to a specific area of the body, or general anaesthesia, in which a patient is put into a deep sleep using a general anaesthetic.
Analgesic Medication used to relieve pain (painkiller).
Anastomosis The surgical connection of separate or severed tubular hollow organs to form a continuous channel, such as two parts of the intestine.
Anticoagulant clinic A place where patients taking blood-thinning medications (such as warfarin) have their blood tested. The blood sample is used to check the international normalised ratio (INR), which is a measure of clotting ability.
Antiemetic Medication used to stop vomiting.
Apothecary Apothecary (from the Latin apothecarius: a keeper of an otheca (a store)) is an historical name for a medical practitioner who formulates and dispenses materia medica to physicians, surgeons and patients – a role now served by a pharmacist.
Arterial aneurysm A weakening in the wall of an artery, causing it to stretch under the pressure of the blood flow.
Aspirate To withdraw fluid by the use of suction, usually by using a syringe (e.g. the liquid contents in the stomach can be aspirated by drawing them up through a tube inserted down through the nose into the stomach, using a large syringe). Also refers to the inhalation of fluid or stomach contents into the lungs, and to the withdrawal of cells or fluid from the body, for instance from a cyst.
Assistant technical An unqualified member of the pharmacy support staff (usually working officer (ATO) in a hospital pharmacy) who is able to perform a limited number of tasks under the supervision of a more senior member of the pharmacy staff.
Audit A process of comparing what currently happens in practice with what
should be happening, with a view to improving the delivery of services. Bioavailability The relationship between the dose administered and the concentration
of unchanged drug in plasma, usually expressed as a percentage. Biotechnology Laboratory-based techniques being developed in biological research,
such as processes using recombinant DNA technology or tissue culture. ‘Black listed’ medicines Medicines that cannot be prescribed on an NHS prescription.
‘Black triangle’ drugs Medicinal products that have recieved marketing authorisation in the past 2 years (indicated in the British National Formulary and on their packaging by a black triangle). Any suspected adverse effects that occur in patients taking these drugs should be reported to the MHRA (see below) via the Yellow Card Scheme.
Blame-orientated An approach which, when an error occurs, focuses on the individual approach responsible for the error and often involves punishing that individual,
for example through suspension or dismissal.
Bolus injection A small volume of fluid injected over a short period of time (up to 5 minutes).
Borderline substances A list of products that have been defined by the Advisory Committee for Borderline Substances as medicinal products and that can be prescribed on an NHS prescription.
Brand-to-generic The process of changing a prescription from a branded medication to switches the equivalent generic medication, which may result in cost savings
to the NHS.
Branded medication A medicine where the formula and mode of manufacture are the property of the manufacturer.
British National A compendium of the licensed medicinal products and appliances that
Formulary are available for prescription in the UK, published every 6 months
(includes clinical indications, recommended doses, preparations, prices, licensed category, adverse drug reactions, cautions and contra- indications); often referred to as the BNF; medicines for children are described in the C-BNF.
British Pharmaceutical Annual meeting for pharmacists and other scientists working within
conference the pharmaceutical industry, where research is presented and
professional issues discussed.
Buccal Administration of a medication by placing it in the mouth between the gum and top lip or cheek.
Bulk medication Large quantity of medication provided in large bottles, which are then dispensed into smaller quantities to individual patients; also known as bulk stock.
Bulk stock See Bulk medication.
Care trusts Organisations that provide a link between local government authorities and primary care trusts to improve the delivery of social care to patients. Caution Conditions where care should be exercised in using a particular drug
(e.g. existing disease state).
Central venous catheter An intravenous line that is inserted into a large vein above the heart, through which injections and infusions of drugs and blood products may be given, and blood samples withdrawn, without causing pain to the patient.
Ceramic slab A slab made of a ceramic material upon which creams and ointments are made (commonly known as a tile).
Chemist’s nostrum See Nostrum.
Chief Medical Officer Principal medical adviser to the Government on health care in England. (CMO)
Chief Pharmaceutical Professional lead for Pharmacy at the Department of Health. Officer (CPO)
Child-resistant closure Lids or other seals on primary packaging of medication that are (CRC) designed to be difficult for children to open, such as lids which have to
be pushed down before they can be turned.
Clic Loc® A brand of CRC commonly used on bottles.
Clinical check The process of evaluating a prescription for the clinical appropriateness for use in an individual patient. This is ideally done when a prescrip- tion is first received by a pharmacist.
Clinical governance A series of tools that help pharmacists (and other health professionals) to deliver a high-quality service to patients, with a focus on continu- ally improving the quality of service delivered.
Clinical management A plan for the treatment of an individual patient that specifies which plan (CMP) medications a supplementary prescriber can prescribe and under which circumstances; the CMP is agreed with both the patient and their doctor.
Clinical pharmacy The activities and services undertaken by a clinical pharmacist to ensure rational and appropriate use of medicines; may take place in many settings, such as hospitals, community pharmacies, nursing homes and clinics.
Clinical training rotation Term used to describe the training of junior pharmacists in a number of different clinical specialities by working in different clinical areas on a rotational basis.
