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Sig, convert, daily supply, dilution (4.1 Math & Sig Codes)

Sig Codes: Instructions for patient labels. Roman Numerals: Used for quantities and doses. Metric Conversions: Moving between volume and weight units. Days Supply / Quantity: Calculating total doses needed. Concentration / Dilutions: Determining active ingredient strength (C1V1 = C2V2 or Allegation).

q.d. / b.i.d. / t.i.d. / q.i.d. (4.1 Math & Sig Codes)

Day frequency: Once daily (q.d.) Twice daily (b.i.d.) Three times daily (t.i.d.) Four times daily (q.i.d.).

a.c. / p.c. / p.r.n. / p.o. (4.1 Math & Sig Codes)

Administration timing/route: Before meals (a.c.) After meals (p.c.) As needed (p.r.n.) By mouth (p.o.).

o.d. / o.s. / o.u. (4.1 Math & Sig Codes)

Ophthalmic (Eye) indicators: Right eye (o.d.) Left eye (o.s.) Both eyes (o.u.).

a.d. / a.s. / a.u. (4.1 Math & Sig Codes)

Otic (Ear) indicators: Right ear (a.d.) Left ear (a.s.) Both ears (a.u.).

Roman Numerals (I to M) (4.1 Math & Sig Codes)

Core numbering system: I=1 V=5 X=10 L=50 C=100 D=500 M=1000. Smaller symbols before larger ones subtract (e.g. IX = 9).

Teaspoon & Tablespoon (4.1 Math & Sig Codes)

Liquid volume measurements: 1 teaspoon (tsp) = 5 mL. 1 tablespoon (tbsp) = 15 mL.

Ounce & Cup Volume (4.1 Math & Sig Codes)

Liquid volume measurements: 1 fluid ounce (fl oz) = 30 mL. 1 cup = 240 mL.

Weight Conversions (4.1 Math & Sig Codes)

Metric to common weight transformations: 1 kilogram (kg) = 2.2 pounds (lbs). 1 grain (gr) = 65 milligrams (mg).

Days Supply Formula (4.1 Math & Sig Codes)

Formula: Total Quantity Dispensed divided by Total Quantity Used Per Day.

Needles, spacers, injection routes (4.2 Supplies & Equipment)

Diabetic Supplies: Needles, syringes, monitors. Inhaler Spacers: Holding chambers to improve lung delivery. Syringes & Needles: Oral (no luer-lock, cannot attach needle) vs. Injectable. IV Filters: Removing particles or bacteria. Immunization Supplies: Needles for IM vs. SQ injections.

Insulin Syringe Calibration (4.2 Supplies & Equipment)

Calibrated standardly in Units instead of milliliters. U-100 is the industry baseline signifying 100 units of insulin per 1 mL.

Needle Gauge Sizing Rule (4.2 Supplies & Equipment)

An inverse scaling system. The larger the gauge number the smaller and thinner the needle diameter (e.g. a 30G needle is ultra-fine whereas an 18G needle is thick).

0.22-Micron Filter Rule (4.2 Supplies & Equipment)

A micro-pore sterile filter used during compounding to physically trap and remove bacteria fungi and particulate matter from solutions.

5-Micron Filter Rule (4.2 Supplies & Equipment)

A specialized filter used exclusively with fluid drawn from glass ampules. It acts as a safety screen to capture microscopic glass shards.

Intramuscular (IM) Rule (4.2 Supplies & Equipment)

Injection standard: Requires a longer 1 to 1.5-inch needle delivered deep into the muscle tissue at a straight 90 degree angle.

Subcutaneous (SQ) Rule (4.2 Supplies & Equipment)

Injection standard: Requires a shorter 5/8-inch needle delivered into the fatty tissue layer at a shallow 45 degree angle.

NDC, lot, expiration (4.3 Product Identifiers)

National Drug Code (NDC): Unique 10 or 11-digit 3-segment number identifying a drug product. Lot Numbers: Batch identifiers from the manufacturer. Expiration Dates: Legal limits for medication safety and efficacy.

NDC Segment 1 (4.3 Product Identifiers)

Identifies the specific Drug Manufacturer or Labeler. Assigned directly by the FDA.

NDC Segment 2 (4.3 Product Identifiers)

Identifies the Drug Product indicating the exact chemical strength formulation and physical dosage form.

NDC Segment 3 (4.3 Product Identifiers)

Identifies the trade Package Size and packaging configuration.

Month-Only Expiration Rule (4.3 Product Identifiers)

Standard legal policy: If a medication lists a month-only expiration date (e.g. 10/2026) the product remains safe and legally dispensable until the very last day of that month (October 31 2026).

Lot Number Recall Utility (4.3 Product Identifiers)

Batch identification tracking code. Utilized by pharmacy staff to instantly identify isolate and remove contaminated or defective manufacturer product lines during drug recalls.

Stock, reverse distribution, waste (4.4 Inventory Management)

Stock Rotation: Placing newest stock behind short-dated items. Expired Meds: Must be completely pulled from active stock. Reverse Distribution: Process for returning credit-eligible medications. Hazardous Waste: Distinct segregation and disposal routes.

FEFO Shelf Rule (4.4 Inventory Management)

First-Expired First-Out layout standard. The inventory practice of pushing items with upcoming expiration dates to the front of the shelf so they are used first.

Dispensable vs. Non-Dispensable (4.4 Inventory Management)

Dispensable: Active unexpired stock in original sealed packaging or properly preserved open stock. Non-Dispensable: Contaminated dropped compromised expired or patient-returned medications (which can never be re-dispensed due to safety).

Return to Stock (RTS) Procedure (4.4 Inventory Management)

Prescriptions filled but not picked up within 10-14 days are returned to inventory. Techs must obscure patient details leave original lot/exp visible or apply an RTS expiration date (typically 1 year or manufacturer date whichever is sooner).

Reverse Distribution (4.4 Inventory Management)

The specialized process of shipping expired or non-dispensable stock to a licensed external processor who evaluates the items to secure partial financial credits from drug manufacturers.

Credit Return Protocol (4.4 Inventory Management)

The specific process of tracking and documenting returned inventory sent to a manufacturer or reverse distributor to secure partial or full financial reimbursement for the pharmacy.

C-II Reverse Distribution Form (4.4 Inventory Management)

Legal return protocol: Shipping Schedule II controlled substances back to a reverse distributor requires the execution of an official DEA Form 222.

C-III to C-V Reverse Distribution (4.4 Inventory Management)

Legal return protocol: Shipping Schedule III through V medications back to a reverse distributor requires a standard invoice/inventory manifest; a DEA Form 222 is not used.

Quarantine & Segregation (4.4 Inventory Management)

Regulatory compliance standard: All expired damaged non-dispensable or recalled stock must be physically pulled from active inventory and stored in a clearly labeled designated quarantine area to prevent accidental dispensing