Generic Name: Citicoline

Brand Name: Nicholin, Somazine, 5'-Cytidine diphosphate choline, CDPC, CDP Choline, CDP-Choline, Citicholine, Citicolina, Cytidine 5-Diphosphocholine, Cytidine 5'-
diphosphocholine, Cytidine (5') diphosphocholine
Classification: Neurotonics, Nootropics
Mechanism of Action
Citicoline seems to increase a brain chemical called phosphatidylcholine. This brain chemical is important Ior brain Iunction. Citicoline might also decrease brain tissue damage
when the brain is injured.It is usually known that phospholipid, especially lecithin, decreases Iollowing decline in brain activity with cerebral trauma. Citicoline, which is a co-
enzyme, accelerates the biosynthesis oI lecithin in the body.
This medication enhances the action oI the brain stem ciliary body especially the ascending ciliary body activating system, which is closely related to consciousness, but does not
exert eIIort on the extrapyramidal system. Citicoline increases cerebral blood Ilow and oxygen consumption oI the brain and improves cerebral circulation and metabolism.
ScientiIic research demonstrates that Citicoline consumption promotes brain metabolism by enhancing the synthesis oI acetyl-choline, restoring phospholipid content in the brain
and aIIecting neuron membrane excitability and osmosis (by its eIIect on the ATP-dependent sodium and potassium pump). When taken orally, its two main components, Cytidine
and Choline are absorbed into the bloodstream.
Citicoline is also believed to protect nerve cells when in low oxygen conditions. Citicoline may be used Ior nutritional support in cerebral vascular disease, head trauma, stroke,
and cognitive disorders. It also is used by those who have age related mental decline, such as Alzheimer`s and Parkinsons.
Indication
O Parkinson`s disease
O ead injury
O Cerebral vascular disease
O Alzheimer`s disease
O Cerebral surgery or acute cerebral disturbance
O Disturbance oI consciousness Iollowing brain surgery
$5ecial Precautions
O Patients with acute, severe & progressive disturbance oI consciousness
O Administration with hemostatics
O Intracranial pressure relieving drugs or use measures to keep body temp low.
$ide Effects
Citicoline seems to be saIe when taken short-term (up to 90 days). The saIety oI long-term use is not known. Most people who take citicoline don`t experience problematic side
eIIects. owever, these are the common side eIIects reported by some patients:
O ody temperature elevation
O #estlessness
O eadaches
O Nausea and vomiting
O Diarrhea
O ow or high blood pressure
O Tachycardia
O Sleeping troubles or insomnia
O lurred vision
O Chest pains
Nursing Management
O Citicoline may be taken with or without Iood. Take it with or between meals.
O The supplement should not be taken in the late aIternoon or at night because it can cause diIIiculty sleeping.
O Women who are pregnant or trying to become pregnant should consult with their doctor beIore taking the supplements. Not enough is known about the use oI Citicoline
during pregnancy and breast-Ieeding. Stay on the saIe side and avoid use.
O Special attention should be paid Ior administration in the neonate, premature and children.
O Contact the physician immediately iI allergic reaction such as hives, rash, or itching, swelling in your Iace or hands, mouth or throat, chest tightness or trouble breathing are
experienced.
O Citicoline therapy should be started within 24 hours oI a stroke. The physician will prescribe the correct dosage and the length oI time it should be taken Ior a medical
condition.
Doctors use prescription abbreviations (based on Latin words) that tell your pharmacist which medication to give you and directions on how to use that medication.
If you learn to understand the medical shorthand used by your doctor, you can read your own prescription immediately after it is written. This will help make sure that you know what
medication you are getting and it will give you a chance to ask questions about your doctor's instructions.
Understanding Your Prescription May Help Prevent a Medical Error
The more you understand about your prescription, the less likely it is that you will have a medical error. For example, your pharmacist may make a mistake reading your doctor's
handwriting. If your doctor's writing is not clear and easily read, your prescription may take longer to fill or you may be given the wrong dose or the wrong directions.
As a smart medical consumer, it is a good idea to check your prescription and make sure that it is filled correctly at the pharmacy. If you think there is an error or a discrepancy, you can
alert the pharmacist or call your doctor.
