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HUC Meds and IVs

HUC Studies: Medications and IV Therapy Orders

apothecary an old European term given to a druggist, meaning one who prepares or sells drugs
chemical name the chemical and molecular formula of a drug
generic name the common name given to the drug by the developer
metric a modern measurement system based on the meter, kilogram, and decimal system
sliding scale the medication dose is written to be dependent on a laboratory result
trade or brand name the name given to the drug by the manufacturer or seller
ac before meals
ASA aspirin
Aer Aerosol
Bid twice a day
cap capsule
cc cubic centimeter
chew chewable
CNS Central Nervous System
Conc Concentrate
CSA Controlled Substance Act
CVC Central Venous Catheter
D5 Dextrose 5%
D5W Dextrose 5% Water
DEA Drug Enforcement Administration
dr delayed release
dr dram
Drsg dressing
effrv effervescent
elcon electronically controlled
er extended release
g gram
gm gram
gr grain
gran granule
gtt drop
h hour
H hypodermic
HA hyperalimentation
Hep loc Heparin lock
hr hour
hs hours of sleep or bedtime
Hyperal Hyperalimentation
ID intradermal
IM intramuscular
imp implant
inj injection
INT intermittent IV needle
IV intravenous
IVP intravenous push
IVPB Intravenous piggyback
L liter
l liter
liq liquid
loz lozenge
LR Lactated Ringer's
MAR Medication Administration Record
mcg microgram
mEq milliequivalent
met metered
mg milligram
ml, mL milliliter
MOM milk of magnesia
NaCl Sodium Chloride (saline)
NF National Formulary
NS Normal Saline
NSAID Nonsteroidal Anti-inflammatory Drug
oz ounce
pc after meals
PCA patient-controlled analgesia
PDR Physician's Desk Reference
PICC peripherpherally inserted central catheter
po oral, by mouth
prn as necessary
pwd powder
q day every day
qid four times a day
RL Ringer's Lactated
sc subcutaneous
sol solution
sq subcutaneous
subl sublingual
subling sublingual
subq subcutaneous
supp suppository
susp suspension
tab tablet
tid three times a day
TPN total parenteral nutrition
USP United States Pharmacopeia
VAD Vascular Access Device
Components of a medication order 1. Medication Name 2. Drug Forms 3. Medication Dose 4. Medication Route 5. Frequency
Medication Name lists what drug the physician wants to give the patient. Can be referred to by 3 diff names. 1. chemical name 2. Generic name 3. Trade, or brand, name
Acetylsalicylic acid asprin; Anacin
(+)-2 (p-isobutylphenyl) ibuprofen, Motrin or Advil
Drug Forms the way the drug is prepared, syrup, tablet or capsule. The form is not always included in med orders. Form is often a clue to means of administering the drug.
Aer; aerosol a product that is packaged under pressure & contains therapeutically active ingredients that are released upon activation of an appropriate valve system; intended for topical application to the skin, local application into the nose, mouth or lungs.
Aer met; aerosol metered A pressurized dosage from consisting of metered dose valves which allow for the delivery of a uniform quantity of spray upon each activation
cap; capsule a solid dosage from in which the drug is enclosed within either a hard or soft soluble container or shell made from suitable form of gelatin.
cap dr; capsule delayed release solid dosage form which the drug is enclosed w/in either a hard or soft soluble container made from gelatin, and which releases a drug(s) at a time other than promptly after administration. Eteric-coated articles are delayed-released dosage forms.
cap er; capsule, extended release solid dosage form which the drug is enclosed w/in hard or soft gelatin container and which releases a drug(s) in such a manner to allow a reduction in dosing frequency as compared to that drug(s) presented conventionally.
