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Pharmacy Practice208
v. Ketones: As with sugar, any amount of ketones detected
in the urine could be a sign of diabetes and requires
follow-up testing.
vi. Bilirubin: Bilirubin is a product of red blood cell break-
down. Normally, bilirubin is carried in the blood and
passes into the liver, where it is removed and becomes
part of bile. Bilirubin in the urine may indicate liver
damage or disease.
vii. Evidence of infection: If either nitrites or leukocyte
esterase a product of white blood cells is detected in the
urine, it may be a sign of a urinary tract infection.
viii. Blood: Blood in the urine requires additional testing it
may be a sign of kidney damage, infection, kidney or blad-
der stones, kidney or bladder cancer, or blood disorders.
Microscopic ExaminationMicroscopic Examination
Microscopic ExaminationMicroscopic Examination
Microscopic Examination
During this examination, several drops of urine are viewed
with a microscope. If any of the following are observed in
above—average levels, additional testing may be necessary:
i. White blood cells (leukocytes) may be a sign of an infection.
ii. Red blood cells (erythrocytes) may be a sign of kidney
disease.
iii. Bacteria or yeasts may indicate an infection.
iv. Crystals that form from chemicals in urine may be a sign of
kidney stones.
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• Lab test results may be positive, negative, or inconclusive.
• Positive test results mean that the amount of a substance
being tested for is higher or lower than normal. Negative
results mean that the substance being tested for was present
in a normal amount.
• A false-positive test result is one that shows a disease or
condition is present while in actuality it is not present. A
false-negative test result may suggest that a person does not
have a disease or condition while in actuality if the disease
is present. For example, a false-negative pregnancy test does
not confirm pregnancy while in actuality the woman is
pregnant.
Interpretation of Clinical Laboratory Tests 209
• The various factors affecting laboratory test results are:
i. Pregnancy
ii. Medicine taken
iii. Eating habits
iv. Smoking
v. Stressed conditions
• Blood chemistry tests are blood tests that measure amounts
of certain chemicals in a sample of blood
• The following some common blood chemistry tests are:
i. An electrolyte panel measures sodium, potassium,
chloride, magnesium, phosphate and bicarbonate.
ii. Kidney function tests (also called a renal panel) measure
blood urea nitrogen (BUN) and creatinine.
iii. Liver function tests measure alanine aminotransferase
(ALT), alkaline phosphatase (ALP), aspartate trans-
aminase (AST), bilirubin, albumin and total protein.
iv. A basic metabolic panel (BMP) includes an electrolyte
panel and kidney function tests and also measures
glucose and calcium.
• Hematology tests include tests on the blood, blood proteins
and blood-producing organs.
• Some other routine blood tests are:
– Complete blood count (CBC): It is an assay of the ratio of red
to white blood cells, types of white cells, and the number
of platelets in blood.
– Hematocrit: A hematocrit is a measure of the blood
volume consisting of red blood cells.
– Red blood cells: Red blood cells carry oxygen from the
lungs to the rest of the body. Abnormal red blood cell
levels might be a sign of anemia, dehydration, bleeding,
or another disorder.
– White blood cells: White blood cells fight infection, so a
high white cell count may indicate infection, blood
disease, or cancer.
– Platelets: Platelets are fragments that stick together to
help blood clot when a blood vessel is broken. Abnormal
platelet levels may signal a bleeding disorder (insufficient
clotting) or a thrombotic disorder (too much clotting).
Pharmacy Practice210
• Hemoglobin is the iron-containing protein in red blood cells
that carries oxygen to cells.
• Mean corpuscular volume (MCV) is a measure of the
average size of the red blood cells. Abnormal MCV may
indicate anemia or thalassemia.
• Mononucleosis testing involves looking for the antibodies
the immune system makes as it works to fight the infection.
• Vitamin B
12
deficiency testing: This vitamin is essential for
healthy blood cells, healthy nerves and stable DNA.