Some doctor's offices now use electronic prescribing. You may receive a printed prescription to take to the pharmacy, or your prescription may be faxed or e-mailed to the pharmacy. Ask to
see a printout of these prescriptions before leaving your doctor's office.
If you do not understand what your prescription says, do not be shy. Ask your doctor or another healthcare provider in the office for assistance. Your questions may help detect and
prevent an error.
A Dr. Mike Quick Tip: Ask your doctor to write down on the prescription for what condition your medication is being used; e.g., not just "take once a day" but "take once a day for high
cholesterol."
eneric vs. Brand Name
hen writing a prescription, your doctor may use either the "generic" name of the medication or the "brand name". For example, sertraline is the "generic" name and Zoloft is the "brand
name" used to identify a medication frequently prescribed for the treatment of depression.
In many states, pharmacists are allowed to dispense a generic medication, even if your doctor writes a prescription for the brand name version of the drug. However, if your doctor writes
"DA" (which means "dispense as written") or initials a box labeled "DA" on your prescription, the pharmacist cannot legally substitute a generic medication for the brand name one.
Reading Your Prescription
Your prescription is usually written on a pre-printed pad with your doctor's name, address, and phone number. You may also see, either on the top or bottom of the prescription, special
identification numbers, such as your doctor's Drug Enforcement Administration (DEA) number for narcotics or controlled substances.
Of course, there is space for your name and address, your age, the date, a place for your doctor's signature, and a blank area in which your doctor writes the following directions:
O ame of the medication
O Dose of the medication
O How often to take the medication
O hen to take the medication
O How to take the medication
Additionally, your doctor will indicate how much medicine the pharmacist should give you and the number of times that your prescription can be refilled.
ommonly Used Medical Abbreviations
Your doctor may use different abbreviations or symbols. If you do not understand them, ask your doctor or pharmacist for clarification.
How Often to Take Your Medication
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
When to Take Your Medication
ac - before meals
hs - at bedtime
int - between meals
pc - after meals
How Much Medication to Take
caps - capsule
gtt - drops
i, ii, iii, or iiii - the number of doses (1, 2, 3, or 4)
mg - milligrams
ml - milliliters
ss - one half
tabs - tablets
tbsp - tablespoon (15ml)
tsp - teaspoon (5ml)
How to Use Your Medication
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."
How to Read Your Doctor's Prescription - Some Examples
Example #1: Your diagnosis is high cholesterol
Zocor 10 mg.
%his is the name of the medication and the dose.
Sig: i po qhs
our instructions are to take 1 pill, by mouth, at bedtime.
Dispense #90
ou will be given 90 pills, enough for about 3 months.
Refill 0 times
our doctor has indicated no refills, most likely because she would like to check your blood cholesterol and then decide if you need more medication or a different dose.
DAW left blank
our pharmacist will most likely give you simvastatin, the generic version of Zocor.
Example #2: Your diagnosis is type 2 diabetes
lucophage 500 mg.
%his is the name of the medication and the dose.
Sig: i po bid pc
our instructions are to take 1 pill, by mouth, twice each day, after meals - this means that you should take this medication right after breakfast and right after dinner.
Dispense #90
ou will be given 90 pills, enough for about 3 months.
Refill 3 times
our doctor has indicated 3 refills, enough medication for one year. %his may mean that your diabetes is "stable" and well controlled on this medication.
DAW left blank
our pharmacist will most likely give you metformin, the generic version of Glucophage.
Example #3: Your diagnosis is high blood pressure
Diovan 40 mg.
%his is the name of the medication and the dose.
Sig: i po qd
our instructions are to take 1 pill, by mouth, once each day - you most likely can take this medication either before or after a meal since your doctor did not say otherwise.
Dispense #90
ou will be given 90 pills, enough for about 3 months.
Refill 0 times
our doctor has indicated no refills, most likely because she would like to check your blood pressure and then decide if you need more medication or a different dose.
DAW left blank
our pharmacist will give you Diovan since there is no generic available for this drug.

