TERMINOLOGY

Fundamental Concepts – Defining "Drug," "Medicine," and Their Classifications

At the very heart of pharmacy lie substances designed to interact with biological systems.
Understanding the precise meaning of core terms is crucial before delving into more complex
concepts.

 Drug:
o Definition: Broadly, any chemical substance that, when administered to a
living organism, produces a biological effect. This can include substances used
for therapeutic purposes (to diagnose, cure, treat, or prevent disease), as well as
recreational substances or poisons.
o In a pharmaceutical context: Often refers to the active pharmaceutical
ingredient (API) – the specific chemical compound responsible for the desired
therapeutic effect.
 Medicine (or Medication):
o Definition: A drug or combination of drugs that has been prepared into a
specific dosage form for administration to a patient for therapeutic purposes. A
medicine contains the API plus excipients (inactive ingredients).
o Significance: "Medicine" implies a therapeutic intent and a formulated product
ready for use.
 Active Pharmaceutical Ingredient (API):
o Definition: The biologically active component of a drug product. It is the
substance in a medicine that produces the intended pharmacological effect.
o Example: In an acetaminophen tablet, acetaminophen is the API.
 Excipient (Inactive Ingredient):
o Definition: Substances other than the API that are included in a drug
formulation. They are considered pharmacologically inactive at the dose used.
o Purpose: Excipients serve various functions, such as acting as fillers, binders
(to hold the tablet together), disintegrants (to help the tablet break apart),
lubricants, colorants, flavoring agents, preservatives, or to aid in the
manufacturing process or enhance stability.
o Examples: Lactose (filler), microcrystalline cellulose (binder), magnesium
stearate (lubricant).
 Formulation:
o Definition: The process of combining the API with excipients to produce a
final medicinal product in a specific dosage form (e.g., tablet, capsule, syrup,
injection). It also refers to the recipe or composition of the medicine.
 Brand Name Drug (Proprietary Drug):
o Definition: A drug marketed under a specific trademarked name by a
pharmaceutical company. The brand name is usually capitalized.
o Context: The company that first develops and patents a new API typically
markets it under a brand name.
o Example: Tylenol® (brand name for acetaminophen).
 Generic Drug:
o Definition: A drug product that is comparable to a brand-name drug in dosage
form, strength, route of administration, quality, performance characteristics,
and intended use. It contains the same API as the original brand-name drug.
 o Context: Generic drugs can be marketed after the patent protection for the
brand-name drug expires. They are typically less expensive.
o Example: Acetaminophen (generic name for the API in Tylenol®).

Dosage Forms and Routes of Administration

Once an active pharmaceutical ingredient (API) is identified, it must be formulated into a

suitable dosage form for administration to a patient via a specific route of administration.
These terms are critical for ensuring the drug reaches its target site effectively and safely.

 Dosage Form (or Pharmaceutical Dosage Form):

o Definition: The physical form in which a drug is produced and dispensed, such
as a tablet, capsule, syrup, injection, ointment, etc. It combines the API with
excipients.
o Purpose: To provide accurate dosing, protect the drug, control drug release,
improve palatability, or facilitate administration.

Common Categories of Dosage Forms:

1. Solid Dosage Forms:

o Tablet (Tab): A solid dosage form containing medicinal substances with or
without suitable excipients, prepared either by compression or molding.
 Types: Chewable, effervescent, enteric-coated (EC – to prevent
dissolution in the stomach), extended-release (ER/XR/SR – to release
drug over a prolonged period), sublingual (SL – under the tongue),
buccal (between cheek and gum).
o Capsule (Cap): A solid dosage form in which the drug is enclosed within a
hard or soft soluble shell, usually made of gelatin.
o Powder: A mixture of finely divided drug and/or chemicals in dry form.
o Granules: Prepared agglomerates of smaller powder particles.
o Lozenge (Troche): A solid preparation intended to dissolve or disintegrate
slowly in the mouth.
o Suppository (Supp): A solid dosage form intended for insertion into body
orifices (rectum, vagina, urethra) where it melts, softens, or dissolves to exert
local or systemic effects.
2. Liquid Dosage Forms:
o Solution: A liquid preparation containing one or more dissolved chemical
substances in a suitable solvent or mixture of mutually miscible solvents.
o Suspension: A liquid preparation containing finely divided, undissolved drug
particles dispersed uniformly throughout a liquid vehicle. Requires shaking
before use.
o Emulsion: A two-phase system in which one liquid is dispersed throughout
another liquid in the form of small droplets (e.g., oil-in-water or water-in-oil).
o Syrup: A concentrated aqueous preparation of a sugar or sugar substitute with
or without flavoring agents and medicinal substances.
o Elixir: A clear, sweetened hydroalcoholic (water and alcohol) liquid
containing flavoring substances and/or active medicinal agents.
o Tincture: An alcoholic or hydroalcoholic solution prepared from vegetable
materials or chemical substances.
3. Semi-Solid Dosage Forms:
 oOintment: A semi-solid preparation intended for external application to the
skin or mucous membranes, usually containing a medicament dissolved or
dispersed in a greasy base.
o Cream: A semi-solid emulsion, either oil-in-water or water-in-oil, for external
application. Less greasy than ointments.
o Gel: A semi-solid system consisting of dispersions of small or large molecules
in an aqueous liquid vehicle rendered jelly-like.
o Paste: A semi-solid preparation containing a high proportion of finely
powdered solids, making it stiffer than an ointment.
4. Other Dosage Forms:
o Inhaler: A device used to deliver medication into the lungs via inhalation
(e.g., Metered-Dose Inhaler (MDI), Dry Powder Inhaler (DPI)).
o Nebulizer solution: A drug solution or suspension administered as a fine mist
via a nebulizer machine.
o Transdermal Patch: A medicated adhesive patch placed on the skin to deliver
a specific dose of medication through the skin and into the bloodstream.
o Parenteral Preparations (Injectables): Sterile preparations intended for
administration by injection, infusion, or implantation into the body.

 Route of Administration:
o Definition: The path by which a drug is brought into contact with the body.
o Common Routes:
 Oral (PO): By mouth. Most common, convenient, and economical.
 Sublingual (SL): Under the tongue.
 Buccal: Between the cheek and gum.
 Rectal (PR): Via the rectum (e.g., suppositories, enemas).
 Topical (Top): Applied to a body surface, such as the skin or mucous
membranes (e.g., creams, ointments).
 Transdermal: Applied to the skin for systemic absorption (e.g.,
patches).
 Parenteral: Administered by injection, bypassing the gastrointestinal
tract. Includes:
 Intravenous (IV): Into a vein.
 Intramuscular (IM): Into a muscle.
 Subcutaneous (SC or SubQ): Beneath the skin.
 Intradermal (ID): Into the dermis (top layer of skin).
 Inhalation (Inh): Breathed into the lungs.
 Intranasal: Sprayed or instilled into the nose.
 Otic: Instilled into the ear.
 Ophthalmic (Ophth): Applied to the eye.

Prescription – Decoding the Pharmacist's Blueprint

A prescription (Rx) is a legal document written by a qualified healthcare practitioner (e.g.,

physician, dentist, veterinarian, nurse practitioner, physician assistant) that authorizes a
pharmacist to dispense a specific medication for a specific patient. Understanding the
components and common abbreviations found on a prescription is fundamental to pharmacy
practice.

 Prescription (Rx):
 o Definition: A written, verbal, or electronic order from a prescriber to a
pharmacist for a medication.
o Rx Symbol: Derived from the Latin word "recipe," meaning "take thou."