cap liq filled; capsule, liquid filled solid dosage form which the drug is enclosed in soluble gelatin shell which is plasticized by addition of a polyol such as sorbitol or glycerin, thicker consistency than hard-shell cap; typically active ingred are dissolved / suspended in a liquid vehicle
core er; core extended release an ocular system placed in the eye from which the drug diffuses through a membrane at a constant rate over a specified period
cream semisolid dosage form containing one or more drug substances dissolved or dispersed in a suitable base; term restricted to products consisting of oil in water emulsions or aqueous microcrystalline dispersions of long chain fatty acids or alcohols
disc a circular platelike structure
douche a liquid preparation intended for the irrigative cleansing of the vagina, that is prepared from powders, liquid solutions or liquid concentrates and contains one or more chemical substances dissolved in a suitable solvent or mutually miscible solvents.
dressing The application of various materials for protecting a wound
elixir a clear, pleasantly flavored, sweetened hydroalcoholic liquid containing dissolved medicinal agents; it is intended for oral use
emulsion A two-phase system in which one liquid is dispersed throughout another liquid in the form of small droplets
enema a rectal preparation for therapeutic, diagnostic, or nutritive purposes
extract a concentrated prep of vegetable/animal drugs obtained by removal of active constituents of the respective drugs w/ a suitable menstrua, evaporation of all/nearly all of the solvent, & adjustment of the residual masses/powders to the prescribed standards
film a thin layer or coating
gel a semisolid system consisting of either suspensions made up of small inorganic particles or large organic molecules interpenetrated by a liquid
gel, jelly a class of gels, semisolid systems that consist of suspensions made up of either small inorganic particles or large organic molecules interpenetrated by a liquid in which the structural coherent matrix contains a high portion of liquid, usually water
gran; granule a small particle or grain
gran effrv; granule effervescent a small particle or grain containing a medicinal agent in a dry mixture usually composed of sodium bicarbonate, citric acid and tartaric acid which when in contact with water has the capability to release gas resulting in effervescence
gum a mucilaginous excretion from various plants
imp; implant a material containing a drug intended to be inserted securely or deeply in a living site for growth, slow release, or formation of an organic union
inhalant a drug/combination of drugs, that by virtue of their heigh vapor pressure can be carried by an air current into the nasal passage where they exert their effect; the container from which the inhalant generally is administered is known as an inhaler.
inj; injection a sterile preparation intended for parenteral use; five distinct classes of injections as defined by US Pharmocopeia
inj sol; injection solution A liq prep containing one or more drug substances dissolvedin a suitable solvent or a mixture of mutually miscible solvents that is suitable for injection
inj susp; injection suspension a liq prep suitable for injection which consists of solid particles dispersed throughout a liquid phase in which the particles are not soluble. it can also consist of an oil phase dispersed throughout an aqueous phase or vice versa
insert er; insert, extended release A specially formulated and shaped solid prep (ring, tablet or stick) intended to be placed in the vagina by special inserter where the medication is released; generally for localized effects; the extended release prep designed for reduction in dosing freq
irrigant a sterile solution intended to bathe or flush open wounds or body cavities; they are used topically never perenterally
liniment a solution or mixture of various substances in oil, alcoholic solutions of soap, or emulsions intended for external application
lotion The term has been used to categorize many topical suspensions, solutions, and emulsions intended for application to the skin.
loz, lozenge a solid preparation containing one or more medicaments, usually in a flavored, sweetened base, which is intended to dissolve or disintegrate slowly in the mouth. A lollipop is a lozenge on a stick.
liq, liquid A intermediate state as matter goes from solid to gas; liquids are also intermediate in that they have neither orderliness of a crystal nor the randomness of a gas. Should not be used to describe solutions, only pure chemicals in their liquid state.
oil An unctuous, combustible substance, which is liquid, or easily liquefiable on warming, and is soluble in either but insoluable in water. Such substances depending on their origin are classified as animal, mineral, or vegetable oil.
ointment A semisolid preparation intended for external application to the skin or mucous membranes.
Paste A semisolid dosage form that contains one or more drug substances intended for topical application.
Patch A drug delivery system that contains an adhesive backing and that permits its ingredients to diffuse from some portion of it (the backing, a reservoir, the adhesive, etc) into the body from the external site where it is applied.
