the ability to release the active ingredient over an
extended period.
Copyright © 2012, 2007, 2004 by Saunders, an imprint of Elsevier Inc. All rights reserved.
9
Dosage Forms (cont’d)

Three major categories of dosage forms:
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Solids- tablets, chewable tabs, enteric-coated tab,
capsules
Liquids- syrups, elixirs, sprays, suspensions
Semisolids- creams, lotions, gels, ointments,
powders, suppositories
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10
Solids


Solid agents can be contained in various
packages and administered by almost all routes
except parenterally (IV).
Most tablets contain fillers (inert substances
that have no active ingredient), sugar coatings,
and certain additives.
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11
Solids(cont)
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Tablets are made to be administered sublingually
(SL) or vaginally.
Chewable tablets are convenient for persons who
have difficulty swallowing and for children.
Tablets can be scored or unscored and coated or
uncoated.
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12
Solids (cont’d)
Unscored tablet
Scored tablet
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13
Solids (cont’d)
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Tablets can be enteric coated (EC)
to protect the drug through the acidic
environment of the stomach or to delay release
of the drug.
Extended-release types are made to control the
amount of drug distributed over a set time.
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14
Solids (cont’d)
Plain tablets
Scored tablets
Enteric-coated tablets
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15
Tablets/Caplets
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Most common type of tablet contains some type
of filler.
Fillers are composed of inert substances
(no active ingredient) that serve to fill space or
cover the tablet (sugar coatings).


Coating improves taste and covers unpleasant odors.
Chewable tablets are also made.
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16
Tablets/Caplets (cont’d)
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Caplets are smooth sided and easier to
swallow.
Many medications have extended-release
forms and regular forms.
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17
Capsules
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Capsules can have either a hard or soft
outer shell.
Hard capsules are composed of sugar,
gelatin, and water.
Pulvule: This is a type of capsule that is
shaped differently for identification purposes.
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18
Capsules (cont’d)
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
Spansules are capsules that can be pulled
apart to sprinkle the medication onto food for
children
Soft-gelatin capsules (gel-caps) cannot be
pulled apart, and often hold medications in
liquid form
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19
Types of Capsules
Capsules
Extended-release capsules
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20
Capsule Sizes
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Capsules come in different sizes: see
Figure 5-5.
Capsuls vary in color, transparency, identifying
marks.
Larger half is called body; shorter half is
called cap.
Not all capsules are meant to be swallowed;
content can be sprinkled on food.
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21
Lozenges/Troches
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These are other forms of tablets that are not
meant to be swallowed but to dissolve in the
mouth, which releases the medication more
slowly; similar to hard candy.
Cough drops
Troches are larger than normal-sized tablets
and are flat; chalky consistency.
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22
Biomaterials
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Biomaterials are polymers that combine with
or encapsulate a drug.
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Can be capsules, tablets, or implants
Activity of the drug can be activated due to
pH or solubility and released over a period of
anywhere from 12 hours to several years.
Also known as excipients.
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23
Implants
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A special type of capsule can be implanted
under the skin and left in place for up to 5 years.
Contraceptives containing progestin are
implanted.
Medication is released in a stair-step method.
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24
Transdermal Patches
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Transdermal patches are solid pieces of material
that hold a specific amount of medication to be
released into the skin over time.
They are easily administered and eliminate a
possible upset stomach.
Uses:




For angina, nitroglycerin
For chronic pain, Duragesic
For motion sickness, scopolamine
Patch overload
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25
Liquids
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They are composed of various solutions.
They can be administered by all routes.
Syrups are sugar-based solutions that have
medications dissolved in them, which improves
the taste of the drug. They tend to be thicker than
water.
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26
Liquids (cont’d)
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Elixirs are agents that contain dissolved
medication in either an alcohol base or water
and alcohol (hydroalcoholic) base.
Alcohol usually covers up the bad taste of the
drug.
Elixirs have the same consistency as water.
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27
Sprays
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Sprays are composed of various bases such as
alcohol or water in a pump-type dispenser.
Nasal decongestants or sunscreens
Nitroglycerin translingual spray that is used
under the tongue for relief of anginal pain
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28
Inhalants and Aerosols
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Inhaler agents come in a variety of forms but all
must be easily inhaled into the lungs.