Essential Components of a Prescription:

1. Prescriber Information: Name, address, phone number, professional license number,

and often DEA number (for controlled substances).
2. Patient Information: Full name, address, date of birth (or age).
3. Date of Issuance: The date the prescription was written.
4. Inscription: The body of the prescription, containing the name of the medication,
strength, and dosage form.
o Drug Name: Can be brand or generic.
o Strength: The amount of active ingredient in each dosage unit (e.g., 500 mg,
20 mg/5 mL).
5. Subscription: Instructions to the pharmacist regarding the quantity to dispense (e.g.,
"Disp: #30" for thirty tablets) or directions for compounding.
6. Signatura (Sig or Signa): Instructions for the patient on how to take the medication.
This is what appears on the prescription label. It typically includes:
o Route of administration
o Dosage (amount per administration)
o Frequency of administration
o Duration of therapy (if specified)
o Purpose (optional, but helpful, e.g., "for pain")
7. Refill Information: Number of authorized refills, if any.
8. Prescriber's Signature: Legal signature of the prescriber.

Common Latin Abbreviations Used in Prescriptions (and on Labels):

Abbreviation Latin Origin Meaning

ac ante cibum before meals
pc post cibum after meals
hs hora somni at bedtime
qd quaque die every day (use "daily" to avoid error)
bid bis in die twice a day
tid ter in die three times a day
qid quater in die four times a day
q_h quaque _ hora every _ hours (e.g., q4h = every 4h)
prn pro re nata as needed
po per os by mouth, orally
SL sub lingua under the tongue
IM intramuscularis intramuscular
IV intravenosus intravenous
SC/SubQ subcutaneus subcutaneous
Top topicalis topically
gtt(s) gutta(e) drop(s)
mL millilitrum milliliter
mg milligramma milligram
mcg/µg microgramma microgram
tab tabella tablet
cap capsula capsule
stat statim immediately
disp dispense dispense
ud ut dictum as directed
AAA apply to affected area
OD oculus dexter right eye (use "right eye" to avoid error)
OS oculus sinister left eye (use "left eye" to avoid error)
OU oculus uterque each eye/both eyes (use "both eyes")
AD auris dextra right ear (use "right ear" to avoid error)
AS auris sinistra left ear (use "left ear" to avoid error)
AU auris utraque each ear/both ears (use "both ears")

Understanding these terms and abbreviations is essential for accurately interpreting and
processing prescriptions, which forms a daily core task for pharmacists.

The Drug's Journey – Introduction to Pharmacokinetics (ADME)

Once a drug is administered, it embarks on a complex journey through the body.

Pharmacokinetics (PK) is the branch of pharmacology that studies "what the body does to
the drug." It encompasses the processes of Absorption, Distribution, Metabolism, and
Excretion – often remembered by the acronym ADME.

 Pharmacokinetics (PK):
o Definition: The study of the time course of drug absorption, distribution,
metabolism, and excretion. PK helps determine appropriate dosing regimens
(dose, frequency, route of administration).

The Four Main Processes of Pharmacokinetics (ADME):

1. Absorption:The process by which a drug moves from the site of administration into
the bloodstream (systemic circulation).
2. Distribution: The reversible transfer of a drug from the bloodstream to various tissues
and organs of the body and back.
3. Metabolism (Biotransformation): The chemical alteration or transformation of a
drug by the body, primarily by enzymes in the liver, but also in other tissues like the
gut wall, kidneys, lungs, and plasma.
4. Excretion (Elimination): The irreversible removal of the drug and/or its metabolites
from the body.

The Drug's Action – Introduction to Pharmacodynamics (PD)

While pharmacokinetics describes what the body does to the drug, Pharmacodynamics (PD)
describes "what the drug does to the body." It involves the study of the biochemical and
physiological effects of drugs and their mechanisms of action.

 Pharmacodynamics (PD): The study of the relationship between drug concentrations

at the site of action and the resulting pharmacological effects, including the
mechanisms by which these effects are produced.

Safety Signals – Adverse Effects, Interactions, and Contraindications

While medications are intended to heal, they are powerful substances that can also cause
harm. Understanding the terminology related to drug safety is paramount for pharmacists to
protect patients.

