| Type | Examples | Description | Prescription Expiration | Transferability | Refillability |
| Schedule I (CI) | Heroin and Marijuana | Deemed to have no therapeutic benefit and a high potential for abuse. | N/A | N/A | N/A |
| Schedule II (CII) | Percocet (Oxycodone and APAP), Adderal (Amphetamine and Dextroamphetamine), ... | General narcotic pain medications and stimulants for ADHD. | Expires in 60 days. | Cannot be transfered. | Cannot be refilled. |
| Schedule III (CIII) | Anabolic steroids | No greater than 90mg of codeine/unit and Testosterone Products. | Expires in 6 months. | Only be transfered once. | Up to 5 times within 6 months. |
| Schedule IV (CIV) | Alprazolam (Xanax), Zolpidem (Ambian) | Sleep/benzodiazepines for anxiety | Expires in 6 months. | Only be transfered once. | Up to 5 times within 6 months. |
| Schedule V (CV) | Lyrica | Cough, nerve pain (lower abuse) | Expires in 6 months. | Only be transfered once. | Up to 5 times within 6 months. |
Required Prescription Information for Controlled Substances
Records of controlled substances must be kept for a minimum of 2 years. And CII records must be kept seperately than CIII, CIV, and CV.
Ephedrine & Pseudoephedrine's limit is 3.6g/day and 9g total in a 30 day period. Must be 18 years or older. A photo ID is required for purchase.Not available for public access (Must talk to pharmacy). Purchaser must be logged.
| 224 | Used by new pharmacies to apply for new registration with the DEA to begin distributing controlled substances. |
|---|---|
| 222 | Used to log transfers of controlled substances. |
| 106 | Used to report theft or Loss of controlled substances. |
| 41 | Used to log destruction of controlled substances. |
FDA requires a REMS if the drug has a high risk for someone getting hurt.
Pharmaceutical waste is regulated by resource conservation and recovery act. And gives the EPA the authority to regulate it.
OSHA requires manufactuers to create safety data sheets (SDSs) are for any hazardous chemicals in the workplace.
NIOSH determines which chemicals are hazardous to people. The EPA determines which are hazardous to the environment.
MedWatch is used to report adverse events and near misses to the FDA. It's voluntary and used to help make sure any potential systemic flaws are addressed.
| Class 1 | There is a high likelihood that someone could die. |
| Class 2 | There is a high chance for people to get sick, but its temporary or reversable. |
| Class 3 | There was an issue but it's unlikely to cause harm. |
"National Drug Take Back Day" - DEA holds drug take back events to help take excess drugs away from people to be disposed of.
NIOSH and ASHP determine a drug to be hazardous if it includes one or more of the following:
| Food, Drug, and Cosmetic (FDC) Act | 1938 | Requires new drugs to be proven safe prior to marketing; starts a new system of drug regulation; requires safe limits for unavoidable poisonous substances; and allows for factory inspections. |
| Durham-Humphrey Amendment | 1951 | Defines the type of drugs that cannot be used safely without medical supervision and limits the sale to prescription only by medical professionals. |
| Combat Methamphetamine Epidemic Act | 2005 | Limits retail sale of over-the-counter products that contain ephedrine, pseudoephedrine, and phenylpropanolamine (PPA), which can be used to manufacture methamphetamine |
| Controlled Substances Act (CSA) | 1970 | CSA categorizes drugs into five schedules based on their potential for abuse and medical use. |
| Poison Prevention Packaging Act (PPPA) | 1970 | Requires child-resistant packaging for most household products and drugs to prevent accidental poisoning in children. |
| Drug Abuse Prevention and Control Act | 1970 | Includes provisions for prevention programs, establishes the Drug Enforcement Administration (DEA), and defines penalties for various drug offenses. |
| Omnibus Budget Reconciliation Act (OBRA) | 1990 | Pharmacist have to counsel medicare paitents. Pharmacies started doing it for everybody. SO everybody is asked if they have questions. |
| Health Insurance Portability and Accountablility Act (HIPAA) | 1996 | Right to privacy |
| Inhibitor | A substance that reduces or stops the activity of an enzyme or receptor. |
| Activator | A substance that increases the activity of an enzyme or receptor. |
| Agonist | A substance that binds to a receptor and activates it, producing a biological response. |
| Antagonist | A substance that binds to a receptor but does not activate it, blocking or dampening the action of an agonist. |
| Reverse Agonist | A substance that binds to a receptor and causes an opposite effect to that of an agonist, often decreasing the baseline activity of a receptor. |
| Blocker | Similar to an antagonist; a substance that blocks the action of a receptor, preventing activation by an agonist. |
| Tincture | Drug dissolved in alcohol. |
| Elixir | Drug dissolved in alcohol with added sugar. |
| Solution | Homogeneous mixture where the drug is completely dissolved in a solvent. |
| Suspension | Mixture where the drug is not completely dissolved (solid particles suspended in liquid). |
| Solvent | Liquid (usually) capable of dissolving another substance. |
| Aqueous | Mixture where the drug is dissolved in water. |
| Emulsion | Mixture of two immiscible liquids (e.g., oil and water), stabilized with an emulsifier. |
| Gel | Semi-solid dosage form that contains a drug dissolved or suspended in a gel base. |
| Powder | Drug in a finely ground solid form that may be reconstituted in a liquid. |
| Paste | Thick, semi-solid mixture that contains a high proportion of solid material. |
| Syrup | Drug dissolved in a sugar solution, typically used for oral administration. |
| Substrate | The substance that results after a drug is metabolized by a particular enzyme. This substance is a substrate of that enzyme. |
| Saline | Salt dissolved in water. |
| Oleaginous | Dissolved in oil |
| Precipitate | |
| Titrate | |
| levegation | |
| other COMPOUNDING TERMS |
USP sets <795> (Nonsterile compounding), <797> (sterile compounding), and <800> (hazardous
compounding) guidelines and standards.