• Renal profiling can provide a unique and valuable snapshot
of how the kidneys are functioning. The blood test will
include testing the levels of creatinine and blood urea
nitrogen.
• Cholesterol testing can alert a doctor as to whether a patient
needs to take action to lower blood cholesterol and whether
further treatment is required. The blood test itself involves
testing the total cholesterol, LDL cholesterol (the bad), HDL
cholesterol (the good), triglycerides and the patient's risk
ratio.
• Blood glucose testing is used to show how well the patient
has been able to control his or her diabetes over the past few
months.
• A urinalysis is a test of the urine. A urinalysis is used to
detect and manage a wide range of disorders, such as
urinary tract infections, kidney disease and diabetes.
• A urinalysis is a common test that is done for several
reasons:
i. To check the overall health: Urinalysis may be done as a
routine medical examination, pregnancy checkup, pre-
surgery preparation, or on hospital admission to screen
for a variety of disorders such as diabetes, kidney disease
and liver disease.
ii. To diagnose a medical condition: Urinalysis may be done to
check abdominal pain, back pain, frequent or painful
urination, blood in urine, or other urinary problems.
iii. To monitor a medical condition: In case of kidney disease or
a urinary tract disease the doctor may recommend a
urinalysis on a regular basis to monitor the condition and
treatment of kidney.
Interpretation of Clinical Laboratory Tests 211
• For a urinalysis, the urine sample is evaluated in three
ways: Visual examination, dipstick test and microscopic
examination.
• Visual examination: A laboratory technician examines the
urine’s appearance. Urine is typically clear.
• Dipstick test: The chemical strips change color if certain
substances are present or if their levels are above normal. A
dipstick test checks for:
i. Acidity (pH)
ii. Concentration
iii. Protein
iv. Sugar
v. Ketones
vi. Bilirubin
vii. Evidence of infection
viii. Blood
• Microscopic examination: During this examination, several
drops of urine are viewed with a microscope.
PRAPRA
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1. Name some non laboratory tests.
2. Give the normal range of Hb, and clotting time.
3. Give the normal range of RBC, ESR.
4. Write the normal values of PCV and MCV.
5. Write the significance of ESR values.
6. Normal values of platelets and WBC.
7. Give the normal range of creatinine and BUN
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1. Write a note on interpretation thyroid functioning test.
2. Write the significance of platelets and ESR.
3. Write a note on interpretation pulmonary functioning test.
4. Write the significance of urine culture test.
5. What is the significance of presence of protein and glucose
in urine?
Pharmacy Practice212
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1. Discuss the hematology parameters and its interpretation.
2. Write the various abnormal constituents of urine and the
diagnostic tests of it.
3. Give the normal range and significance of the following:
a. RBC b. ESR
c. PCV d. Ferritin
e. Thrombocytes
4. Write the signifance of blood chemistry values.
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1. Kidney function test measures:
A. Urine amount
B. Bile content
C. Blood urea nitrogen and creatinine
D. Albumin
2. ______ is the study of blood, in particular how blood can
affect overall health or disease.
A. Toxicology B. Histology
C. Cardiology D. Hematology
3. Abnormal MCV may indicate:
A. Thrombosis B. Anemia or thalassemia
C. Cirrhosis D. None of these
4. Heart disease may occur due to:
A. LDL B. HDL
C. Triglyceride D. Fatty acids
5. ________ is a quick, noninvasive test used to check the
appearance, concentration and amount of urine.
AnswersAnswers
AnswersAnswers
Answers
1. C 2. D 3. B 4. A 5. Urinalysis
Glossary 213
Absorption rate: The amount of time it takes after a drug is
administered for it to enter the bloodstream.
Acute: Usually refers to a condition that has a fast onset time,
severe effect, and short course of duration.
Admixture: Two or more drugs blended or mixed together to
create a desired substance or solution.