Closed question A question that can only be answered with a small number of responses, such as yes or no.
Closure The lid or other method of sealing a medicinal product in the primary packaging.
Colloid A suspension containing molecules with large molecular weights.
Colorectal surgery Surgery on the lower part of the intestine – the colon and rectum. Commissioner The person who is responsible for commissioning health services
within a primary care trust.
Commissioning The process by which primary care trusts and general practices purchase health services for the general population that they serve. Community pharmacist A pharmacist working in the community sector of pharmacy.
Community pharmacy A premises registered with the RPSGB (see below) for the provision of pharmaceutical services to the general public; a term used to describe the skills specifically used by a community pharmacist in their day-to- day work.
Complementary A general term for an extensive list of medical systems that differ from medicines allopathic (Western) medicine, including acupuncture, Ayurvedic, tribal traditional medicine, herbal or phytotherapeutic, homoeopathic and other treatments. Complementary medicine is not the same as holistic medicine.
Compliance The extent to which a person’s behaviour – taking medications,
following a recommended diet or executing lifestyle changes – coincides with medical or health advice.
Composition The proportion and combination of elements or components that form a substance.
Compounding The process of combining more than one chemical agent to produce a medicinal product.
Compromised swallow Patients who have difficulty swallowing are described as having a ‘compromised swallow’ (e.g. after a stroke), and may require non-oral dosage forms.
Concordance Describes an equal relationship between a patient and a health profes- sional in which decisions about health care, including medication taking, are made in partnership, with each person contributing their own type of expertise and both parties agreeing on the final decision. Confections A sweetened medicinal product; a sweet preparation.
Conical measure A type of laboratory glassware that consists of a conical cup with a notch on the top to allow for the easy pouring of liquids; conical measures have graduated markings on the side to allow easy and accurate measurement of volumes.
Conserve A product that has been preserved with sugar.
Continuing professional The process of life-long learning that will soon be mandatory for development (CPD) pharmacists who wish to continue to practise in the UK.
Contraindication A medical condition or factor that increases the risk involved in using a drug to the extent that the risks are likely to outweigh the benefits; The risk–benefit ratio of using the drug must be considered in individual patients and may prohibit the use of the drug.
Controlled drug (CD) A medicinal product that is categorised in Schedules 1–5 of the Misuse of Drugs Regulations 2001 because it is considered to be dangerous or otherwise harmful.
Controlled drug (CD) A record of CDs that are kept in a pharmacy or hospital ward, where register they have been received from, and who they have been supplied to. The number of dose units in the register must agree with the number of physical dose units in the pharmacy.
Cost-effectiveness The relative cost of a treatment compared with the therapeutic effect it will have. Ideally, a treatment should be low cost and provide a strong benefit to the majority of patients it is intended for.
Counter prescribing The process of recommending over-the-counter (OTC) treatments (or other non-prescription remedies) for patients.
Critical care The area of the hospital where patients who require intensive care are treated (such as the intensive care/therapy init (ICU/ITU)).
Critical event An occasion where something significant has occurred that is outside normal experience. The occurrence can be positive (such as unusually excellent patient service) or negative (such as an adverse event resulting in patient harm).
Decongestant A medication used to relieve a blocked nose.
Demijohn A large narrow-necked bottle made of glass or earthenware, usually
encased in wickerwork.
Dental Practitioners’ A list of medicinal products that can be prescribed by a dentist on an
Formulary NHS prescription.
Department of Health Government department that runs the NHS in England. (DH)
Dependent prescriber See Supplementary prescriber.
Deranged blood clotting An abnormality in the ability of the blood to clot. This is indicated by abnormal blood test results, and the presence of signs such as bruising and bleeding gums (blood clotting is decreased) or an increased tendency to clot, producing clots in the legs (deep venous thrombosis). Deregulated A term used to describe the down-grading in classification of a medica- tion from prescription only (POM) to a pharmacy medicine (‘P’), or from ‘P’ to general sales list (GSL).
Destruction of old Bins used in pharmacies to contain drugs that need to be destroyed pharmaceuticals (e.g. out-of-date medications, and medications returned by patient). (DOOP) bins
Diagnosis The identification of a condition or disease state that a patient has. Diploma in clinical A postgraduate qualification available to both hospital and community
pharmacy pharmacists that provides in-depth knowledge on how to manage the use of drugs in patients with a variety of disease states.
Disintegration testing Measurement of the time taken for a dosage form (e.g. tablet) to fully break apart under specific experimental conditions. Disintegration is often required for the drug to be released and absorbed.
Dispensary The area within a pharmacy where medicines are dispensed.
Dispensary receptionist Member of the pharmacy support staff who answers the telephone and greets patients and health professionals who visit the hospital pharmacy. Dispensing The process of supplying a medicine to a patient in accordance with
the directions on a prescription.
Dispensing assistant Member of the pharmacy support staff who has undergone limited training that allows them to order and dispense medicines, in addition to the role performed by a medicines counter assistant.
Dispensing doctor A practitioner, typically in a rural area, who is licensed to dispense medi- cines to patients who live more than 1 mile from their nearest pharmacy.
