Nomenclature

Nomenclature

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

Drug Classifications

 Therapeutic Effect  Antihypertensive  Antiemetic  Antibiotic  Diuretic  Physiologic Action  B-adrenergic blocker  Ca channel blocker

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)

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

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

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

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

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

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

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)

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

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

Nomenclature / Drug Names (cont.) Trade Name Empirin Empirin #1 Generic Name Aspirin 325mg Aspirin 325 mg Empirin #2 Codeine Phosphate 7.5mg

Aspirin 325 mg Codeine Phosphate 15mg The larger the number, the greater the amount of the controlled substance contained therein.

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)

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

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

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

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

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

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

Terms

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

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

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

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

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

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

Sources of Drugs

 Any chemical substance taken into body for the purpose of affecting body function is referred to as a drug

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)

Sources of Drugs  Plants Example Chinchona Bark Trade Name Quinidine Purple Foxglove Poppy Plant (Opium) Digitalis Paregoric, Morphine, Codeine Classification Antiarrhythmic Cardiotonic Antidiarrheal, Analgesic, Analgesic, Antitussive

Sources of Drugs  Minerals Example Magnesium Trade Name Milk of Magnesia Classification Antacid, Laxative Zinc Gold Zinc Oxide Oint.

Sunscreen, Skin Protectant Solganal, Auranofin Anti-inflammatory; Used in tx of Rheumatoid Arthritis

Sources of Drugs  Animals Example Pancreas of Cow, Hog Trade Name Insulin; regular, NPH, PZI Stomach of Cow, Hog Pepsin Thyroid Gland Of Animals Thyroid, USP Classification Antidiabetic Hormone Digestive Hormone Hormone

Sources of Drugs  Synthetic Example Meperidine Trade Name Demerol Diphenoxylate Co-Trimoxazole Lomotil Bactrim, Septra Classification Analgesic Antidiarrheal Anti-Infective Sulfonamide; Used in the treatment of UTI’s

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)

Drug Actions

 Depressing  Stimulating  Destroying  Replacing Substances

Questions???