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Week 2
Medication Orders
and
Measurement Systems
Chapters 5 and 7
Presented by: Dr. S
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Medication Order Issues

Are you expected to know everything?
– No healthcare professional is

Tip
 Obtain a good, current reference
 When in doubt ask
– No silly questions related to patient safety
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JCAHO
(Joint Commission on Accreditation
of Healthcare Organizations)

Created an Official “Do Not Use” List
– Why?
 easily misinterpreted abbreviations
increased risk of errors
compromised patient safety
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“Do Not Use” List Examples

DON’T

DO
1.
“u” or “IU” for units
1.
Spell out the word “units”
2.
“q.d." "qd" "Q.D." "QD“ 2. Spell out the word “daily”
3.
“Q.O.D.”
3.
Spell out “every other
day”
The Joint Commission on Accreditation of Healthcare Organizations. The Official “Do
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Not Use List”.Retrieved September 29, 2007, http://www.jointcommission.org
“Do Not Use” List Examples

DON’T

DO
1.
Trailing zero
–
“5.0 mg”
1.
Avoid the use of a zero
after a decimal point
– “5”
1.
Decimal point without a
leading zero
– “.5” can be mistaken
for “5”
2.
Use a leading zero before
a decimal
– “0.5”
The Joint Commission on Accreditation of Healthcare Organizations. The Official “Do
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Not Use List”.Retrieved September 29, 2007, http://www.jointcommission.org
Common Medical Abbreviations:
Route

Route
– IM
intramuscular
 Example: Depo-Provera ® 150 mg/mL, # 1mL
150 mg IM q 3 months
– SC
subcutaneous
 Example: Lantus 100 units/mL, # 1 vial
Inject 10 units SC q hs
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Common Medical Abbreviations:
Route

Route
– SL
sublingual (under the tongue)
 Example: nitroglycerin 0.4 mg SL tabs, #25
i tab SL q 5 min x 3 doses prn chest pain
– PO
by mouth
 Example: atenolol 25 mg, # 30
i tab po q am
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Common Medical Abbreviations:
Route
IV
 p.r.
 p.v.

intravenous
per rectum
per vagina
A.D.
right ear
A.S.
left ear
A.U.
both ear
O.D.
Right eye
O.S.
Left eye
O.U.
Both eyes
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Common Medical Abbreviations:
Frequency
a.c.
 p.c.
 prn

before meals
after meals
as needed;
as needed for
– prn pain
– prn HA
h.s.
 stat

at bedtime
immediately
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Common Medical Abbreviations:
Frequency
q 2h
every 2 hours
 q 4-6h every 4-6 hours

b.i.d.
 t.i.d.
 q.i.d.

twice a day
three times a day
four times a day
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Questions?
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Manufacturer’s Label
Required Info
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Parts of a Manufacturer’s
Medication Label
Generic and Trade Names
 National Drug Code
 Controlled Substances Drug Schedules
 Dosage Strength
 Precautions
 Administration Instructions
 Storage Requirements
 Lot Numbers and Expiration Dates

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Generic and Trade Names
FDA recognizes the United States
Pharmacopoeia/National Formulary (USP/NF) as
official registrar of all FDA approved drugs.
 USP/NF contains over 3700 medications and
dietary supplements.
 Generic is drug’s official name in USP.
 Brand or Trade names that have a U.S. patent
and have ® example Motrin®
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How are drugs named?
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Chemical name – based on structure
– N-acetyl-p-aminophenol
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Generic/nonproprietary name – USP/NF
official name
– acetaminophen (note it is lowercase)
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Trade/brand/proprietary name – manuf
registered name while under patent
– Tylenol (note it is uppercase like a proper
name)
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National Drug Code
All drugs assigned NDC code
 Helps identify the manufacture, the
product, and container size.
 Always 11 digits.
 Divided into 5 -4-2
 Manufacture is first 5 digits
 Product code is 4
 Package size is 2

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NDC 00006-0543-61
00006 is the code for manufacturer. In
this case Merck & Co, Inc
 0543 is the specific drug in this case
simvastatin generic name.
 61 is the size of the bottle, in this case 60
tablets.