Dispensing error An error in the dispensing of a medication.
Dispersible Describes a dosage form, usually a tablet, that breaks down into small particles in water and forms a suspension of those particles.
Dissolution The kinetic process in which the molecules of a solid dissolve in a solvent such as the gastric fluid.
Domiciliary visit Visit to a patient’s home to provide a service, for example a medica- tion review carried out in a patient’s home would be a domiciliary medication review.
Dosage The prescribed amount of medicine, including the dose (amount)
and the timing (e.g. two tablets three times a day).
Dose The amount of medication that a patient should take (e.g. one tablet). Doubling-up The process used when combining a small amount of one ingredient with a larger amount of another in order to ensure even distribution. Drug chart The prescription chart used in a hospital; this is a record of the medica- tion that a patient is prescribed during their hospital stay. Each drug order is signed by a doctor (or other authorised prescriber) and a nurse signs the drug chart each time a medicine is administered. A pharma- cist signs the drug chart and endorses it with additional instructions, an indication of where the medicine is available from (such as ‘stock on the ward’, ‘patient’s own’, or the number of dose units supplied by the pharmacist) and the date.
Drug order In a hospital setting, this refers to a prescription written for an individual patient on a drug chart.
Duration The length of time for which a patient will take a medication (e.g. 1 week). Duty of care A legal obligation to provide a reasonable standard of care to a patient when providing a service such as dispensing a prescription or counter prescribing.
Efficacy The ability to produce a desired outcome. In terms of medicines, this refers to the ability of a medicine to produce the desired therapeutic outcome.
Elective admission Routine planned admission to hospital, usually for surgery or other planned treatment.
Elixir A sweet-tasting liquid preparation of a pharmaceutical product. Similar to a linctus, but containing less alcohol.
Embrocation A medicinal liquid that is rubbed into the skin to relieve muscular stiff- ness and pain.
Emergency admission Non-routine unplanned admission to hospital for an illness or injury (e.g. by ambulance or through the Emergency department).
Emergency department Point of contact for emergency care provided by hospitals (formerly called A&E – Accident and Emergency).
Emergency supply A supply of a medication usually taken by a patient that is provided by a pharmacist in an emergency where the patient does not have a prescription.
Emollient A substance composed of fat or oil that soothes and softens the skin. Emulsion A mixture of oil and water, generally of a milky or cloudy appearance. Endoscope An instrument that is inserted into the body to view internal parts.
Enema Liquid or foam dosage form that is administered via the rectum.
Enhanced service The highest tier of service provision under the new Pharmacy Contract, which contains services that can be commissioned from community
pharmacies by primary care trusts according to the needs of the local population.
Enteral Administration of food or medication via the gastrointestinal tract. Enteric coating A special coating applied to tablets or capsules to protect the dosage
form from degradation by stomach acid or to protect the stomach from irritant drugs. The coating is susceptible to degradation by the alkaline environment of the small intestine, where the drug is released and absorbed.
Enterostomal tube A tube that runs from an opening in the skin of the abdomen into the stomach or jejunum.
Enzyme enhancement Increase in the ability of enzymes to carry out their required function. Enzyme inhibition Prevention or reduction of an enzyme’s ability to carry out a process,
as a result of the interaction of some substance with the enzyme. Epidural Administration of a medication (usually an anaesthetic) by injection
into the epidural space around the spinal column via a lumbar puncture. Essential service The lowest tier of service provision under the new Pharmacy Contract, which contains services which must be provided by all community pharmacies.
Excipient A biologically inactive substance used as a carrier for the active ingre- dients of a medication (i.e. the drug). Excipients are included in a formulation for their specific properties such as bulking, improving powder flow, solubility, disintegration and mechanical strength. Expiry date The date after which a drug product should not be used or taken. The
period of time between manufacture and the expiry date depends on the stability of the product.
Extemporaneous The preparation of a medicinal product from individual ingredients preparation within a pharmacy in response to a prescription for an individual patient. Products are either prepared to recipes from the standard formu- laries (e.g. British Pharmacopeia) or to recipes written by the prescriber. These are unlicensed products.
Food and Drug The organisation that grants marketing authorisations in the USA. Administration (FDA)
Final check The final check that a pharmacist (or appropriately qualified techni- cian if a prescription has already been clinically checked by a pharma- cist) makes to ensure that the dispensed medicinal product is the same as that requested by a prescriber on a prescription.
First-pass effect Metabolism in the liver of a drug that has been absorbed via the gastroin- testinal tract and is carried directly to the liver via the portal vein, before reaching the target organ. Efficacy may be reduced by first-pass effect (also known as first-pass metabolism); some drugs are activated by this process (e.g. tramadol).
Formulary A list of medications that are approved for prescription/supply in a local area, for example within a hospital trust.
Formulation The quantities and sources of ingredients used to make a product; the act, process, or result of formulating or reducing to a formula.
Foundation hospital trust Management structure for highly performing hospitals that provides greater independence and financial control compared with NHS acute trusts.
Frequency How often a patient should take their medication (e.g. twice a day).