Patch er; patch extended release A drug delivery system in the from of a patch that releases the drug in such a manner that the dosing frequency is reduced compared to that drug presented as a conventional dosage form.
Patch er elcon, Patch extended release electronically controlled A drug delivery system in the from of a patch which is controlled by an electric current that releases the drug in such a manner that dosing frequency is reduced compared to that drug presented as a conventional dosage from
pill A small, round solid dosage from containing a medicinal agent intended for oral administration
poultice a soft, moist mass of meal, herbs, seed, etc. usually applied hot in cloth that consists of gruel-like consistency
pwd, powder An intimate mixture of dry, finely divided drugs and/or chemicals that may be intended for internal or external use.
Rinse A liquid used to cleanse by flushing
salve A thick ointment or cerate (a fat or wax-based preparation with a consistency between an ointment and a plaster.
shampoo a liquid soap or detergent used to clean the hair and scalp and often used as a vehicle for dermatologic agents
sol, solution A liquid preparation that contains one or more chemical substances dissolved, i.e. molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents.
sol conc, solution concentrate A liquid preparation (i.e. a substance that flows readily in its natural state) that contains a drug dissolved in a suitable solvent or mixture of mutually miscible solvents; the drug has been strengthened by the evaporation of its nonactive parts
spray A liquid minutely divided as by a jet of air or steam
stick a dosage form prepared in a relatively long and slender often cylindrical form
supp, suppository A solid body of various weights and shapes, adapted for introduction into the rectal, vaginal, or urethral orifice of the human body; they usually melt, soften, or dissolve at body temperature
susp, suspension A liquid preparation which consists of solid particles dispersed throughout a liquid phase in which the particles are not soluble
syrup An oral solution containing high concentrations of sucrose or other sugars; the term has also been used to include any other liquid dosage from prepared in a sweet and viscid vehicle, including oral suspensions
tab, tablet A solid dosage form containing medicinal substances with or without suitable diluents
tab chew; tablet chewable A solid dosage form that contains medicinal substances with or without suitable diluents that is intended to be chewed, producing a pleasant tasting residue in the oral cavity that is easily swallowed and does not leave a bitter or unpleasant aftertaste
tab coated, tablet coated A solid dosage from that contains medicinal substances with or without suitable diluents and is covered with a designated coating
tab dr, tablet delayed release A solid dosage from, which releases a drug(s) at a time other than promptly after administration. Enteric-coated articles are delayed release dosage forms.
tab effrv, tablet effervescent A solid dosage form containing, in addition to active ingredients, mixtures of acids (citric acid, tartaric acid) and sodium bicarbonate, which release CO2 when dissolved in water; it is intended to be dissolved or dispersed in water before administration
tab er, tablet extended release A solid dosage form containing a drug which allows at least a reduction in dosing frequency as compared to that drug presented in conventional dosage form
tincture An alcoholic or hydroalcoholic solution prepared from vegetable materials or from chemical substances
troche A discoid-shaped solid containing the medicinal agent in a suitable flavored base; troches are placed in the mouth where they slowly dissolve, liberating the active ingredient
wafer a thin slice of material containing a medicinal agent.
Medication Dose the measured amouth of the medication that is to be given. Two main systems: apothecary and metric
Apothecary Doses is an older system that was formerly used to measure meds. Based on the ounce, which is divided into 8 drams or 480 grains. Written in lower case Roman numbers. 15 grains = gr xv
Metric Doses modern decimal measurement system based on meter as unit of length and kilogram as unit of mass. In healthcare: gram for weigh; L or cubic centimeter for volume. Written in Arabic numerals
Sliding Scale Doses Often dose of medication is indicated by a specific condition or diagnostic exam result. Dose dependent on lab result. Ex: Insulin.
Medication Route How will the patient take the drug or how ill it get into the patient's system? Topical, oral or enteral, and parenteral.
Oral medications enter the patient's system through the digestive tract either by mouth or through feeding tube
Topical medications have a local effect and are applied directly where the action is desired.