 Adverse Drug Reaction (ADR) / Adverse Drug Event (ADE):

o Definition (ADR): Any noxious, unintended, and undesired effect of a drug
that occurs at doses normally used in humans for prophylaxis, diagnosis, or
therapy of disease, or for the modification of physiological function. (WHO
definition)
o Definition (ADE): Any untoward medical occurrence that may present during
treatment with a pharmaceutical product but which does not necessarily have a
causal relationship with this treatment. ADE is a broader term that includes
harm from medication errors.
o Severity: Can range from mild (e.g., nausea) to severe (e.g., anaphylaxis, liver
failure).
 Side Effect:
o Definition: A known, often unavoidable, secondary effect of a drug that is
different from the intended therapeutic effect. Side effects are usually
predictable and dose-dependent. They can be undesirable, neutral, or even
beneficial.
o Context: Often used interchangeably with ADR, but "side effect" can imply a
less serious or more predictable outcome.
 Toxicity:
o Definition: The degree to which a substance can damage an organism. Drug
toxicity typically refers to adverse effects that occur due to excessive dosing or
prolonged exposure, or when drug elimination is impaired.
 Allergy (Hypersensitivity Reaction):
o Definition: An immunologically mediated adverse reaction to a drug, where
the body's immune system mistakenly identifies the drug (or its metabolite) as
a harmful foreign substance (allergen).
o Manifestations: Can range from skin rashes (e.g., urticaria/hives) and itching
(pruritus) to life-threatening anaphylaxis (severe, rapid allergic reaction
involving difficulty breathing, drop in blood pressure).
o Cross-sensitivity: An allergic reaction to a drug that is chemically similar to
one the patient has previously had an allergic reaction to.
 Idiosyncratic Reaction:
o Definition: An unpredictable, abnormal, or peculiar response to a drug that is
not related to its known pharmacological actions and occurs in a small
percentage of individuals. Often has a genetic basis.
 Drug Interaction:
 o Definition: A situation in which a substance (another drug, food, herbal
product) affects the activity of a drug when both are administered together.
Interactions can alter the pharmacokinetics (ADME) or pharmacodynamics
(PD) of one or both drugs.
o Types:
 Drug-Drug Interaction: Occurs when two or more drugs react with
each other.
 Drug-Food Interaction: Food can affect the absorption or metabolism
of drugs. (e.g., grapefruit juice inhibits CYP3A4, increasing levels of
certain drugs; dairy products can chelate tetracyclines, reducing their
absorption).
 Drug-Herb Interaction: Herbal products can interact with
conventional medications.
 Contraindication:
o Definition: A specific situation, condition, or factor (e.g., pre-existing disease,
pregnancy, concurrent medication) in which a particular drug should not be
used because the risk of use clearly outweighs any potential therapeutic
benefit.
o Absolute Contraindication: The drug should never be used under any
circumstances.
o Relative Contraindication: The drug may be used with caution if the benefits
outweigh the risks, and alternative therapies are not available or suitable.
 Precaution (or Warning):
o Definition: A statement advising caution when prescribing or using a drug
under certain conditions due to an increased risk of adverse effects or potential
problems. It is less restrictive than a contraindication.

Regulatory Terms in Pharmacy

 Over-the-Counter (OTC) Drug:

o Definition: A medication that can be purchased without a prescription. These
drugs are deemed safe and effective for use by the general public without
direct medical supervision when used according to labeled instructions.
 Prescription Drug (Legend Drug):
o Definition: A medication that can only be dispensed with a valid prescription
from a licensed healthcare practitioner. The label bears the legend "Rx only" or
"Caution: Federal law prohibits dispensing without a prescription."
 Controlled Substance (Scheduled Drug):
o Definition: A drug or chemical whose manufacture, possession, or use is
regulated by the government due to its potential for abuse or addiction.