Chapters below 1000 are enforceable by federal law. Chapters above 1000 are purely informational or
suggestions and are not enforced.
Good to know probably
media test are !
practical application
master formulations
cleaning procedures
Let the hood run for 30 mins after its turned Off
asceptic technique
garbing types
hazordous vs nonharzordous
PPE
D5W and NS
Needle gauge sizes
The most typical sizes used are from 14G which is the
thickest,
up to 34G which would be the thinnest.
wipe hoods side to side. back to front. dont spray into filter.
Dwell time between disinfecting (kills germs) and sanitizing (reduces germs). and wipe away residue.
5-micron filter tip needle for drawing up from an ampule
| Addiction | A chronic, often relapsing condition where an individual becomes compulsively engaged in a behavior or substance use, despite harmful consequences. It involves both psychological and physical components, where the person may feel unable to control cravings and urges. |
| Dependence | A physiological state where the body becomes reliant on a substance to function normally. This is marked by the development of tolerance and the occurrence of withdrawal symptoms when the substance is reduced or stopped. It can be physical, psychological, or both. |
| Tolerance | The process by which the body becomes less responsive to a substance over time, requiring larger amounts to achieve the same effect. This occurs as the brain adapts to the substance’s presence, altering its neurochemistry and reducing sensitivity to the drug. |
| Withdrawal | A set of physical and psychological symptoms that occur when a person reduces or stops using a substance to which they have become dependent. Symptoms can vary from mild (anxiety, irritability) to severe (seizures, hallucinations), depending on the substance. |
| Neuroadaptive Changes | The brain's ability to reorganize and change its structure and function in response to experience or environmental changes. In addiction, neuroplasticity refers to the brain’s adjustment to the presence of a substance, leading to changes in neurotransmitter systems, neural pathways, and brain regions involved in reward, pleasure, and decision-making. |
| Q | Every, each |
| X | for |
| C | with |
| S | without |
| SS | 1/2 |
| H | hours |
| PO | By Mouth |
| OU | Both Eyes |
| OD | Right Eye |
| OS | Left Eye |
| AU | Both Ears |
| AD | Right Ear |
| AS | Left Ear |
| Q4H | Every 4 hours; Six times a day, spaced evenly. |
| Q6H | Every 6 hours; four times a day, spaced evenly. |
| Q8H | Every 8 hours; three times a day, spaced evenly. |
| Q12H | Every 12 hours; twice a day, spaced evenly. |
| QD | Every Day |
| BID | Twice a day |
| TID | Three times a day |
| QID | Four times a day |
| HS | at Bedtime |
| AM | in the morning |
| PM | in the evening |
| ac | before meal |
| cf | with food |
| pc | after meal |
| PRN | As needed |
| STAT | now; Immediatly |
| QS | Quantity sufficient |
| DAW | dispense as written |
| AAA | apply to affected area |
| sup | suppository |
| sol | solution |
| susp | suspension |
| syr | syrup |
| tab | tablet |
| cap | capsule |
| gtt(s) | drops |
| inj | injection |
| K | Potassium |
| KCl | Potassium Chloride |
| ASA | Aspirin |
| APAP | Acetaminophen |
| IR | Immediate Release |
| DR | Delayed Release |
| EC | Enteric Coated (protects stomach) |
| ER (XL, XR) | Extended Release |
| kg | kilogram |
| g | gram |
| mg | milligram |
| mcg | microgram |
| l or L | liter |
| mL | milliliter |
| GI | Gastrointestinal |
| NS | Normal saline (0.9%) |
| 1/2NS | Half saline (0.45%) |
| SOB | Shortness of Breath |
| Rx | prescription |
| SIG | Signa, meaning directions |
| QTY | Quantity |
| Enteral Route | SIG Code | Description | Examples |
| Refers to intestines. Routes that reach the GI tract. Typically oral. | |||