& D&#&


Category:


ntihypokalemic

electrolyte replenisher

Indications

Accepted

Hypokalemia (treatment)Potassium supplements are indicated in patients with hypokalemia, with or without metabolic alkalosis;
{64}
in chronic
{25}
digitalis intoxication; and in patients
with hypokalemic familial periodic paralysis.
{18}
Potassium supplementation is indicated in severe hypokalemia in patients receiving potassium-wasting diuretics for uncomplicated
essential hypertension,
{42}

{46}
when dosage adjustment of the diuretic is ineffective or unwarranted.
{15}
Potassium supplementation may be needed in patients receiving antibiotics that
cause potassium depletion, either by drug-induced nephrotoxicity (e.g., amphotericin B,
{71}
polymyxin B, or gentamicin
{69}

{70}
) or by a nonreabsorbable anion effect (e.g., azlocillin,
carbenicillin, mezlocillin, penicillin, piperacillin, or ticarcillin
{72}
).
{64}
Potassium chloride is usually the salt of choice in the treatment of hypokalemia, since it is better absorbed from the
gastrointestinal tract than the nonchloride potassium salts, and the chloride ion may be required to correct hypochloremia, which often occurs with hypokalemia.
{42}
n rare circumstances
(e.g., patients with renal tubular acidosis), potassium depletion may be associated with metabolic acidosis and hyperchloremia. n such patients, potassium replacement should be
accomplished with potassium salts other than chloride, such as potassium acetate, potassium bicarbonate, potassium citrate, or potassium gluconate.
{42}


Hypokalemia (prophylaxis)Potassium supplements are indicated to prevent hypokalemia in patients who would be at particular risk if hypokalemia were to develop (e.g., digitalized
patients with significant cardiac arrhythmias). Potassium depletion will occur when the rate of loss through renal excretion and/or loss from the gastrointestinal tract exceeds the rate of
potassium intake.
{14}

{64}
Potassium supplements may also be indicated in patients who suffer from hepatic cirrhosis with ascites;
{42}
states of aldosterone excess with normal renal
function;
{42}

{64}
certain diarrheal states, including those induced by chronic laxative use
{42}

{46}
; prolonged vomiting;
{42}

{46}
Bartter's syndrome;
{64}
potassium-losing nephropathy; and in
patients, including children, on long-term corticosteroid therapy.
{27}

{74}

Deficiency of potassium may lead to muscle weakness, irregular heartbeat, mood or mental changes, or nausea or vomiting.
{42}

{46}


Acceptance not estabIished
There are insufficient data to show that potassium supplementation lowers blood pressure in hypertensive patients.
{76}


&naccepted
nteric-coated tablets of potassium chloride are no longer recommended for use because of the high incidence of severe injury to adjacent gastrointestinal tissues during tablet
dissolution.
{04}

{42}



!harmacoIogy/!harmacokinetics

!hysicochemicaI characteristics:
MoIecuIar weight-
Potassium acetate: 98.14
Potassium bicarbonate: 100.12
Potassium chloride: 74.55
Potassium citrate: 324.41
Potassium gluconate: 234.25

Mechanism of action/Effect:

Potassium is the predominant cation (approximately 150 to 160
{15}
mq per liter) within cells. ntracellular sodium content is relatively low. n extracellular fluid, sodium predominates and
the potassium content is low (3.5
{15}
to 5 mq per liter). membrane-bound enzyme, sodium-potassiumactivated adenosinetriphosphatase (Na
+

+
TPase), actively transports or
pumps sodium out and potassium into cells to maintain these concentration gradients.
{73}
The intracellular to extracellular potassium
{21}
gradients are necessary for the conduction of
nerve impulses in such specialized tissues as the heart, brain, and skeletal muscle, and for the maintenance of normal renal function and acid-base balance.
{74}
High intracellular
potassium concentrations are necessary for numerous cellular metabolic processes.

EIimination:
#enal90%.
{74}

Fecal10%.
{74}



!recautions to Consider

Carcinogenicity

No data are available on long-term potential for carcinogenicity in animals or humans. Potassium is a normal dietary constituent.
{14}

{15}


!regnancy/Reproduction

Pregnancy
Studies have not been done in humans.
{34}


Studies have not been done in animals.