Parenteral routed medications in medication orders, refers to an injection
po; oral by mouth, orally
subling, subl; sublingual or buccal dissolved under the tongue or inside the cheek
aerosol inhalation directly inhaled into the lungs
topical or transdermal applied directly to the skin
instillation dropped into the ear, eye, or nose
intraocular a disk similar to a contact lens
insertion introduced into body openings, such as a suppository
ID or H; intradermal hypodermic Injected into the upper layer of the skin
subq, sc, or sq; subcutaneous Under the skin into fat or connective tissue
IM; intramuscular Injected into deep muscle
IV; intravenous injected into the vein
IVP; IV push or bolus Given directly into a vein by a syringe and needle or an injection port of IV tubing, used for relatively large volumes of fluid or does of a drug given rapidly to hasten or magnify a response.
INT; intermittent Needle connected to a small length of tubing with a resealable cap used for intermittent infusions of small amounts
Hep loc; Heparin lock or flush, saline lock or flush Needle connected to a small length of tubing with a resealable cap used for intermittent infusion of small amounts
IVPB; IV piggyback Used when a patient has an established continuous IV; a bag is connected to a side arm of an existing IV
Admixture for a continuous even drip of med, a drug is added to a commercially prepared IV solution
PCA; patient controlled analgesia Allows patient to administer his or her own IV med via a special pump and IV tubing
CVC; central venous catheter IV line inserted thru the subclavian vein. A consent may be needed for the insertion procedure. Used for total parenteral nutrition (TPN), hyperalimentation (HA/hyperal) or IV solutions with a dextrose concentration greater than 10%
epidural injected into epidural space of spinal cord
intrathecal injected into subarachnoid space for the purpose of instilling a medication for diffusion throughout the spinal fluid.
VAD, Vascular Access Devices include various catheters, cannulas, and infusion ports that allow for long-term IV therapy or repeated access to the central venous system
FREQUENCY "When or how often will the medication be given?"
VAD, nontunneled central venuous catheter (triple-lumen) Brand: Hohn, Deseret Short term fluid or blood administration, obtaining blood specimens, and administering medications
VAD, tunneled central venous catheter (single or double lumen) Brand: Hickman, Broviac, Groshong Long term (months to years) fluid replacement therapy, medication administration, nutritional supplement, and blood specimen withdrawal.
VAD, implanted infusion port Brand: Chemo-Port, Infuse-a-Port, Mediport, Port-a-Cath Long term (months to years)fluid replacement therapy, medication administration (especially chemotherapy), blood or blood product administration, and blood specimen withdrawal
VAD, peripherally inserted central catheter (PICC) Brand: C-PICC, Groshong PICC, SoloPICC Long term fluid replacement therapy, medication administration (chemotherapy, antibiotics, controlled narcotics) blood or blood product administration, and blood specimen withdrawal.
Q day everyday (0900)
bid twice a day 0900-1700
tid three times a day 0900-1300-1700
qid four times a day 0900-1300-1700-2100
ac before meals 1000-1400-1800
pc after meals 0730-1130-1630
hs bedtime or hour of sleep 2100
q 12 hr every 12 hours 0900-2100
q 8 hr every 8 hours 0800-1600-2400
q 6 hr every 6 hours 0600-1200-1800-2400
q 4 hr every 4 hours 0900-1300-1700-2100-0100-0500
Order duration orders can be categorized by time frame or duration of order. For meds: stat; standing; standing prn; one-time or short series orders
stat Orders that are activated immediately
Standing orders that remain active until further orders are written to D/C or change. Dr has to write the order only once as a standing order and the patient will receive meds everyday as ordered until the Dr writes another order to change or D/C the med.
Standing prn Orders that remain active or in place until further orders are written to D/C or change but for which the medication is administered only as necessary.
one-time or short series orders that are active or in place only once or just for the specified amount of time. Dr may order meds given for 4 days or for 10 doses. HUC may have to indicate the times for short-term frequency orders
PRN frequencies DR will write a qualifying phrase: while awake; for nausea; for pain; if unable to sleep
Military time Most health care facilities use Military time/24 hr clock.