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Storage, Lot Numbers and
Expiration Dates
Storage information (Room Temp,
Refrigeration)
 Lot Numbers-Important for recalls
 Expiration Dates-can be affected if not
stored properly.
Other things that effect expiration
dates type of container and humidity.

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The controlled substance drug
schedule
There are 5 schedules
 Labeled with a C and roman number
 Which schedule is determined based on
potential for dependency and abuse.
 The lower the number the higher the
potential for dependency and abuse.
 Good examples on pg 83 in your text.

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Week 2 Seminar
Measurement Systems and Their Equivalents
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Assignment Hints
Show your work, so I can give partial
credit
 Utilize resources – seek help early
 Don’t forget about the Math Center if you
need help
 Save files with your name first, then
assignment Msmith_caclulations_Unit3

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Metric System
Based on the decimal system
 Is the international standard for
scientific and industrial measurements
 Used in more than 90% of developed
countries

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Three Basic Units of
Measurement

Weight – gram (g, gm)

Volume – liter (L)

Length – meter (m)
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Common Prefixes
Deci- = 0.1 (one-tenth of one unit)
 Centi- = 0.01 (one-hundredth of one
unit)
 Milli- = 0.001 (one-thousandth of one
unit)
 Micro- = (one-millionth of one unit)
 Kilo- = 1000 units

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Metric Prefixes
Figure 6-2. The basic units of measure–gram, liter, and meter–with prefixes indicating larger
or smaller measures. Thus, deka- (“ten”) refers to ten basic units, and deci- (“tenth”) refers to
one-tenth of the basic unit. Chart on page 131
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Sliding Mnemonic
Conversions
Kilo
10-3
hecto
10-2
deka
10-1
EX: .0045kg<=
EX: .075km <=
METER(m)
LITER(L)
GRAM(g)
<<base>>
4.5g
75m
deci
centi milli * * micro(µ)
101
102
103 * * 106
=> 4,500mg = 4,500,000mcg (µ)
=>7500cm =75,000mm
Metric Rules
Zero ALWAYS placed before decimal ex:
0.78 (not .78)
 **If not included on assignments it will be
counted as incorrect
 Zero NEVER added to the end
ex: 1.01 (not 1.0100)
 No fractions ex: 0.1 (not 1/10)

Which is correct?
2.0 g
 0.2g
¼g


What are the “zero” rules?
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Length Measurement
Conversion Factors
1 Meter = 39.37 inches
2.5 cm = 1 inch
1 m = 1000 mm
1 m = 100 cm
1 cm = 10 mm
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Meter Conversion Factors
= 1,000,000 micrometers

1 meter= 1000 millimeters
=
=
=
=
=
100 centimeters
10 decimeters
0.1 dekameters
0.01 hectometers
0.001 Kilometers
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Let’s learn to convert units!
Really just a 4 step process….
 1. What units are we converting to and
from?
 2. What is our conversion factor?
 3. Set up equation so units cancel. Start
with what you are given.
 4. Carry out the math.
 5. Review – does our answer make sense?

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Length Conversion Factors

How many cm is 75 mm?
1.First determine the units you are converting to
and from – mm to cm
2. Our conversion factor is 1 cm = 10 mm
3. Then use your conversion factor setting up so
units cancel. Start with what you are given.
75mm x 1cm/10mm =
4. Carry out the math
75 x 1/10 = 7.5 cm
5. Does our answer make sense? Should we have a
smaller number for cm?
75 mm = 7.5 cm (remember 1 cm = 10 mm)
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Let’s go through it again…
75mm =____ cm
 Remember 1cm = 10mm from page
133
 75mm x 1cm or
75mm x 1cm
10mm
10mm
 mm cross each other out leaving cm
 75/10= 7.5cm