Adverse reaction: When the body has an undesired or negative
response to a medication or drug-drug interaction.
Agonist: A drug that triggers a receptor to produce a
physiologic response. An easy way to remember the difference
is: Agonists try to make things happen, antagonists try to stop
things from happening.
Allergic reaction: A response from the immune system to a
substance which a patient has an allergy to.
Allergy: When the body is highly sensitive to (an otherwise
harmless) substance.
Ampule: A (small) sealed glass vial that is to be ‘broken’ open
and normally contains injection solution.
Analgesic: Often referred to as “pain relievers”, analgesics are
drug used to reduce or suppress pain (e.g. aspirin, ibuprofen,
oxycodone, etc.).
Anaphylaxis: An extreme reaction to something you are
severely allergic to, such as a peanuts, shellfish or a beesting
which requires emergency medical attention and may be life-
threatening.
Anesthetic: Drugs that create an insensitivity to pain by
blocking nerve transmission to the brain.
Antagonist: Drugs designed to block a receptor-mediated effect
created by neurotransmitters. An easy way to remember the
difference is: Agonists try to make things happen, antagonists
try to stop things from happening.
Glossary
Pharmacy Practice214
Anthelmintic: Agent that destroys intestinal worms
Antibacterial: Agent that destroys or prevents bacterial growth
Antiflatulent: Agent that relieves excess intestinal gas
Antihyperlipidemic: Agent that lowers cholesterol levels
Antihypertensive: Agent that lowers blood pressure
Antipruritic: Agent that relieves itching
Antipyretic: Agent that lowers an elevated body temperature
Antiseptic: Dilute solution applied to living tissue to destroy
or prevent growth of microorganisms, e.g. hand sanitizer
Antispasmodic: Agent that prevents or relieves spasms
Antitussive: Agent that relieves coughing
Anticoagulant: A drug that is used to decrease or prevent the
formation of blood clots
Anticonvulsant: These are drugs used to help prevent seizures
or to lessen the severity of a seizure.
Antiemetic: Drugs used to prevent, alleviate or suppress
nausea and vomiting.
Antihistamine: Drugs used to counteract the immune systems
histamine reaction to allergy or respiratory illness.
Antineoplastic: Drugs prescribed to slow the growth of
malignant tumors.
Antipyretic: Drugs used to prevent or reduce fever (abnormally
high body temperature).
Antispasmotic: Drugs used to relieve or prevent muscle spasms.
Aqueous: It refers to when something is, or to be water based.
Aseptic technique: A sanitation practice performed with a goal
of minimizing contamination by pathogens.
Auxiliary label: Additional labels placed on prescription
packaging that provide supplementary information, various
warnings, routes of administrations, etc.
Bactericidal: Drugs that destroy/kill bacteria.
Bacteriostatic: Drugs that slow down or inhibit the duplication
(growth) of bacteria.
Bioavailability: The rate which a drug is made available to the
target site of physiological activity.
Glossary 215
Bio-equivalence: When a drug has the same biological effect/
efficacy/bioavailability as a similar drug with a different
formulation.
Bronchodilator: A drug that widens passages in the lungs to
ease breathing.
CC: Abbreviation for cubic centimeter = same as 1 ml (milliliter)
Celsius: It is basically the same as centigrade (see next term below).
Centigrade: Standard measure of temperature in science/
metric system. Water freezes at 0 and boils at 100.
Closed formulary: A program where drugs not listed in the
formulary require prior authorization or may not be covered
whatsoever by the insurer.
Chronic: It refers to an illness that persists for a long period of
time or frequent re-occurrence.
Communicable: It refers to illness/disease that is contagious
or transmittable to others.
Compound: A final substance (or solution) made from two or
more substances.
Controlled release (CR): It refers to drug formulations
designed to release gradually over a specific time.
Dehydration: When the body loses water and electrolytes
essential for bodily function.
Denominator: Number below the line in a fraction that
indicates the number which one whole is divided.