Automatic stop dates and renewals med orders may have automatic stop dates even if the dr writes med order as standing order, facility may have a policy that gives the max duration of med orders. Facility will also have notification policy.
Classifications meds are usually classified or grouped according to the disease or body system they affect.
Antianginal Cardiovascular: Treat angina (chest pain)//isosorbide (Isordil), nitroglycerine
Antiarrhythmic Cardiovascular: Treat cardia arrhythmias//atropine (Atropair), digoxin (Lanoxin), lidocaine, procainamide (Pronestyl), propranolol (Inderal)
Blood modifiers and anticoagulants Cardiovascular: To form or then blood//clopidogrel bisulfate (Plavix), dipyridemole (Persantine), enoxaparin (Lovenox), epoetin alfa recombinant (Procrit), heparin, warfarin (Coumadin)
Antihypertensive Cardiovascular: To treat hypertension (high blood pressure)//atenolol (Tenormin), captopril (Capoten) clonidine (catapres), quinapril hydrochloride (Acupril), verapamil (Isoptin)
Antihyperlipidemic Cardiovascular: To treat high cholesterol// atorvastatin (Lipitor) clopidogrel (Plavix) Iovastatin (Mevacor) pravastatin (Pravachol)
Diuretics Cardiovascular: treat hypertension, fluid retention/Hydrocholorthiazide (Hydro-diuril)
Potassium supplements Cardiovascular: replaces potassium-often lost because of the use of diuretics//potassium bicarbonate (K+care), potassium chloride (Kaochlor, Klor-con, Klorvess, Slow-K), potassium gluconate (Kaon)
Antibiotics Anti-Infective: treats bacterial infections: amoxicillin (Amoxil), ceflacor (Ceclor), gentamicin (Garamycin), tetracycline (Panmycin), tobramycin (Nebcin)
Antiviral Anti-Infective: treat viral infections//acyclovir (Zovirax)
Amphetamine CNS: CNS stimulant//dextroamphetamine sulfate (Dexadrine)
Anti-anxiety drug CNS: treat anxiety/diazepam (Valium), hydroxyzine (Atarax), lorazepam (Ativan), ranitidine (Zantac)
Anticonvulsants CNS: treat seizures//carbamazepine (Tegretol), divalproex (Depakote), phenytoin (Dilantin)
Antidepressants CNS: treat depression//amitriptyline (Elavil), bupropion hydrochloride (Wellbutrin), sertraline hydrochloride (Zoloft)
Antiparkinson agents CNS: treat Parkinson's disease//amantadine (Symmetrel) entacapone (Comtan), levodopa (L-dopa)
Antiphychotic CNS: treat mental illness//haloperidol (Haldol), quetiapine (Seroquel)
Anagesics-narcotic CNS: treat pain//codeine, fentanyl (Sublimaze), hydrocodone and acetaminophen (Vicodan), hydromophone (Dilaudid), meperidine (Demerol) morphine sulfate
Analgesics-non-narcotic CNS: treat pain//acetaminophen (Tylenol), asprin (abbreviated ASA)
Tranquillizers/hypnotics CNS: induce rest// flurazepam (Dalmane), temzaepam (Restoril), zolpiden tartrate (Ambien)
Antidiabetic agents- hypoglycemics Endocrine: treat diabetes//glipizide (Glucotrol), metformin (Glucophage), tolbutamide (Orinase)
Antidiabetic agents- insulin Endocrin: treat diabetes// lente insulin, NPH insulin, regular insulin
Corticosteroids Endocrin: treat diseases of metabolism, anti-inflammatory or immunosuppressant therapy//betamethasone, hydrocortisone, methylprednisone (Solu-Medrol) prednisone
Thyroid drugs Endocrine: treat hypothyroidism// levothyroxine (Levothroid)
Antidiarrheal GI: treat diarrhea// diphenoxylate hydrochloride (Lomotil); loperamide (Imodium)
Antiemetics GI: treat nausea and vomiting// prochlorperazine (Compazine) thiethylperazine (Torecan)
Laxitives GI: treat constipation// bisacodyl (Dulcolax), docusate sodium (Colace), magnesium hydroxide (Milk of Magnesia, MOM)
Antihistamines Respiratory: treat allergies/ diphenhydramine (Benadryl), fexofenadine (Allegra), hydroxyzine hydrochloride (Atarax)