FD Pregnancy Category C.
{25}

{34}



Contents Cl (equiv to 9.8 mq) 750 mg
ndications Hypokalemia. Prophylaxis during treatment w/ diuretics.
Dosage Adult & elderly !rophyIaxis 2 durules daily. HypokaIemia djust dosage according to serum level. Suggested dose: 2 durules bid or more until serum is restored to
normal, then prophylactic dosage.
dministration Should be taken with food (Swallow whole w/ glass of liqd, do not break/chew/crush. Do not administer to a patient in a supine position.).
Contraindications #enal insufficiency, hyperkalemia, untreated ddison's disease, constriction of the esophagus &/or obstructive changes in the alimentary tract.
Special Precautions Obstructive changes in the alimentary tract, constriction of the esophagus. Heart/kidney disease. Pregnancy & lactation.
Drug nteractions salts & -sparing diuretics, eg spironolactone. miloride, triamterene, tacrolimus, C inhibitors.
View more drug interactions with alium
S Class lectrolytes
TC Classification 12B01 - potassium chloride ; Belongs to the class of potassium-containing preparations. &sed as dietary supplements.
Amp|c||||n Su|bactam drug study
8rand Name unAS?n
&NSYN (ampicillin and sulbactam) is an injectable antibacterial combination consisting of the semisynthetic antibiotic ampicillin sodium and the beta-lactamase inhibitor sulbactam sodium for
intravenous and intramuscular administration.
mpicillin sodium is derived from the penicillin nucleus, 6-aminopenicillanic acid. Chemically, it is monosodium (2S, 5#, 6#)-6-[(#)-2-amino-2-phenylacetamido]- 3,3-dimethyl-7-oxo-4-thia-1-
azabicyclo[3.2.0]heptane-2-carboxylate and has a molecular weight of 371.39.
Sulbactam sodium is a derivative of the basic penicillin nucleus. Chemically, sulbactam sodium is sodium penicillinate sulfone; sodium (2S, 5#)-3,3-dimethyl-7-oxo-4-thia 1-azabicyclo [3.2.0]
heptane-2-carboxylate 4,4-dioxide. ts chemical formula is C
8
H
10
NNaO
5
S with a molecular weight of 255.22

CLASSIIICA1ICNS
1betopeotlc
AnLllnfecLlves
9botmocoloqlc
Amlnopenlcllllns/ beLa lacLamase lnhlblLors
AC1ICNS
9bysloloqlc Mecboolsm
- 8acLerlcldal acLlon AcLlve agalnsL SLrepLococcl enumococcl LnLerococcl Paemophllus lnfluenzae
- use should be reserved for lnfecLlons caused by beLalacLamaseproduclng sLralns
9botmocoloqlc Mecboolsm
- 8lnds Lo bacLerla cell wall resulLlng ln cell deaLh specLrum ls broader Lhan LhaL of penlclllln AddlLlon of sulbacLam lncreases reslsLance Lo beLalacLamase enzymes produced
by bacLerla LhaL may lnacLlvaLe amplclllln
INDICA1ICN
- 1reaLmenL of resplraLory lnfecLlons
NUkSING CCNSIDLkA1ICNS
- Assess paLlenL for lnfecLlon (vlLal slgns wound appearance spuLum urlne sLool and W8Cs) aL beglnnlng and LhroughouL Lherapy
- CbLaln a hlsLory before lnlLlaLlng Lherapy Lo deLermlne prevlous use of and reacLlons Lo penlcllllns or cephalosporlns ersons wlLh a negaLlve hlsLory of penlclllln senslLlvlLy
may sLlll have an allerglc response
- CbLaln speclmens for culLure and senslLlvlLy before Lherapy llrsL dose may be glven before recelvlng resulLs
- Cbserve paLlenLs for slgns and sympLoms of anaphylaxls (rash prurlLus laryngeal edema wheezlng) ulsconLlnue Lhe drug and noLlfy Lhe physlclan lmmedlaLely lf Lhese occur
keep eplnephrlne an anLlhlsLamlne and resusclLaLlon equlpmenL close by ln Lhe evenL of an anaphylacLlc reacLlon
- CauLlon paLlenL Lo noLlfy physlclan lf fever and dlarrhea occur especlally lf sLool conLalns blood pus or mucus Advlse paLlenL noL Lo LreaL dlarrhea wlLhouL consulLlng healLh
care professlonal May occur up Lo several weeks afLer dlsconLlnuaLlon of medlcaLlon
-lnsLrucL paLlenL Lo noLlfy physlclan lf sympLoms do noL lmprove

hat are the possibIe side effects of ampiciIIin and suIbactam (&nasyn)?
et emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have any of these serious side effects:
fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
diarrhea that is watery or bloody; or
fever, chills, body aches, flu symptoms.
ess serious side effects may include:
nausea, vomiting, stomach pain, bloating, gas;
vaginal itching or discharge;
headache;
itching;
swollen, black, or "hairy" tongue;
thrush (white patches or inside your mouth or throat); or
pain, swelling, or other irritation where the needle is placed.

