Drug Prescription Label Instructions and Their Abbreviation Codes

Almost everyone has taken some form of prescription medication in their lives and has needed to ask the doctor what the pills do, and when or how often they should be taken. Like secret organizations, the medical profession holds tightly to its near-god status by its access to the secrets of medicine. Although those secrets are more available to the public today through the Internet than ever before, the secret code used in prescribing drugs or describing drug cautions often remains a mystery, known only to doctors who prescribe them, the pharmacists who dispense them, and the people who may have learned a bit from taking a particular medication of their own.

More than fifty years after the Catholic Church stopped holding most services in Latin for the benefit of their lay members who couldn't understand it, American medical schools and the doctors they crank out can't let go of the use of Latin for writing prescriptions. So for those who expected if they concentrated on it hard enough, they might figure out what the abbreviations on prescription drug labels stood for, ain't gonna happen. They aren't in English - they are abbreviations of Latin words and phrases, most of which the average person never heard of.

Although the medical machine is growing at an astronomical rate while TV advertising encourages everyone to see their doctor to find out if xxxxx treatment or prescription drug "is right for you", doctors actually do not run the world. The International bankers do. When the showdown comes, it will become clear. So for the moment, let's tell some secrets about prescriptions and what all those Latin abbreviations on the labels, the "instruction codes" for taking the enclosed drug, mean.

"Prescription" is a word that also has Latin roots. It comes from the word "praescriptus" meaning "to write before"-pre+scribere. This indicates that the written instructions on how to compound the medicine and how to take it must be written out before the drug could be obtained and used. Thus a prescription had to be written by a knowledgeable person - whether a chemist (from which the specialty of pharmacist came) or a physician.

The order was generally that the physician (or herbalist, in some cases) determined the need for a drug or herb, it was generally also prepared by them (until pharmacy specialists later took over that job), and then it was provided to the patient. Naturally, the more knowledgeable professionals were required to complete the task, the more people had to be paid to obtain the concoction, so it's obvious why the gap between the chemist and patient grew to include several intermediate steps (and specialists).

Instructions given to a patient for taking medications were not always simple. They may originally have included finding plants or roots, paring them, boiling or grinding them, drying and flaking them, making teas or poultices of them, and applying them to the skin, binding them about the body with strips of cloth, immersing oneself in a bath of them, or simply eating them. Today this has generally been distilled down to the 'simply eating' of them, usually in pill or capsule form, for just about every form of medication. All that remains to be told is when to take them and for how long.

It is only in approximately the last 30 years that convention finally changed, thanks to pharmacists. Most drug store pharmacists witnessed their customers' obsequious dismay with the Latin abbreviations and began to type in the translations in English, such as "Take one pill twice daily," instead of typing on the container label the exact inexplicable Latin abbreviations the doctors wrote down. Perhaps they tired of answering the phone and checking their records repeatedly to help confused customers who were unable to remember how to take their new prescription and simply couldn't figure out the label 'instructions'.

The following is a list of most of the Latin abbreviations doctors are taught in medical school for writing prescriptions. These instructions are translated and typed onto the labels of prescription drug containers by pharmacists to explain to the user how and when to take the medications.

• a.c. before meals (from ante cibum, before meals)
• ad lib: use as much as necessary (from ad libitum)
• b.i.d. or BID twice a day
• caps capsules
• da or daw dispense exactly as written
• g (or gm or GM) gram
• gtt. drops (from Latin guttae drops)
• h. hour
• h.s. or HS at bedtime (hour of sleep)
• mg milligram
• ml milliliter
• p.c. after meals (from post cibum, after meals)
• p.o. by mouth, orally (from per os, by mouth)
• p.r.n., or pid as necessary (from pro re nata, as needed)
• q.d. or QD once a day (from quaque die, once a day)
• q.i.d. four times a day (from quater in die)
• q.o.d. or QOD every other day
• q._h.: every h hours (from quaque, h = the # of hours)
• q.2h. every 2 hours
• q.3h. every 3 hours
• q.4h. every 4 hours
• t.i.d. or TID three times a day (from ter in die, 3 times daily)
• ut dict. as directed (from ut dictum,)

Note that 3 times a day does not mean breakfast, lunch, and dinner time (12 hours of daylight). Three pills "per day" means every 8 hours or 3 divisions of 24 hours. This little fact is often not mentioned by prescribers.

Further prescription abbreviations indicate cautions regarding the medication being taken. Not Latin nor have they been used historically by ancient physicians and pharmacists, these are relatively recent (many mandated by the FDA) since the recognition that users of prescription drugs routinely assume medications to be totally safe, while in fact the history of prescription medication use is fraught with serious side effects, interactions, organ (usually liver) failure, and death, even when taken as directed.

The following are caution codes that any medication user should know: If you see one of the universal or special caution codes on a prescription, talk to your pharmacist about it before using the medicine. It may be just as effective to take an alternative prescription substance, or even a natural one if you request it.

Universal caution codes - for any of these codes on your prescription container label (sometimes stickers or pictures may be used), ask the pharmacist before taking.)

• D = Can/does cause drowsiness
• H = Can be/is habit forming
• I = Can interact with one or more other drugs, foods, or herbs
• X = SOS (may contain a problem-causing substance like acetaminophen; consult a doctor or
  pharmacist before taking.)

Special caution codes -

• ASA = contains salicylates (aspirin-based substances)
• C = caution (for those with certain conditions like high blood pressure)
• G = May cause or aggravate glaucoma
• S = May cause or aggravate diabetes

Anyone taking prescription medication does not have to simply trust the experts about it (medical sources such as doctors, nurses, pharmacists). This information, once a secret from the very people taking the medications, is currently available to anyone from the Physicians Desk Reference (PDR). This volume, growing by one-fourth its thickness annually due to the insatiable competition between drug companies, may quickly become multiple volumes, but its information is available for the consumer in libraries, doctor's offices, most drug stores, and in various forms on the Internet.

Prescription drug users should never assume they know exactly what they are taking; it's wise to always check the PDR when obtaining prescription drugs for dosing by weight, pictures of the pills or tablets by size, shape, and color to confirm you were given the correct medication, and read the label carefully to confirm the dosage is the same as you were told by the doctor (or if a refill, the same as you got previously) and does not exceed dosing recommendations in the PDR itself. If anything does not look right, contact your doctor and find out about the discrepancy before using.

The Journal of the American Medical Association (JAMA) from over ten years ago (1998), reported that ordinary prescription drugs killed over 106,000 Americans annually when used according to instructions; three times more people than are killed by automobiles, indicating that prescription drug death was then the fourth leading killer in the country, next only to cancer, heart disease, and stroke. With thousands more drugs on the market today, many of them being fast-tracked through FDA approval, we can only guess the current number of deaths. Buyer be aware.