Histamine antagonists Respiratory: Treat allergies// cimetidine (Tagamet), Prochlorperazine (Compazine)
Bronchodilators Respiratory: Open bronchial tubes// albuterol (Proventil), bitolterol (Tornalate), metaproterenol sulfate (Alupent) terbulatine (Brethine) theophylline (Theolair, Theo-bid)
Nonsteroidal anti-inflammatory drugs (NSAIDs) Muscoskeletal: treat inflammatory disease and pain// etodolac (Lodine), ibuprofen (Motrin), indomethacin (Indocin), naproxen (Naprosyn)
Skeletel muscle relaxants Muscoskeletal: treat musculoskeletal and neurological disorders// methocabamol (Robaxin)
Antineoplastic Muscoskeletal: Chemotherapeutic, treat cancer// carmustine (BICNU) cyclophosphamide (Cytoxan) cytarabine (Cytosar-U) melphalan (Alkeran), tamoxifen (Tamofen Nolvadex)
Two most common ways to dispense medications are: unit dose and automated dispensing
Unit-dose dispensing medication is dispensed in a package that is ready for administration to patient.
Unit-does dispensing cart variation Pharmacist verify med orders, techs fill drugs in unit-dose carts. Carts have drawers for each patient, labeled with identifying info. MAR sits on top of cart. Drawers for entire unit slide out for pharmacy to replace with fresh/updated meds each day.
Automated dispensing drug storage devices or cabinets that electronically dispense meds in a controlled fashion and track med use. Advantage - permitting nurses to obtain meds for inpatients at point of use.
Intravenous (IV) therapy may be used to provide fluids, medications and nutrition directly into the patient's bloodstream through a vein.
Difference between IV route for medication and IV therapy is the time of administration.
IV route for medication medication is administered into an IV needle or catheter inserted into the vein and the order is completed.
IV route for therapy the fluids, medication or nutrition is continuously flowing into the IV catheter or needle.
IV order components amount, solution, rate and additives
IV Amount How much fluid in IV bag? or What is the size of the bag? Indicated in cubic centimeters (cc) or milliliters (mL). For adult patients, common size is one Liter/1000cc/1000mL
IV Solution What kind/type of solution is in the IV bag? Common solutions are saline or dextrose or a combo of both. IV solutions are packaged in plastic bags or glass containers.
D5W Dextrose 5% water
NS or 0.9NaCl Normal saline
D5 1/2 NS or D5.45NaCl Dextrose 5% water and one half normal saline
d5 1/4 NS or D5.25NaCl Dextrose 5% water and one-fourth normal saline
RL or LR Ringer's Lactated or lactated Ringer's
IV Rate How fast should the IV fluid drip? Order may be written in hours or mL per hour; regulated through special tubing or a pump.
Additives What meds should be added to the continuous IV infusion? Common additives include potassium chloride (KCl), vitamins, and heparin
IV admixture an IV with a mixture of fluids and medication
Total parenteral nutrition (TPN) or hyperalimentation practice of feeding by bypassing the GI system & infusing nutrients directly into bloodstream. TPN is given to someone who cannot eat anything & must receive all nutrients thru IV line. Soln cont protein, fat, calories, vitamins & minerals is infused IV.
TPN given thru central IV line. Dextrose soln of greater than 10% is usually the base for TPN. Other nutrients such as sodium, potassium, magnesium, calcium, insulin, multivitamins, and trace elements can be added.
Resources to assist in transcription of medication The United States Pharmacopeia (USP) National Formulary (NF) Physician's Desk Reference (PDR) Info about drug names, doses, routes and contraindications.