Patient Safety/Quality Assurance PTCB Test Prep

What are ISMP Error-prone Abbreviations?

Apr 24th, 2022
ISMP error-prone abbreviations

ISMP and the PTCB Exam

There are many organizations and bodies that pharmacy technicians are expected to know for the PTCB exam. The ISMP is one of them.

The ISMP is the Institute for Safe Medication Practices.

As the name suggests, the modus operandi of the ISMP is to promote patient safety and to advocate best practice to health professionals. The ISMP are a non-profit organization dedicated to this stated goal.

One of their many functions is to evaluate medication errors. On the ISMP website, for instance, they offer a reporting program where patients, consumers, or healthcare professionals can report a medication or vaccine error. These errors can then be evaluated to establish what went wrong and what protocols should exist to prevent the same error from recurring.

The ISMP, then, play an important role in preventing medication error through error report analysis and through an education role that serves to inform healthcare professionals of best medication practice.

ISMP Error-Prone Abbreviations

Some PTCB test questions can ask about ISMP error-prone abbreviations.

For instance, you may be asked to identify which pharmacy abbreviation should be avoided or which is the preferred version of it. Alternatively, you may be asked PTCB questions about medicine abbreviations and where it is best practice to write the full drug name rather then the abbreviation. This may be necessary where the abbreviation is easily confused with another similarly named drug.

Below, we have put together some of the top ISMP error-prone abbreviations to know for the PTCB exam. Whilst this is not an exhaustive list, it does detail some of the major examples you are expected to know.

You can learn more about error-prone abbreviations by visiting the ISMP website.

AbbreviationInterpretation / ProblemBest Practice
ccCubic centimeters but may be mistaken as units.Use mL
µgMicrogram, which may be confused with mg.Use microgram
AD AS AURefers to right ear, left ear, and both ears; but has been confused with right eye, left eye, both eyes.Use Right Ear
Use Left Ear
Use Both Ears
Per OsRefers to by mouth/orally, though has been mistaken with left eye (which is OS).Use PO, by mouth, or Orally
SCRefers to subcutaneous, though has been mistaken for sublingual.Use SUBQ
HS hsHS = Half Strength
hs = at bedtime
Both have been mistaken with one another
Use capitals HS for ‘half-strength’, and lowercase hs for ‘at bedtime’
q1dRefers to ‘daily’ but has been mistaken as four times daily (qid).Use Daily
UDMeans ‘as directed’ and has been mistaken as ‘unit dose’.Use As Directed
APAPRefers to acetaminophen, but this is not its recognized drug name.Use Acetaminophen
HCTRefers to hydrocortisone, but this has been mistaken as hydrochlorothiazide.Use Hydrocortisone
MgSO4Refers to magnesium sulfate, but this has been mistaken as morphine sulfate.Use Magnesium Sulfate
MTXRefers to methotrexate, but this has been mistaken as mitoxantrone.Use Methotrexate
TXARefers to tranexamic acid, but this has been mistaken for TPA (tissue plasminogen activator).Use Tranexamic Acid
LevoReferring to levofloxacin, but this has been mistaken for the medicine, Levophed (norepinephrine).Use Levofloxacin
1/2 tabletReferring to half tablet, but this has been mistaken for 1 or 2 tablets.Use Half Tablet or reduced font size ½ tablet.
Roman numeralsMistaken designations.
For example, mistakenly assigning the value 10 to V.
Use Arabic numerals (1, 2, 3 etc.) to express doses.
.5mgReferring to half a milligram.
However, this can be mistaken for 5mg – a 10x higher dose!
Use 0.5 mg
1.0mgReferring to one milligram.
However, this can be mistaken for 10mg – again, a 10x higher dose.
Avoid the trailing zero.
Use 1 mg
The m in 10mg has been mistaken as a 0, therefore a space should exist between the 10 and the mg.Use 10 mg
Avoid 10mg
Use 10 units
Avoid 10units
100000 unitsThe lack of commas between 0s can lead to misinterpretation. 1000000 has been mistaken as 100000, for example.Add commas for values above 1,000.
Alternatively, use words – such as 100 million – for added clarity.

Take Home Message

ISMP error-prone abbreviations get tested on the PTCB exam.

Knowing these abbreviations is important not only for the exam but also to help you in your future professional practice. The purpose of these recommendations is to decrease the probability of medication error – and medication errors are common in the United States.

Medication errors:

  • Injure more than 1.3 million Americans each year.
  • Cause 7,000 to 9,000 deaths annually in the US.
  • $40 billion is spent each year addressing patients who have been affected by medication errors.

Given the widespread nature of medication errors, it is incumbent upon pharmacy technicians to be aware of best practice measures.

The ISMP – through their highly effective reporting system, reviews, and recommendations – greatly assist this process and ensure that medication errors are as limited as possible.

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