HUMUN N
Ceneric Aame Iso5hane Insulin
assification Antidiabetic drugs
ction
Increase glucose transport across muscle and Iat cell membranes to reduce blood glucose level. Promotes conversion oI glucose to its storage Iorm, glycogen; triggers amino acid uptake and conversion to protein in
muscle cells and inhibits protein degradation; stimulates triglyceride Iormation and inhibits r3elease oI Iree Iatty acids Irom adipose tissue; and stimulates lipoprotein lipase activity, which converts circulating
lipoproteins to Iatty acids.
Indications
Diabetic ketoacidosis, Type I diabetes, adjunct to type II diabetes inadequately controlled by diet and oral antidiabetic agents.
dverse Reactions
Common: lipoatrophy, lipohypertrophy
Uncommon: urticaria, pruritus, swelling, redness, stinging, warmth at injection site, hypersensitivity reactions
iIe-threatening: anaphylaxis, hypoglycemia
Aursing onsiderations
O Dosuge Is uIwuys expressed In USP unILs. remember Lo use onIy LIe syrInges cuIIbruLed Ior LIe purLIcuIur concenLruLIon oI InsuIIn udmInIsLered
O e uwure LIuL some puLIenLs muy deveIop InsuIIn resIsLunce und requIre Iurge InsuIIn doses Lo conLroI sympLoms oI dIubeLes.
O %o mIx InsuIIn suspensIon, swIrI vIuI genLIy or roLuLe beLween puIms or beLween puIm und LIIgI. don`L sIuke vIgorousIy: LIIs cuuses bubbIIng und uIr In syrInge
O now LIuL IenLe, semIIenLe, und uILruIenLe InsuIIns muy be mIxed In uny proporLIon. ReguIur InsuIIn muy be mIxed wILI NPH or IenLe InsuIIns In uny proporLIon. WIen mIxIng reguIur
InsuIIn wILI InLermedIuLe or Iong ucLIng InsuIIn, uIwuys druw up reguIur InsuIIn InLo syrInge IIrsL.
O NoLe LIuL swILcIIng Irom sepuruLe InjecLIons Lo u prepured mIxLure muy uILer puLIenL response. WIenever NPH or IenLe In mIxed wILI reguIur InsuIIn In LIe sume syrInge, gIve IL
ImmedIuLeIy Lo uvoId Ioss oI poLency.
O don`L use InsuIIn LIuL cIunges coIor or becomes cIumped or grunuIur In uppeurunce
O cIeck expIruLIon duLe on vIuI beIore usIng conLenLs
O now LIuL usuuI udmInIsLruLIon rouLe Is SC. Ior proper SC udmInIsLruLIon, remember Lo pIncI u IoId oI skIn wILI LIe IIngers uL IeusL IncIes upurL, und InserL uL u q- Lo qo-degree ungIe,
dependIng on LIe Lype oI syrInge.
O Press buL do noL rub sILe uILer InjecLIon. RoLuLe InjecLIon sILes und cIurL Lo uvoId overuse oI one ureu. now LIuL dIubeLIc puLIenLs muy ucIIeve beLLer conLroI II InjecLIon sILe Is roLuLed wILIIn
sume unuLomIc regIon.
O SLore InsuIIn In cooI ureu. ReIrIgeruLIon Is desIrubIe buL noL essenLIuI, excepL wILI reguIur InsuIIn concenLruLed.