Diluent: A liquid that decreases the concentration of a solution
by diluting it, or turns powder into a liquid.
Diuretic: Drugs that increase the body’s urine discharge flow,
thereby decreasing overall fluid accumulation.
Effervescent tablet: These emit bubbles when put into water,
and rapidly dissolve usually leaving a froth.
Electrolytes: These are fluids containing sodium and potassium
salts designed to maintain or replenish proper balance of a
patient’s electrolyte levels. They are commonly used after
dehydration of along with diuretics.
Elimination: Another word for excretion, which is when the
body removes non-usable waste. In pharmacokinetics, this is
the last step.
Pharmacy Practice216
Extemporaneous compounding: Following a set/written
recipe to compound prescription drugs.
Fahrenheit: Standard temperature measurement scale in the
US—water freezes at 32 and boils at 220.
Flow rate: In IV math, it is the amount of drops that are needed
per minute (gtt/min).
Formulary: A predetermined list of drugs that is considered
preferred and acceptable by a therapeutic committee for
managed care systems. A formulary is carefully chosen in order
to offer a wide enough range to accommodate medical
therapies, but not wasteful.
Gastrointestinal: Anything relating to the stomach and large
intestines.
Generic drug: A medication not protected by patent, distri-
buted and marketed under it is pharmaceutical/chemical name,
usually by multiple manufacturers at a lower end-user cost.
Gram: Unit of dry measure. 15.43 grains make up 1 gm.
A gram is also 1/1000 of a kilogram.
Inert ingredients: Filler/non-drug ingredients in medication
which are inactive.
Infusion rate: Fluid volume of an IV necessary to deliver
enough drug within the time frame the prescriber sets.
Intracardiac: It refers to an injection administered directly into
the patient’s heart.
Intradermal: An injection into the top layer of skin, done at an
angle.
Inventory: A comprehensive list of the assets/items currently
and physically in stock.
Isotonic: It refers to a solution with the same tonicity (saline)
as human blood.
Narcotics: Drugs that induce various stages of narcosis to dull
the senses, typically used to treat pain.
Net profit: A measure of profitability after all business related
expenses have been accounted for.
NS (normal saline): Isotonic solution of 0.9% concentration of
sodium chloride in sterile water.
Glossary 217
Ophthalmic: It refers to the eye. For treatment of, around or in
the patient’s eye.
Opiate: Drugs that are derived from opium, typically used for
pain management.
Orange book: Published by the FDA, the “Approved drug
products with therapeutic equivalence evaluations” is available
as a resource to help healthcare professionals in choosing drugs
for generic substitution.
OTC drugs: Medications sold “Over-the-counter”, which can
be obtained without prescription.
Otic: It refers to the ear. For treatment of, around or in the
patient’s ear.
Parenteral: It refers to drug administration that is delivered
directly, and not through the intestinal tract. Mainly used to
classify injection routes of administration.
Pharmacokinetics: What the body does with a drug from when
it is administered to the time, it is eliminated.
Pharmacology: A vague term which refers to the science and
study of drugs, including the chemistry and biological effects.
pH Level: A measure of the alkalinity or acidity of a solution.
The pH scale ranges from 0 to 14 and 7 is neutral.
Placebo: Commonly referred to as a ‘sugar pill’. A placebo
contains no medicine. However, the patient supposes it does,
and results may occur because of this belief. Placebos are mostly
used in clinical trials to experiment with groups of people in
double-blind studies.
Psychotropic: It refers to drugs that have a psychological effect
and result in altering a patient’s mind, mood or behavior.
Route of administration: The prescribed path a drug is to be
taken into the body.
Rx: An internationally recognized symbol or abbreviation for
“Prescription”.
Sedative: It refers to drugs that work on the central nervous
system to help calm anxiety, stress, etc.
Sig code: Medical abbreviations and acronyms used in
healthcare to communicate directions.