PTCB - Chapter 6 - Calculations - Definitions

Roman Numerals
ss = 1/2
I = 1
V = 5
X = 10
L = 50
C = 100
D = 500
M = 1000

Rule 1 = when the second of two letters has a value equal to or smaller than that of the first, add their values together
         XX = 10 + 10 = 20            DC = 500 + 100 = 600                  LXVI = 50 + 10 + 5 + 1 = 66

Rule 2 = when the second of two letters has a value greater than that of the first, subtract the smaller from the larger
        IX = 10 - 1 = 9                   XXXIX = 30 + 9 = 39                   XC = 100 - 10 = 90


Positional notation
- a system used in Roman numerals whereby the position of the numeral signifies its mathematical value

Denominator
- the bottom or right number in a fraction

Numerator
-  the top or left number in a fraction

Least Common Denominator
- smallest possible denominator for an equivalent fraction so that two fractions can be added or subtracted and have the same denominator

Rules for Assigning Significant Figures

1. Digits other than zero are always significant
2. Final zeros after a decimal point are always significant
3. Zeros between two other significant digits are always significant
4. Zeros used only to space the decimal are never significant

Conversions

- a changing one unit of measure into another so that both amounts remain equal

Liquids

liter = L ⮞ 1 L = 10 dL = 1000 mL

deciliter = dL ⮞ 1 dL = 0.1 L = 100 mL

milliliter = mL ⮞ 1 mL = 0.001 L = 0.01 dL

Solids

kilogram = kg ⮞ 1 kg = 1000 g

gram = g ⮞ 1 g = 0.001 kg = 1000 mg

milligram = mg ⮞ 1 mg = 0.001 g = 1000 mcg

microgram = mcg or ug ⮞ 1 mcg = 0.001 mg = 0.000001 g

Avoirdupois System

pound = lb ⮞ 1 lb = 16 oz

ounce = oz ⮞ 1 oz = 437.5 gr

grain = grain ⮞ 1 gr = 64.8 mg

Apothecary System

gallon = gal ⮞ 1 gal = 4 qt

quart = qt ⮞ 1 qt = 2 pt

pint = pt ⮞ 1 pt = 16 fl oz

fluid ounce = fl oz ⮞ 1 fl oz = 8 fl oz

fluid dram = fl dr, ʒ ⮞ 1 ʒ = 60 min

minim = min or Mx

Household Units

teaspoon = tsp ⮞ 1 tsp = 5 mL

tablespoon = tbsp. ⮞ 1 tbsp. = 3 tsp = 15 mL

cup = cup ⮞ 1 cup = 8 fl oz

Temperature

F = (9/5) C + 32

C = (5/9) (F - 32)

Conversion

1 L = 33.8 fl oz                     1 oz = 28.35 g

1 pt = 473.167 mL                1 g = 15.43 gr

1 fl oz = 29.57 mL                1 gr = 64.8 mg

1 kg = 2.2 lb                         1 tsp = 5 mL

1 lb = 453.59 g                     1 tbsp. = 15 mL

Variable

- an unknown value in a mathematical equation

Flow rate

- the rate (in mL/hour or mL/min) at which a solution is administered to a patient; also known as rate of administration

Concentration

- the strength of a solution as measured by the weight-to-volume or volume-to-volume of the substance being measured

Percents and Solutions

weight-to-volume: grams per 100 mL ⮞ g/100 mL

volume-to-volume: milliliters per 100 mL ⮞ mL/100 mL

Milliequivalent (mEQ)

- the unit of measure for electrolytes in a solution

qs ad

- the quantitiy needed to make a prescribed amount

Total parenteral nutrition (TPN)

- administration of all nutrients intravenously; also known as hyperalimentation

Valence

- the number of positive or negative charges on an ion

Percent Solution Formula

(x volume needed / want %) = (volume prescribed / have %)

Powder Volume

The final volume of the constituted product (FV)

The volume of the diluent (D)

The powder volume (PV)

FV = D + PV

Body Surface Area

- a measure used for dosage that is calculated from the height and weight of a person and measured in square meters

