PRESCRIPTION INTERPRETATION

Pharm.D Balsam Alhasan

INTRODUCTION
Many of the calculations performed in the

pharmacy rely on the pharmacists ability to

interpret a prescription. Two significant factors, in regard to prescription interpretation, are the METRIC LINE and ROMAN NUMERALS. Most of the weighing and measuring is done in the metric system with:

 a. Solids being weighed in the unit of grams or parts of a gram. b. Liquids being measured in milliliters or parts of milliliters.

METRIC LINE
The METRIC LINE acts as a decimal point for both grams and milliliters. The unit gram is indicated if the substance is a solid and milliliters if the

substance is a liquid.

Question:

NOTE:
The metric line pertains to grams and milliliters only. When any other unit designation follows an amount on the prescription, the metric line must be ignored for that substance. For example:

(1 gr = 64.8 mg)

Problem Set #1

 Roman numerals are sometimes used in place of Arabic numbers on a prescription to designate the number of tablets or the number of fluid ounces of a liquid to be dispensed. For example:

Abbreviations used in prescriptions:

Letters or symbols based on Latin words, that define rout, frequency, time of administration, dosage form, name of the drug or disease or a combination of the above.

Instructions on the prescription:

Name of the medication Dose of the medication How often to take the medication When to take the medication How to take the medication

How many pills or boxes..etc.

How many refills, if any.

Frequency abb.
ad lib - freely, as needed bid - twice a day prn - as needed q every q3h - every 3 hours q4h - every 4 hours qd - every day qid - four times a day qod - every other day tid - three times a day

Time of administration:
ac - before meals hs - at bedtime int - between meals

pc - after meals

Amount or size of dose:

caps capsule gtt drops I, II, III, or IV- the number of doses (1, 2, 3, or 4) mg milligrams ml milliliters ss - one half tabs tablets tbsp - tablespoon (15ml) tsp - teaspoon (5ml)

Rout of administration/area of application:

ad - right ear al - left ear c or o with od - right eye os - left eye ou - both eyes po - by mouth s or without sl sublingual top - apply topically

 Often the abbreviation "sig" will appear just before the directions on the prescription. "Sig" is short for the Latin, signetur, or "let it be labeled."

Common Abbreviations
Abbreviation a.c. a.d. or AD ad. lib. a.l. alt. die alt. h. a.m. aq. a.s. or AS a.u. or AU aurist. Meaning before food right ear freely as wanted left ear every other day every other hour morning water left ear each ear ear drops Latin ante cibum auris dexter ad libitum aurix laevus alternus die alternus horis ante meridiem aqua auris sinister auris utro auristillae

b.d. b.i.d. cap. div. eq.pts. gtt. h.

twice a day twice a day capsule divide equal parts drop hour

bis die bis in die capsula divide equalis partis gutta hora

h.s.
Mane mixt.

at bedtime
in the morning mixture

hora somni
mane mixtura

narist.
no.

nasal drops
number

naristillae
numero

Nocte O.

at night pint

nocte octarius

oc.
o.d. o.d. or OD o.l. o.m.

eye ointment
daily right eye left eye in the morning

oculentum
omni die oculus dexter oculus laevus omni mane

o.n.
o.s. or OS o.u. or OU

at night
left eye each eye

omni nocte
oculus sinister oculus utro

p.c. p.m. p.o. p.r. p.r.n. p.v. q.4.h. q.6.h. q.d. or QD

after food afternoon orally rectally as occasion requires vaginally every 4 hours every 6 hours every day

post cibum post meridiem per os per rectum pro re nata per vaginum quaque 4 hora quaque 6 hora quaque die

q.d.s.
q.i.d. q.o.d or QOD q.q.h.

four times a day

four times a day Every other day every four hours

quater die sumendus

quater in die quaque altera die quarta quaque hora

q.s.
s.i.d. Sig. or S. stat. supp. syr.

a sufficient quantity
once a day write on the label immediately suppository syrup

quantum sufficiat
semel in die signa statim suppositorum syrupus

tab.
t.d.s. t.i.d. ut dict. or u.d. ung.

a tablet
three times a day three times a day as directed ointment

tabella
ter die sumendus ter in die ut dictum unguentum

Be careful!!!!!!
Despite their widespread use in prescription writing,

some of them are considered dangerous to use by

Institute of Safe Medication Practices (ISMP) since they have been found to cause serious medication errors as a result of misinterpretation. Hence, their use is discouraged. Problematic Latin abbreviations are illustrated in the following table:

Abbreviation AD, AS, AU

Intended Meaning Right ear, Left ear, Each ear

Misinterpretation Correction Mistaken as OD, Use "right ear", OS, OU (right eye, "left ear", "each left eye, each eye) ear".

OD, OS, OU

Right eye, left eye, each eye

Mistaken as right Use "right eye", ear, left ear, each "left eye", "each ear. eye". Mistaken as bedtime Mistaken as halfstrength Use "halfstrength" Use "bedtime"

HS

Half-strength

hs

at bed-time, hours of sleep

Abbreviation
o.d. or OD

Intended Meaning
Once daily

Misinterpretation

Correction

Mistaken as "right Use "daily" eye" (OD Oculus Dexter) leading to oral medications given through the eye "os" can be mistaken as left eye Mistaken for q.i.d, Use "PO", "by mouth" or "orally". Use "daily" Use nightly.

Per os

By mouth, orally

q.d. or QD qhs

Every day

Nightly at bedtime Mistaken as "qhr" or every hour.

q.o.d or QOD

Every other day

Mistaken as "q.d" (daily) or "q.i.d" (four times daily)

Use "every other day"

Problem Set:
Example 1: Simvastatin 40 mg I PO qhs Disp. 60 tabs Refill =0

Example 2
Isordil 5mg tab

I tab S.L PRN q5min up to III tabs.

Disp. 30 tabs

Refill = 3

Example 3:
Diclogesic ear drops:

III gutt ad qid.

Disp. 1 Refill = 0

Example 4
Voltarin CR 75 mg tabs

I tab PO bid pc.

Disp. 30 tabs.

Refill = 1

Questions?