|---|---|---|---|
| Oral | PO | swallowed by mouth | most pills and capsules |
| Buccal | dissolves in the cheek | nicotine gum | |
| Sublingual | SL | under the tongue | NTG |
| Orally disintegrating tablet | ODT | dissolves on the tongue | Zofran/Ondansetron |
| Rectal or vaginal | into the rectum or vagina | Suppository or enimas/douche | |
| Parenteral Routes | SIG Code | Description | Examples |
| Routes outside of the GI tract. Typically injections. | |||
|---|---|---|---|
| Intravenous | IV | into the vein | Fluid Replacement |
| Intramuscular | IM | into the muscle | most vaccines |
| Subcutaneous | SUBQ , SC, SQ | into the fat | Insulin, Ozempic, etc. |
| Intrathecal | into cerebrospinal fluid | Analgesics, Chemotherapy agents, etc. | |
| Intradermal | |||
| Topical Route | SIG Code | Description | Examples |
| Enters through a membrane or the skin. Every thing other than GI or injections. | |||
|---|---|---|---|
| Transdermal | through the skin | patches | |
| Optic | OD, OS, OU | into the eyes | eye drops |
| Otic | AD, AS, AU | into the ears | ear drops |
| Cream, Ointment, Lotion, etc. | rubbed into the skin | Anti-infective creams, etc. | |
| Nasal | applied into nostrils. systemic | Flonase | |
| -caine | Local Anasteia e.g. Lidocaine |
| -triptan | Selective Serotonin Receptor Agonist |
| -triptyline | Tricyclic Antidepressant |
| -dronate | Local Anasteia |
| -olol | Beta Blockers |
| -statin | HMG-CoA Reductase Inhibitors |
| -ipine | Calcium Channel Blockers (Dihydropyridine) |
| -osin | Alpha Blockers |
| -pril | ACE Inhibitors |
| -sartans | ARBs |
| -vir | Antivirals |
| -azole | Azole Antifungals |
| -zepam and -zolam | Benzodiazepines |
| -glutide | GLP-1 Analogs |
| -gliptin | DPP-4 Inhibitors |
| -gliflozin | SGLT-2 Inhibitors |
| -glitazones | Thiazolidinedione (TZD) |
| -floxacin | Fluoroquinolone |
| -thromycin | Macrolides |
| -one | Most Steroids |
| -prazole | Proton Pump Inhibitors PPI |
| -cillin | Penicillins |
| -ose | Sugar |
| -ol | Alcohol |
| -emia | Presence in Blood |
| Hyper- | prefix means above |
| Hypo- | prefix means below |
| Excipient | Inactive Ingredients |
| Expectorant | brings up mucus from the lungs |
| Decongestant | reduces inflammation in the nose |
| BUD | Beyound Use Date. Not the same as an expiration date. BUD's refer to a drugs stability and sterility, especially following state changes. |
| Indication | FDA's approved use for a drug |
| Orange Book | Contains therapeutic equivalent drugs. |
| Purple Book | Contains bioequivalent drugs. MABs, insulins, hormones, enzymes |
| Orphan Drug | developed to treat certain rare medical conditions |
| Contraindicated | Means to avoid specific combinations with a drug. Could refer to other drugs, foods, or other external factors, such as sunlight, lying down, etc. |
| Off Label Use | other uses for a drug outside of what it's been studied and directly approved for by the FDA. |
| Brand/Trade Name | Marketing name for a drug. A drug can have any number of these. |
| Generic Name | The Shortened chemical name of a drug. Each drug usually only has 1. |
| Chemical Name | The full chemical name for the active compound. There will only be 1. |
| Arrhythmia | irregular heartbeat. |
| Tachycardia | high resting heart rate |
| Bradycardia | low resting heart rate |
| Edema | Swelling from excess fluid |
| Angina | Chest Pain |
| Bolus dose | A dose administered to reach an effective concentration of drug quickly. |
Capsule Size 000 is biggest
higher number is smaller
5 is the smallest
Anything that goes directly to the bloodstream or passes a membrane needs to be sterile.
Topicals and anything oral doesn't have to be.
LASA reffers to Look-Alike-Sound-Alike drugs. In response to the ISMP recommeds specific drugs use Tall man Lettering.