Nomogram

- a chart showing relationships between measurements

Calculation of Children's Doses

Clark's Rule

    (weight of child / 150 lb) x adult dose

Young's Rule

    (age of child / age + 12) x adult dose

Body Surface Area Formula

    (child BSA x adult dose) / avg adult BSA

Determining Selling Prices for Prescriptions

average wholesale price (AWP) + professional fee = selling price

Gross Profit

gross profit = selling price - acquisition cost

Net Profit

Net profit = selling price - acquisition cost - dispensing fee

or 

Net proft = gross profit - dispensing fee

PTCB - Chapter 5 - Prescriptions - Key Concepts

Prescriptions

• A prescription is a written or verbal order from a practitioner for the preparation and administration of a medicine or a device
• Medical doctors (MD), doctors of osteopathy (DO), dentists (DDS), and veterinarians (DVM) are the primary practitioners who write prescriptions. Podiatrists and optometrists are also allowed to write prescriptions. All practitioners must write within the scope of their practice
• In many states, nurse practitioners, physicians assistants, and/or pharmacists are also allowed limited rights to prescribe medications
• In community pharmacies, pharmacy technicians generally the prescription, collect patient data (correct spelling of name, address, allergy, and insurance information, etc) and enter it into a computerized prescription system

Prescription Information

• The pharmacist should be consulted on all OTC and Schedule II prescriptions
• The prescription is entered into the computer and drug-drug, drug-disease, and drug-allergy information is automatically checked by the pharmacy software. If third party billing is involved, this is done only simultaneously

The Fill Process

•  Once the prescription and third party billing is confirmed by the online computer system, the label and receipt are printed and the prescription is prepared
• Since the patient is expected to self administer the medication, the label's directions for use must be clear, unambiguous, and concise
• Pharmacists must provide counseling to patients on all new prescriptions and on any refilled prescriptions when clarification is required. A patient may refuse counseling
• In institutional settings, nursing staff generally administer medications to patients
• Technicians must require the advice of the pharmacist whenever judgement is required

Labels

• Many computerized prescription systems will automatically indicate which auxiliary labels to use with each drug

HIPAA

• The Health Insurance Portability and Accountability Act (HIPAA) contains regulations related to privacy and protected health information (PHI)
• Examples of PHI are name and address, date of birth, Social Security number, payment history, account number, name and address of healthcare provider and/or health plan, and medical or prescription history
• Under HIPAA, pharmacies and other covered entities are required to provide a written notice of their privacy practices to their patients
• A pharmacy may disclose PHI to business associates that perform services for the patient
• All personnel who have access to PHI must be formally trained regarding HIPAA

PTCB - Chapter 5 - Prescriptions - Common abbreviations

Route of Administration

a.d. = right ear                                                p.r. = rectally
a.s., a.l. = left ear                                            p.v. = vaginally
a.u. = each ear                                                inh. = inhalation
o.d. = right eye                                               per neb = nebulizer
o.s., o.l. = left eye                                          SC, subc, subq = subcutaneous (under the skin)
o.u. = each eye                                               IM = intramuscular
p.o. = by mouth                                             IV = intravenous
SL = sublingual, under the tongue                IVP = intravenous push
top. = topically                                              IVPB = intravenous piggyback


Dosage Form

tab. = tablet                                                      syr. = syrup
cap. = capsule                                                  liq. = liquid
SR, XR, XL = slow/extended release             supp. = suppository
sol = solution                                                  crm = cream
susp = suspension                                           ung., oint = ointment


Timing of Administration

bid = twice a day                                            prn = as needed
tid = three times a day                                    a.c. = before food
qid = four times a day                                    p.c. = after food
am/qam = morning/each morning                 stat = immediately
pm = afternoon/evening                                q_h = every _ hour
h.s. = at bedtime


Measurement

i, ii = one, two, etc                                 mcg, ug = microgram
ss = one half                                          mg = milligram
gtt = drop                                               g = gram
mL = milliliter                                       mEq = milliequivalent
tsp = teaspoon (5 mL)                           aa = of each
tbsp. = tablespoon (15 mL)                   ad = to, up to
fl oz = fluid ounce (30 mL)                  aq ad = add water up to
L = liter                                                qs, qs ad = add sufficient quantity


Other

UTD = as directed                          w/ = with
NR = no refill                                 w/o = without
DAW = dispense as written

PTCB - Chapter 5 - Prescriptions - Definitions

Extemporaneous compounding
- the on demand preparation of a drug product according to a physician's prescription, formula, or recipe

Over the counter (OTC) drugs
- medications that do not require a prescription but may be filled with a prescription

Prescription
- an instruction from a medical practitioner that authorizes a patient to be issued a drug or device

The Prescription Process

1.  A prescription is ordered by a prescriber
2. The prescription arrives at the pharmacy
3. Patient and prescriber information is gathered
4. The prescription data is entered into the computer system
5. Insurance and billing information is processed
6. The label is generated
7. The prescription is prepared
8. The pharmacist checks the prescription
9. The patient receives the prescription
10. The pharmacist provides counseling