Pharmacokinetic and dynamic interactions of the angiotensin-converting enzyme inhibitor imidapril with hydrochlorothiazide, bisoprolol and
nilvadipine.
anufacturer # mperial
Distributor &nited ab
Contents midapril HCl 10 mg, hydrochlorothiazide 12.5 mg
ndications Treatment of HTN.
Dosage nitially, 1 tab once daily. djust dose based on clinical response.
dministration ay be taken with or without food
Contraindications History of angioneurotic edema; sulfonamide or thiazide hypersensitivity; renal failure anuria (CrCl <30 m/min).
Special Precautions Na depletion or hypovolemia, dialysis, major surgery or during anesth. lderly w/ renal disease. &nilateral or bilateral renal artery stenosis. Patients w/ renal function
dependent on #S eg heart failure. Hepatic disease. out or hyperuricemia. History of pancreatitis. 2nd & 3rd trimesters of pregnancy.
dverse Drug #eactions midapril HCl: Cough, dizziness, hypotension, headache, strange sensation in pharynx & rash. Hydrochlorothiazide: Weakness; hypotension; pancreatitis, jaundice, diarrhea,
vomiting, sialadenitis, cramps, constipation, gastric irritation, nausea & anorexia; hematologic & hypersensitivity reactions; electrolyte imbalance, hyperglycemia, glycosuria,
hyperuricemia; muscle spasm; vertigo, paresthesia, dizziness, headache, restlessness; renal failure & interstitial nephritis; Stevens-Johnson syndrome, exfoliative dermatitis;
impotence.
View D# onitoring Website
Drug nteractions ithium; -sparing diuretics, supplements, or salt substitutes; NSDs.
View more drug interactions with Norplus
S Class C nhibitors/Direct #enin nhibitors / Diuretics
TC Classification C09B - C inhibitors and diuretics ; &sed in the treatment of cardiovascular disease.


Killip class
lrom Wlklpedla Lhe free encyclopedla
ump Lo navlgaLlon search
The illi5 classification is a system used in individuals with an acute myocardial inIarction (heart attack), in order to risk stratiIy them. Individuals with a low Killip class are less
likely to die within the Iirst 30 days aIter their myocardial inIarction than individuals with a high Killip class.
|1|

WVit] TbW stuV
The study was a case series with unblinded, unobjective outcomes, not adjusted Ior conIounding Iactors, nor validated in an independent set oI patients. The setting was the
coronary care unit oI a university hospital in the USA.
250 patients were included in the study (aged 28 to 94; mean 64, 72 male) with a myocardial inIarction. Patients with a cardiac arrest prior to admission were excluded.
Patients were ranked by Killip class in the Iollowing way:
O ||||p c|ass I lncludes lndlvlduals wlLh no cllnlcal slgns of hearL fallure
O ||||p c|ass II lncludes lndlvlduals wlLh rales or crackles ln Lhe lungs an S
3
and elevaLed [ugular venous pressure
O ||||p c|ass III descrlbes lndlvlduals wlLh frank acuLe pulmonary edema
O ||||p c|ass IV descrlbes lndlvlduals ln cardlogenlc shock or hypoLenslon (measured as sysLollc blood pressure lower Lhan 90 mmPg) and evldence of perlpheral vasoconsLrlcLlon (ollgurla
cyanosls or sweaLlng)
WVit] Conclusions
The numbers below were accurate in 1967. Nowadays, they have diminished by 30 to 50 in every class.
Within a 95 conIidence interval the patient outcome was as Iollows:
||||p c|ass I 81/230 paLlenLs 32 (2738) MorLallLy raLe was found Lo be aL 6
||||p c|ass II 96/230 paLlenLs 38 (3244) MorLallLy raLe was found Lo be aL 17
||||p c|ass III 26/230 paLlenLs 10 (6614) MorLallLy raLe was found Lo be aL 38
||||p c|ass IV 47/230 paLlenLs 19 (1424) MorLallLy raLe 67
The Killip-Kimball classiIication has played a Iundamental role in classic cardiology, having been used as a stratiIying criteria Ior many other studies. Worsening Killip class has
been Iound to be independently associated with increasing mortality in several studies.
Killip class 1 and no evidence oI hypotension or bradycardia, in patients presenting with acute coronary syndrome, should be considered Ior immediate IV beta blockade.