Diuretics are medications that remove excess fluids. Sometimes referred to as water pills.
Congestive Heart Failure refers to excess fluid around the heart.
Always use the smallest possible container that is at or above the amount of drug needed to be dispensed.
Non controlled prescriptions expire after a year.
Pharmacology - Pharmacokinetics - Pharmaceutics - Pharmacodynamics - Systemic Localised Absorption Distribution Metabolism Excretion Potency Efficacy
| Anti-infective | Antibiotics, Antifungals, Antivirals, ... |
| Antitussive | suppress coughing |
| Analgesic | pain reliever |
| Antipyretic | Fever Reducer |
| Anxiolytic | Anti-anxiety |
| Antihistamine | blocks Histamine |
| Antispasmodic | suppresses muscle spasms |
| Antiemetic | prevent and treat nausea and vomiting |
| Antiepileptic/Anticonvulsants | treatment of epileptic seizures |
| Anticoagulant | prevents or reduces the coagulation of blood. Antithrombotic |
| Antiplatelet | decreases platelet aggregation. Antithrombotic |
| Anticholinergic | Blocks acetylcholine |
| Antidiarrheal | reduce the frequency of diarrhea |
| Controlled Room Temp Excursions | 15°C - 30°C | 59°F - 86°F |
| Controlled Room Temp | 20°C - 25°C | 68°F - 77°F |
| Cool | 8°C - 15°C | 46°F - 59°F |
| Refrigerator | 2°C - 8°C | 36°F - 46°F |
| Freezer | -25°C - 10°C | -13°F - 14°F |
| Incubator | 30°C - 35°C | 86°F - 95°F |
Steroids increase glucose, so it's important to be aware of that if the patient is diabetic and taking any medications for their insulin.
Antibiotics reduce the efficacy of oral contraceptives.
Patients should be careful about consuming vitamin K while on Warfarin.
Grapefruit should be avoided with Calcium channel blockers. Especially the Non-Dihydropyridine.
Grapefruit should also be avoided with some HMG-CoA Reductase Inhibitors (-statin) drugs aswell.
Atorvastatin (Lipitor), Lovastatin (Mevacor), and Simvastatin (Zocor).
Grapefruit also affects Buspirone (Buspar) so it should be avoided while taken the drug.
Avoid dairy with Tetracycline class drugs.
As well as Ciprofloxacin (Cipro) and Levothyroxine (Levoxyl and Synthroid)
Ciprofloxacin (Cipro) and Doxycycline (Vibramycin and Doryx) can increase sensitivty to sunlight.
Tetracyclines also are typically avoided in young children under 8 years of age due to permanent teeth discoloration they cause in this patient group.
Doxazosin (Cardura), Warfarin (Coumadin), and Colchicine (Colcrys) are common NTI (narrow therapeutic range) drugs.
ACE Inhibitors have a common side effect of causing a cough.
Don't lie down for 30 minutes after taking Alendronate (Fosamax), because of GI issues that could arise.
Fentanyl Patches last for 3 days, 72 hours.
Isotretinoin requires the iPledge and at least 7 days, before it can be filled after a negative birth control test.
Most Vaccines require refridgeration. However these specifically must be stored in the freezer:
Pseudoephedrines increase blood pressure.
NSAIDs are tough on kidneys. They also are known to thin the blood slightly, reducing clotting factor. So its important to note if the patient is on any other direct anticoagulant or antiplatelet drugs.
Acetaminophen (Tylenol) is rough on the liver.
Clindamycin (Cleocin) Should not be refridgerated.
MOST RECONS ARE 10 DAYS
Cifalexin Keflex has to be fridge
Amoxicilin is 14
Augmentin (Amoxicillin and Clavulanate Potassium) is 10 days and has to be fridge
!
Avoid overuse of Afrin Nasal Spray (Oxymetazoline) as it creates dependence. Not more than 2-3 days at a time.
ACE Inhibitors and potassium or spironolactone should be avoided as it'll cause hyperkalemia.
ACE Inhibitors are contraindicated with ARBs.
Budesonide can lead to thrush if your mouth isn't properly rinsed afterwards.
Ketorolac (Toradol) requires a shot before taking the pill form, and shouldn't be taken more than 6 days.
| Class | Indication | Generic | Brand |
| oral film prescribed to treat dependence on opioid drugs. It works to reduce withdrawal symptoms | Buprenorphine and Naloxone | Suboxone | |
| acne and plaque psoriasis. promotes skin cell renewal and reduces inflammation | tazarotene | Tazorac | |
| Antihistamine | Reduces effects of histamine especially in regard to Allergies. Also used to treat motion sickness and to induce sleep. | Diphenhydramine | Benadryl |