Signa

- from the latin word signa meaning "to write". It is abbreviated to Sig or S (or left out entirely). It indicates the directions for use and the administration route

DAW (dispense as written)

- a code specifying that the brand name drug, rather than its generic equivalent, is to be dispensed

Schedule II drugs

- drugs that have a high potential for abuse or addiction but that also have safe and accepted medical uses; they require special handling

Health Insurance Portability and Accountability Act (HIPAA)

- a federal act that protects the privacy of individuals and the sharing of protected health information

Protected health information (PHI)

- any personal information that could be used to identify an individual or their health history

PTCB - Chapter 4 - Terminology - Key Concepts

Terminology

• Much of medical science terminology is made up of a combination of root words that originated from either Greek or Latin words, suffixes, and prefixes
• A prefix is added to the beginning of a root word and a suffix is added to the end of a root word to clarify the meaning
• Combining vowels are used to connect the prefix, root word, or suffix parts of the term

Organ System Terminology

• The cardiovascular system circulates blood throughout the body in blood vessels called arteries, capillaries, and veins
• The endocrine system consists of the glands that secrete hormones (chemicals that assist in regulating body function)
• The GI tract contains the organs that are involved in the digestion of foods and the absorption of nutrients
• The integumentary system (ie, the body's covering) is the first line of defense against disease and physical hazards
• The lymph and blood systems are the center of the body's immune system
• The body contains more than 600 muscles that give it shape and produce movement
• The nervous system is the body's system of communication. The neuron (nerve cell) is its basic functional unit
• The skeletal system protects soft organs and provides structure and support for the body's organ systems
• The female reproductive system produces hormones (estrogen, progesterone), controls menstruation, and provides for childbearing
• The male reproductive system produces sperm and secretes the hormone testosterone
• The respiratory system brings oxygen into the body through inhalation and expels CO2 gas through exhalation
• The primary organ of the urinary tract is the kidney; each kidney has millions of nephrons that help remove waste materials and drugs from the blood
• The ear provides the sense of hearing maintains the body's equilibrium
• The eye is the sensitive organ involved in sight. Several body functions are involved in protecting this organ (eg, tear production, blinking)

Drug Classifications / Medical Abbreviations

• The same system used in medical science terminology can be applied to the names given to various drug classes
• There are an estimated 10,000 abbreviations used in medical science. Many abbreviations are specific to an institution or area of the country

PTCB - Chapter 4 - Terminology - Roots

ROOT - BODY

card = heart                         mast = breast

cyst = bladder                     my = muscle

derma = skin                       nephr = kidney

dont = teeth                         neur = nerve

gastr = stomach                   ocul = eye

glyc = sugar                        opia = vision

hemat = blood                     oste = bone

hepat = liver                        ot = ear

lingu = tongue                     partum = bring forth

thorax = chest                      pector = chest

thyroid = thyroid                 pneumon = lung

ven = vein

CARDIOVASCULAR SYSTEM

aneur = widening                oxy = oxygen

angi = vessel                       pector = chest

aort = aorta                         phleb = vein

arter = artery                      stenosis = narrowing

ather = plaque                    thromb = clot

card = heart                        vas (cu) = blood vessel

cyte = cell                           ven = vein

embol = embolus

ENDOCRINE SYSTEM

aden = gland                     pancreat = pancreas

adrena = adrenal               plas = development

crine = to secrete              somat = body

glyc = sugar                     tetan = tetanus

lipid = fat                         thym = thymus

myx = mucus                   thyroid = thyroid

nephr = kidney

GASTROINTESTINAL TRACT

chol = bile                          hepat = liver

col = colon                         herni = hernia

duoden = duodenum          lapar = abdomen

enter = intestine                 orexia = appetite

esophag = esophagus        pancreat = pancreas

gastr = stomach                 pepsia = digestion

hemat = blood                   phag = swallow

INTEGUMENTARY SYSTEM

adip = fat                     mast = breast

cutane = skin               melan = black

derm (at) = skin           necr = death (of cells, etc)