OIIicial Do-Not-Use list in the United States required by Joint Commission
|1|

Not recommended Ior use by other organizations
|2|

ist of abbreviations used in medical 5rescri5tions
Abbreviation atin Meaning Possible confusion
aa ana oI each

ad ad up to

a.c. ante cibum beIore meals

a.d. auris dextra right ear "a" can be mistaken as an "o" which could read "o.d.", meaning right eye
ad lib. ad libitum use as much as one desires; Ireely

admov. admove apply

agit agita stir/shake

alt. h. alternis horis every other hour

a.m. ante meridiem morning, beIore noon

amp ampule

amt amount

aq aqua water

a.l., a.s.
auris laeva, auris
sinistra
leIt ear "a" can be mistaken as an "o" which could read "o.s." or "o.l", meaning leIt eye
A.T.C. around the clock

a.u. auris utraque both ears "a" can be mistaken as an "o" which could read "o.u.", meaning both eyes
bis bis twice

b.d./b.i.d. bis in die twice daily

.M. bowel movement

NF ritish National Formulary

bol. bolus
as a large single dose (usually
intravenously)

.S. blood sugar

.S.A body surIace areas

b.t.

bedtime mistaken Ior "b.i.d", meaning twice daily
UCC bucca inside cheek

cap., caps. capsula capsule

c, c. cum
with (usually written with a bar on top oI
the "c")

cib. cibus Iood

cc cum cibo with Iood, (but also cubic centimetre)
mistaken Ior "U", meaning units; also has an ambiguous meaning; use "m" or
"milliliters"
cI with Iood

comp. compound

cr., crm cream

CST Continue same treatment

D5W
dextrose 5 solution (sometimes written
as D
5
W)

D5NS dextrose 5 in normal saline (0.9)

D.A.W.
dispense as written (i.e., no generic
substitution)

dc, D/C, disc discontinue or discharge ambiguous meaning
dieb. alt. diebus alternis every other day

dil. dilute

disp. dispersible or dispense

div. divide

d.t.d. dentur tales doses give oI such doses

D.W. distilled water

elix. elixir

e.m.p. ex modo prescripto as directed

emuls. emulsum emulsion

et et and

eod every other day

ex aq ex aqua in water

Il., Ild. Iluid

It. Iiat make; let it be made

g gram

gr grain

gtt(s) gutta(e) drop(s)

hypodermic

h, hr hora hour

h.s. hora somni at bedtime

h.s

hour sleep or halI-strength ambiguous meaning
ID intradermal

IJ, inj injectio injection mistaken Ior "IV", meaning intravenously
IM intramuscular (with respect to injections)

IN

intranasal mistaken Ior "IM", meaning intramuscular, or "IV", meaning intravenously
IP intraperitoneal

IU

international unit mistaken Ior "IV" or "10", spell out "international unit"
IV intravenous

IVP intravenous push

IVP intravenous piggyback

.A.S. label as such

CD coal tar solution

lin linimentum liniment

liq liquor solution

lot. lotion

mane mane in the morning

M. misce mix

m, min minimum a minimum

mcg microgram

m.d.u. more dicto utendus to be used as directed

mEq milliequivalent

mg milligram

MgSO4

magnesium sulIate may be conIused with "MSO4", spell out "magnesium sulIate"
mist. mistura mix

mitte mitte send

m millilitre

MS

morphine sulIate or magnesium sulIate can mean either morphine sulIate or magnesium sulIate, spell out either
MSO4

morphine sulIate may be conIused with "MgSO4", spell out "morphine sulIate"
nebul nebula a spray

N.M.T. not more than

noct. nocte at night

non rep. non repetatur no repeats

NS normal saline (0.9)

1/2NS halI normal saline (0.45)

N.T.E. not to exceed

o2 both eyes, sometimes written as o
2


od omne in die
every day/once daily (preIerred to qd in the
UK
|3|
)

od oculus dexter right eye
"o" can be mistaken as an "a" which could read "a.d.", meaning right ear, conIusion
with omne in die
om omne mane every morning

on omne nocte every night

o.p.d. once per day

o.s. oculus sinister leIt eye "o" can be mistaken as an "a" which could read "a.s.", meaning leIt ear
o.u. oculus uterque both eyes "o" can be mistaken as an "a" which could read "a.u.", meaning both ears
oz ounce

per per by or through

p.c. post cibum aIter meals

pig./pigm. pigmentum paint

p.m. post meridiem evening or aIternoon

p.o. per os by mouth or orally

p.r. per rectum by rectum

P#N, prn pro re nata as needed

pulv. pulvis powder

PV per vaginam via the vagina

q quaque every

q.a.d. quoque alternis die every other day

q.a.m.
quaque die ante
meridiem
every day beIore noon

q.d.s. quater die sumendus Iour times a day can be mistaken Ior "qd" (every day)
q.p.m.
quaque die post
meridiem
every day aIter noon

