1. Nomenclature

2. Drugs are categorized under broad subcategories called classifications Drugs with several types of therapeutic effects fit under several classifications (Aspirin)

3. Drug Classifications Therapeutic Effect  Antihypertensive  Antiemetic  Antibiotic  Diuretic Physiologic Action  B-adrenergic blocker  Ca channel blocker

4. Classifications (cont.) The same drug may belong to more than one classification  Propranalol: B-blocker (physiologic action), antianginal, antiarrhythmic, antihypertensive  Perphenazine: antiemetic =controls N/V, antipsychotic = anticholinergic side effects (dry mouth, constipation, urinary retention, blurred vision, tachycardia, sedation)

5. Nomenclature/Classifications (cont.) Prototype Drug = representative of many drugs within the class  Diazepam: Benzodiazepine, sedative/hypnotic, antianxiety  Similarities: pharmacokinetics, pharmacodynamics, effects, side effects, adverse reactions, contraindications, drug/food interaction

6. Nomenclature / Drug Names Generic  Name given to drug before it becomes official  Given by the United States Adopted Names Council  Typically derived from chemical name  Usually shorter

7. Nomenclature / Drug Names (cont.) Trade/Brand  Name that is registered by the manufacturer  Followed by the trademark symbol ®  Can only be used by the manufacturer  May have several trade names (depending on number of manufacturers)  The first letter of the name is capitalized

8. Nomenclature / Drug Names (cont.) Chemical  Gives exact chemical composition of the drug  Places atoms or molecular structure

9. Nomenclature / Drug Names (cont.) Official  Name listed in the United States Pharmacopoeia-National Formulary  May be the same as the generic name Acetaminophen/N-acetyl-p- aminophenol/Tylenol, Datil

10. Nomenclature / Drug Names (cont.) When a new drug is produced it is given a generic name It must be tested and approved by the FDA Listed in the USP/NF by an official name Producing company has an exclusive right for 17 years and other companies can produce the same drug, but will assign own trade name

11. Nomenclature / Drug Names (cont.) Patient Education  Generic and trade name drugs have same basic ingredients by law Trade name drug is more expensive  Advertising  Pharmacy dispension  Though basic ingredients are same, the “fillers” may be different (fillers may effect speed drug is dissolved or takes effect, some dyes may cause allergic reaction)

12. Nomenclature / Drug Names (cont.) Combination drugs  Have several generic names, but only one trade name  Darvocet-N-100 = Acetaminophen 650mg, Propoxypene napsylate, 100mg

13. Nomenclature / Drug Names (cont.) Trade names with numbers  The number refers to the amount of one of the generic components  A differentiating factor  Number represents the amount of the controlled substance

14. Nomenclature / Drug Names (cont.) Trade NameGeneric Name Empirin Aspirin 325mg Empirin #1Aspirin 325 mg Codeine Phosphate 7.5mg Empirin #2Aspirin 325 mg Codeine Phosphate 15mg The larger the number, the greater the amount of the controlled substance contained therein.

15. Nomenclature / Drug Names (cont.) Potential med errors  Trade name misinterpreted for the # of tablets to give  Allergic reaction to one of the generic components (check for aspirin allergy)  Giving 2 #3’s instead of one #4 (doubles the dose of aspirin from 325mg to 650mg)

16. Drug References PDR = Physician’s Desk Reference  Distributed to practicing physicians  All drugs cross referenced White “manufacturer’s index” (company that makes drug) Pink “product index” (trade and generic name) Blue “product category index” (drug classification) Green (description of substances used for medical testing) Photographs of many drugs List of all US Poison Control Centers

17. Drug References (cont.) PDR (cont.)  Geared for physicians  Lengthy descriptions  Difficult to identify what is most important to remember  No easily identifiable nursing implications

18. Drug References (cont.) USP/DI = US Pharmacopaeia/Dispensing Information  Must be purchased  Practical guidelines for the patient (everyday language)  Tips for proper use of medication and what precautions to take

19. Drug References (cont.) AHFS = American Health-System Formulary Service  Good, concise information  Arranged by classification with a description of each classification at the beginning of each section

20. Drug References (cont.) Compendium of Drug Therapy  Distributed to physicians  2 hardback volumes  Easy to read  Photographs of drugs  Phone # of major pharmaceutical companies  Poison control centers listed

21. Drug References (cont.) Davis’s Drug Guide  Best resource for nursing Includes nursing implications  Assessment  Potential nursing diagnoses  Implementation  Patient/family teaching  Evaluation  Well organized

22. Terms Indication  Medical condition for which the drug is meant to be used  Benadryl = allergic skin reaction, mild Parkinsonian symptoms, nasal allergies

23. Terms (cont.) Action  Cellular changes that occur as a result of the drug  Know which body system is affected  Benadryl competes with histamine for cell receptor sites on effector cell

24. Terms (cont.) Contraindication  Condition for which the drug should not be given  Pregnancy, lactation

25. Terms (cont.) Warning & Precaution  Conditions or types of patients that warrant closer observation for specific side effects when given drug  Hx of bronchial asthma, HTN

26. Terms (cont.) Side Effects & Adverse Reaction  List of possible unpleasant or dangerous secondary effects other than the desired effects  Benadryl causes sedation, dizziness, thickening of bronchial secretion  Ototoxicity – aspirin  Nephrotoxicity – gentamycin  Photosensitivity – antipsychotic/Haloperidol

27. Terms (cont.) Interaction  Other foods or drugs that may alter the effect of the drug  MAO inhibitors have major interaction, some causing BP changes and even death

28. Sources of Drugs Any chemical substance taken into body for the purpose of affecting body function is referred to as a drug

29. Sources of Drugs (cont.) Plants = primary source of substances used in human body  Berries, bark, leaves, resin from trees, roots Minerals = from the earth & soil  Iron, sulfur, potassium, silver & even gold Animals = substances from the glands, organs & tissues of animals  Pork insulin Synthetic = man made (test tube drugs)

30. Sources of Drugs Plants ExampleTrade NameClassification Chinchona BarkQuinidineAntiarrhythmic Purple FoxgloveDigitalisCardiotonic Poppy PlantParegoric,Antidiarrheal, (Opium)Morphine,Analgesic, CodeineAnalgesic, Antitussive

31. Sources of Drugs Minerals ExampleTrade NameClassification MagnesiumMilk of MagnesiaAntacid, Laxative ZincZinc Oxide Oint.Sunscreen, Skin Protectant GoldSolganal, AuranofinAnti-inflammatory; Used in tx of Rheumatoid Arthritis

32. Animals ExampleTrade NameClassification Pancreas of Cow,Insulin; regular,Antidiabetic HogNPH, PZIHormone Stomach of Cow,PepsinDigestive Hog Hormone Thyroid GlandThyroid, USPHormone Of Animals Sources of Drugs

33. Synthetic ExampleTrade NameClassification MeperidineDemerolAnalgesic DiphenoxylateLomotilAntidiarrheal Co-TrimoxazoleBactrim, SeptraAnti-Infective Sulfonamide; Used in the treatment of UTI’s

34. Effects of Drugs Systemic  Effect is made throughout body (Tylenol) Local  Affects are limited to the area of the body where it is administered (Preparation H for hemorrhoidal pain)

35. Drug Actions Depressing Stimulating Destroying Replacing Substances

36. Questions???