hist = tissue                 pnych = nail

kerat = hard

LYMPH AND BLOOD SYSTEMS

aden = gland              lymph = lymph

bacter = bacteria        phleb = vein

cyt = cell                   splen = spleen

hemat = blood          sepsis = to putrefy

hemo = blood           thromb = clot

leuk = white             thym = thymus

MUSCULAR SYSTEM

burs = bursa

chondr = cartilage

fibr = fiber

my = muscle

rhabdo = rod

tendin = tendon

NERVOUS SYSTEM

alges = pain                    myel = spinal cord

cerebr = cerebrum          neur = nerve

encephala = brain           phas = speech

esthes = sensation           psycho = mind

mening = meninges        somat = body

ment = mind

SKELETAL SYSTEM

arthr = joint                                                  oste = bone

carp = wrist                                                  patell = knee cap

crani = skull                                                 ped, pod = foot

dactyl = finger or toe                                   pelv = pelvis

femor = thigh bone                                      phalang = bones of fingers and toes

fibul = smaller lower leg bone                     scoli = crooked, bent

humer = upper arm bone                              rachi = vertebrae

lord = curve                                                  spondyl = vertebrae

tibi = large, lower leg bone                          stern = sternum, breast bone

FEMALE REPRODUCTIVE SYSTEM

cervic = cervix                           men = menstruation

condyle - knob, knucle              metr = uterus

eclamps = shining forth             ovari = ovary

gynec = woman                         salping = fallopian tube

hyster = uterus                           toc = birth

lact = milk                                 uter = uterine

mamm = breast                         vagin = vagina

mast = breast

MALE REPRODUCTIVE SYSTEM

andr = male                             semin = semen

balan = glands penis               sperm = sperm

crypt = hidden                        vas = vessel duct

orch = testis                            varic = varicose veins

orchid = testis                         test = testis, testicle

prostat = prostate gland

RESPIRATORY SYSTEM

aer = air                                      ox = oxygen

aero = gas                                   pector = chest

bronch = bronchus                     pneumon = lung, air

capn = carbon dioxide               pulmon = lung

cyan = blue                                respire = breath

laryng = larynx                          rhin = nose

nas = nose     sinus = sinus

URINARY TRACT

albumin = protein                 ur = kidney

cyst = bladder                       uresis = urination

glycos = glucose                  ureter = ureter

keto = ketones                     urethr = urethra

lith = stone                          uria = urine, urination

nephr = kidney                    vesic = bladder

ren = kidney 

SENSES - HEARING

acous = hearing                           miring = eardrum

acusis = hearing condition          ot = ear

audi = hearing                             salping = eustachian tube

cerumen = wax like                    tympan = eardrum

labyrinth = inner ear

SENSES - SIGHT

ambly = dim, dull                           ocul = eye

blephar = eyelid                              ophthalm = eye

conjunctiv = conjunctiva                opia = vision

corne = cornea                                opt = eye, vision

glauc = gray                                    retin = retina

irid, ir = iris                                    stigmat = point (ed)

lacrim = tear duct

PTCB - Chapter 4 - Terminology - Definitions

Combining vowel
- a vowel used to connect the prefix, root word, or suffix parts of a term

Prefix
- a modifying component of a term, located at the beginning of the term

Root word
- the base component of a term which gives it a meaning that may be modified by other components

Suffix
- a modifying component of a term located at the end of the term

Diastolic phase / Relaxation phase
- the blood pressure after the heart has completed a pumping stroke

Endocrine system
- a system of glands that secrete hormones into the bloodstream

Systolic phase
- the blood pressure as the heart is pumping blood into the cardiovascular system

Blood pressure
- reported as systole/diastole
- a sphygmomanometer is used to measure blood pressure
- diastole number: over 90 - hyper, below 60 - hypo

Alimentary tract
- the organs from the mouth the to anus. The GI tract is a portion of the alimentary tract

Integumentary system
- the body covering: skin, hair, nails

Lymphocyte
- a type of white blood cell (leukocyte) that helps the body defend itself against bacteria and diseased cells

Flexor movement
- an expansion or outward movement by muscles

Neuron
- the functional unit of the nervous syste,

Osseous tissue
- the rigid portion of the bone tissue

Alveolar sacs (alveoli)
- the small sacs of specialized tissue that transfer oxygen out of inspired air into the blood and CO@ out of the blood and into the air for expiration

Nephron
- the functional unit of the kidney responsible for removing wastes from the blood and producing urine

Conjunctiva
- the eyelid lining

Cornea
- the transport outer part of the eye

Eustachian tube
- the tube that connects the middle ear to the throat

Lacrimal gland
- the gland that produces tears for the eyes

Retina
- the inner lining of the eye that translates light into nerve impulses

Tympanic membrane
- the membrane that transmits sound waves to the inner ear