q.h. quaque hora every hour

q.h.s. quaque hora somni every night at bedtime

q.1h, q.1 quaque 1 hora
every 1 hour; (can replace "1" with other
numbers)

q.d., q1d quaque die every day mistaken Ior "QOD" or "qds", spell out "every day" or "daily"
q.i.d. quattuor in die Iour times a day

q4PM

at 4pm mistaken to mean every Iour hours
q.o.d. every other day mistaken Ior "QD", spell out "every other day"
qqh quater quaque hora every Iour hours

q.s. quantum suIIiciat a suIIicient quantity

QWK

every week

# rectal

rep., rept. repetatur repeats

#, #/ #inger's lactate

s sine
without (usually written with a bar on top
oI the "s")

s.a. secundum artum use your judgement

SC, subc, subcut, subq,
SQ
subcutaneous
"SC" can be mistaken Ior "S", meaning sublingual; "SQ" can be mistaken Ior "5Q"
meaning Iive every dose
sig write on label

S sublingually, under the tongue

sol solutio solution

s.o.s., si op. sit si opus sit iI there is a need

ss semis one halI or sliding scale ambiguous meaning; mistaken Ior "55" or "1/2"
SSI, SS#I

sliding scale insulin or sliding scale regular
insulin
mistaken to mean "strong solution oI iodine" or "selective serotonin reuptake
inhibitor"
stat statim immediately

supp suppositorium suppository

susp suspension

syr syrupus syrup

tab tabella tablet

tal., t talus such

tbsp tablespoon

troche trochiscus lozenge

t.d.s. ter die sumendum three times a day

t.i.d. ter in die three times a day

t.i.w. three times a week mistaken Ior twice a week
top. topical

T.P.N. total parenteral nutrition

tr, tinc., tinct. tincture

tsp teaspoon

U

unit mistaken Ior a "4", "0" or "cc", spell out "unit"
g

microgram mistaken Ior "mg", meaning milligram
u.d., ut. dict. ut dictum as directed

ung. unguentum ointment

U.S.P. United States Pharmacopoeia

vag vaginally

w with

wI with Iood (with meals)

w/o without

X times

Y.O. years old

ist of symbols used in 5rescri5tions
$ymbols atin Meaning Possible confusion

at mistaken Ior "2"; spell out "at"
~

greater than mistaken Ior a "7"


less than mistaken Ior an ""
%
take, take this, or take
thus
prescription drug



bat is DoxofllinW {Ansimar]?
DoxoIylline is a type oI enzyme inhibitor drugs that is used to treat Asthma. In animal and human studies, it has shown similar eIIicacy to theophylline but with signiIicantly less
side eIIects. DoxoIylline belongs to category oI enzyme inhibitor activity drugs. SpeciIically, DoxoIylline is a new generation long acting oral methylxanthine derivative.
Methylxanthines are phosphodiesterase inhibitors. DoxoIylline is available as the rand Name, Ansimar. DoxoIylline also has antitussive and bronchodilator aIIects, and acts as a
phosphodiesterase inhibitor.
nVication for usW of DoxofllinW {Anismar]

For maintenance therapy in patients suIIering with Asthma and Chronic Obstructive Pulmonary Disease (COPD).
SiVW EffWcts of DoxofllinW {Anismar]
O no CnS and CvS slde effecLs
O uoxofylllne has a prolonged bronchodllaLor effecL and unllke Lheophylllne lL has leasL adenoslne lnLeracLlons
O lL ls hlghly safe ln smokers
O 1here ls no sleep dlsLurbances and no effecLs on gasLrlc secreLlons wlLh doxofylllne
DosagWs of DoxofllinW {Anismar]
Adult:400mg once a day. Single dose, administration in the evening reduces nocturnal, symptoms and helps to keep the patients complaint Iree during the day.
owever, in certain cases, 400mg twice daily is recommended on the basis oI the clinical response. Doses as high as 1200mg/day (400mg 3 times day) may also be prescribed .
rWcautions wbilW using DoxofllinW {Anismar]
Initial treatment oI acute episodes oI bronchospasm.