Common devices available OTC are vaporizers
and humidifiers.

Respiratory therapists use nebulizers to give
breathing treatments to hospital patients.

Patients can also be trained to use nebulizers
at home.
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29
Inhalants and Aerosols (cont’d)
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Anesthetics are inhaled solutions that are
administered by an anesthesiologist during
surgery.
Prescribed inhalants contain drugs that treat
asthma and allergies.
Metered dose inhalers (MDIs) dispense a
specific amount of drug with each puff or
inhalation.
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30
Emulsions
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The mixture of water and oil when used with an
emulsifier binds the two together.
Many different types of emulsifiers are used.
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31
Suspensions
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These are liquids that have very small, solid
particles suspended in the base solution.
They can be used orally by children and seniors.
Suspensions have a “Shake well” sticker and a
date of expiration.
Reconstituted medication will need to be shaken
and refrigerated.
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32
Enemas
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Enemas might be administered for two different
reasons: retention or evacuation.
They can be used to deliver medication to the
body, bypassing the stomach while being
absorbed.
Most common use is to evacuate the lower
intestine to prepare for surgeries or for women in
labor.
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33
Semisolids
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Semisolids contain both liquids and solids.
They are meant for topical application.
Creams have medications in a base that is part oil
and part water and for topical use.
Lotions are thinner than creams because their
base contains more water.
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34
Semisolids (cont’d)
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Ointments contain medication in a glycol or oil
base; they cover the skin surface and keep out
moisture.
Gels contain medication in a very viscous (thick)
liquid that easily penetrates the skin.
Pastes contain a smaller amount of liquid base
than solids. They are able to absorb skin
secretions, unlike other topical agents.
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35
Suppositories
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They 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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36
Powders
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Powders are solids, yet they can be packaged in
some forms that allow them to be sprayed,
similar to liquid dosage forms.
One of the main uses is to decrease the amount
of wetness of an area.
Antifungal foot agents
They can also be spread over a wide area.
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37
Injectables
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Normally used for rapid response.
Storage temperatures are important.
Available in many types of containers:

Ampules
 Glass bottles
 Glass and plastic vials
 Bags
 Add-O-vials
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38
Routes of Administration
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By mouth or oral medications are very
convenient, do not need to be measured, less
expensive, systemic, and safe.
The downside is that they do not work as quickly
as parenterals(IV’s).
Some drugs cannot be taken orally because they
are not as effective.
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39
Sublingual and Buccal Agents
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Nitroglycerin, which treats anginal attacks, is the
most commonly used sublingual tablet.
Buccal agents are placed between the gum and
cheek, where the medication penetrates the
mouth lining and then enters the bloodstream.
See Figure 5-11.
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40
Rectal
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Rectal (R) agents are used for a person who is
vomiting and cannot take oral medications.
To reduce inflammation, either ointments or
creams can be used in addition to suppositories.
They work on a specific site and not
systemically(through the body system).
Downside: they are uncomfortable and the actual
amount of drug absorbed is hard to predict.
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41
Topical
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Topical (TOP) preparations effects range from
systemic to localized for rashes.
There are agents to fight skin infections,
inflammation, and UV rays of the sun.
They work at the site of action and systemically.
An advantage is easy application.
A downside is that they might cause a reaction.
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42
Parenteral: Intravenous, Intravenous
Piggyback, Intramuscular, Subcutaneous
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Parenteral comes from the Greek and means “side
of intestine” or “outside of intestine.”
The most common parenteral medications are
given IV, IM, or SC.
Very-small–gauge needles are used, and the
length depends on the site being injected.
A benefit is speed of action.
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43
Parenteral: Intravenous, Intravenous Piggyback,
Intramuscular, Subcutaneous (cont’d)
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Parenteral drugs work within a few minutes.
This is important for emergency situations, for
those who are combative, or for those who are
unable to swallow.
A disadvantage is the increased risk of infection.
Narcan
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44
Parenteral: Intravenous, Intravenous Piggyback,
Intramuscular, Subcutaneous (cont’d)