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Let’s try another length example
How many mm in 2.5 m? _____mm = 2.5 m
1. We are given m and want mm as our answer
2. What is our conversion factor (page 133)?
1 m = 1000 mm
3. Set up equation so units cancel
2.5m x 1000mm/1m =
4. Carry out math
2.5 x1000/1 = 2500 mm
5. Review – does our answer make sense?
look at conversion factor 1m = 1000 mm
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What would happen if we set it
up like this?
2.5 m x 1m/1000mm =
Can you tell why it is wrong? Should our final
answer be larger or smaller than our original
number?
conversion factor is 1 m = 1000 mm
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Try this on your own

How many mm in 3.6 m?
1.
I am converting from ……….
2.
My conversion factor is…….
3.
My equation set – up is……
4.
My answer is……
5.
My answer makes sense!
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How did you do?
How many mm in 3.6 m?
1.
I have m and want to convert to mm.
2.
My conversion factor is found on page 133 and is 1 m = 1000 mm
3.
My set up is: 3.6 m x 1000 mm/1 m (m cancel out!)
4.
When I solve it I get 3600 mm
5.
Based on the conversion factor and the fact that mm are smaller
than m, my answer makes sense!
3600 mm = 3.6 m
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Metric Volume Conversion
Factors based on Liter
=1,000,000microliters
 1 Liter (L) = 1,000 milliliters
= 100 centiliters
=10 deciliters
=0.1 dekaliter
=0.01 hectoliter
=0.001 kiloliter
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Volume Conversion Factors
1 mL = 1cc
1 teaspoonful=5mL or 5cc’s
1 tablespoon=3 tsp = 15mL or 15cc’s
1 L = 32 ounces (approx)
1L = 1000 mL=1000cc
1L = 1qt (approx)
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Metric Weight Conversion
Factors based on Gram
=1,000,000micrograms

1 gram= 1000 mg
=
=
=
=
=
100 centigrams
10 decigrams
0.1 dekagram
0.01 hectogram
0.001 kilogram
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Most Commonly Used
Milligram
 Gram
 Kilogram
 1000mg (mg)=1 gram (g)
 1000gms (g) = 1 kilogram (kg. or kilo)
Mark pages in text where common
conversions are found – better yet – make
your own list! (you’ll thank yourself!)

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Weight Measurement
Conversion Factors
1
1
1
1
kg = 2.2 pounds
kg = 1000 g
mg = 0.001g
mg = 1000 mcg or µg
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Let’s practice with weight
conversions
How many mg in 8 g?
1.I want to go from g to mg.
2.My conversion factor is 1000 mg = 1 g
3.My set up is
8 g x 1000mg/g =
4.When I solve it I get 8000 mg
5.My answer makes sense because I am
going from a larger unit to a smaller
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Your turn
How many mg in 635 mcg?
 1. What units are we going to and from?
 2. What is my conversion factor?

1 mg = 1000mcg or µg
3. Set up equation. Start with what you
are given.
 4. Solve.
 5. Does it make sense?

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How did you do?
How many mg in 635 mcg?
 1. I have mcg and want to convert to mg.
 2. 1 mg = 1000 mcg
 3. 635 mcg x 1 mg/1000 mcg
 4. 0.635 mg
 5. Mcg are smaller than g so my answer
makes sense!

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Apothecary System
Conversion Factors
Old measurement system for calculating
drug orders
 1 drop (gtt) of water = 1 minim (ɱ)
 60 minims(=60gtts) = 1 fluid dram (fӠ)
 1 grain = approximately the weight of 1
grain of wheat or rice = 60mg

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Household System Conversion
Factors

Volume
–
–
–
–

1
1
1
1
cup (c) = 8 oz
pint (pt) = 2 c = 16 oz
quart (qt) = 2 pt = 4 c =32 oz
gallon (gal)= 4 qt= 8 pt = 16c = 128oz
Weight or mass
– 1 pound = 16 oz

Length
– 1 foot = 12 in
– 1 yard = 3ft 36in
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You are doing great!
Keep practicing!
Resources include:
Quiz Review
Workbook (answers in doc sharing)
Math Resource Center
Me!
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