Injections are more expensive and require
preparation and administration by trained
personnel.
Another downside is that once a drug is
injected, there is little time to alter its course if
an allergic reaction takes place or too much
drug is given.
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45
Eye, Ear, Nose
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All eye agents are sterile and are to be kept sterile
during use.
Doctors often use eye solutions to treat ear
conditions, but ear solutions cannot be used to
treat eye conditions because the eye is sterile.
Eye treatments are for infections, inflammation,
and glaucoma.
A main disadvantage of solutions for the eye, if
not kept sterile, is that they can introduce bacteria
into the area being treated.
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46
Eye, Ear, Nose (cont’d)
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Ophthalmics do not last as long as other
treatments because of the blinking of the eye
and tearing.
Ointments make it hard to see clearly.
For the eye, ear, and nose, there are different
types of agents, including ointments, solutions,
and suspensions.
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47
Eye, Ear, Nose (cont’d)
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Otic preparations are not necessarily sterile
because they treat the ear canal and do not
penetrate a sterile environment.
Most ear treatments are for clearing up infections
or cleaning out ear wax buildup.
Most nasal sprays are used to treat colds and
allergies.
These dosage forms work on the specific site
rather than the whole body.
Nasal Spray Addiction
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48
Pharmacokinetics vs.
Pharmacodynamics


Represent many different components
concerning the actions of a drug
Considerations such as:

Levels of the drug throughout the blood and tissues
 Absorption or movement of the drug throughout the
body
 Overall distribution
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49
Pharmacokinetics vs.
Pharmacodynamics (cont’d)
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Metabolism
Excretion of the drug
Reaction of the drugs with other drugs
Patient compliance
Life of the drug that includes bioavailability,
half-life, bioequivalence, and excretion
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50
Absorption


Medications are made to get through natural
body barriers, such as the skin, stomach,
intestines, blood-brain barrier, and other
membranous tissues.
How well the drug passes through these
barriers is the one factor that determines its
ultimate effectiveness.
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51
Distribution


After the absorption of a medication, it is
distributed throughout the body from the
bloodstream into tissues, membranes, and,
ultimately, organs of the body.
The distribution of a drug is not necessarily equal
throughout the whole body.
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52
Metabolism
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

Most metabolism takes place in the liver.
Metabolism changes the chemical structure
of the original drug.
There are different influences that can alter
metabolism such as age, gender, genetics,
diet, and other chemicals digested.
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53
Excretion/Elimination
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

Excretion is the last phase of a drug’s life in the
body.
There are many ways a drug can be excreted
from the body: via the kidneys, feces,
exhalation, sweat glands, breast milk.
Urination and bowel movements are the most
common methods of excretion.
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54
Bioavailability
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
This is the rate at which the drug makes it to its
destination and is available to the site of action
for which it was intended.
Many drugs travel into the liver before they
have a chance to be absorbed into the whole
system.
This is known as the “first-pass effect.”
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55
Half-Life
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
Half-life refers to the measurement of the time it
takes the body to break down and excrete one
half of the drug.
This is an important factor in the creation of
drugs because it tells the manufacturer how
long it takes the body to rid itself of the drug.
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56
Bioequivalence


This is the comparison between drugs either from
different manufacturers or in the same company
but from different batches of a drug.
Generic drug manufacturers strive to achieve the
same equivalence to compete with brand name
manufacturers.
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57
Packaging and Storage Requirements



Medications are packaged according to
manufacturers’ specifications to ensure
effectiveness and shelf life of the drug
All medications have a package insert that
describes the storage and stability of the drug.
All dosage forms are approved through the FDA.
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58
Medical Terminology


Medical terms have their origins in Greek
and Latin.
There are four segments of word parts:





Prefix
Suffix
Root word
Combining form
See Box 5-3 and Table 5-9.
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59
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Chap 5 Dosage Forms, Routes of Administration