Chemical name

Generic name

Official name

Trade or brand name

(Best to use generic name to avoid confusion)

Motrin IB

Advil

Therapeutic & Pharmacologic

Classified by chemical type,active ingredient, what they are used for (purpose)

Can be in one or more classes

Examples:antiinfectives,diuretics,laxatives,Anti-diabetic,Anti-neoplastic.

Prescription (legend drugs)

Nonprescription (over the counter(OTC))

Controlled substance-Carefully monitored b/c they can be abused & cause physical or psychological dependency.

High abuse potential

Lack of accepted safety, not approved for medical use in the U.S.

Examples: heroin, marijuana, ecstacy, peyote.

Potential for high abuse with severe physical or psychological dependence.

Approved for medical use in the U.S.

Examples: Opiods such as meperidine, mathadone, morphine, oxycodone, amphetamines and cocaine.

Less abuse potential than schedule II drugs.

Potential for moderate physical or psychological dependence.

Examples: Anabolic steroids, ketamine, hydrocodone/codeine compounded with a nonsteroidal anti-inflammatory drug.

Less abuse potential than schedule III drugs.

Limited dependence potential.

Examples: Some sedatives and anxiety agents, non-opioid analgesics, "diet drugs"

Limited abuse potential

Examples: Small amounts of opioid (codeine) used as antitussive or antidiarrheals, pregabalin (Lyrica)

Must be written in ink

Must include name and address of patient and DEA number of the healthcare provider. 

Can't be filled more than 6 months after written.

Cant be refilled more than 5 times.

8-12 hours

to account for every ampule, tablet, vial or other form of controlled drug.

Orphan Drug Act of 1983

Liquid and parenteral drugs: Already dissolved-quickly absorbed.

Solid forms of drugs: Tablets or capsules-Disintegrate into small particles; dissolve into bodyfluids in GI tract.

Enteric-coated tablets don't disintegrate until they reach the alkaline environment of the small intestine.

Activities within the body after the drug has been administered.

Absorption-Half-life

Distibution-Onset, Peak, & Duration(important with insulin)

Metabolism

Excretion

Drug is absorbed by the small intestine; liver first metabolizes drug; amount of drug remaining may not be sufficient to produce therapeutic effect, as a result the patient needs higher dosage for desired effect.

Body changes drug to a more or less active form of excretion-called metabolites.

Elimination of drugs from the body.

Due to diminished kidney function in the older adult and immature kidney function in children.

Time required for the body to eliminate 50% of the drug.

Important when deciding dosage and frequency of the drug.

Drugs with short half-life(2-4 hours are administered frequently (aspirin for example)

Drugs with long half-life (21-24 hours) require less frequent dosing (Digoxin for ex. has a 36 hour half-life)

Alterations of chemical components of body fluids, such as changes in pH caused by antacids.

Genetically determined abnormal response to normal doses of a drug.

Inherited traits cause abnormal metabolism of drugs. 

A-Safest

B-

C-

D-

X-

Undesirable response to a drug. 

Can be common or infrequent.

Can be mild, severe or even life threatening.

Could occur after one dose or after several doses.

Some reactions are predictable, others are unpredictable.

Allergic Drug Reactions

(Hypersensitivity Reactions)

Usually begin after more than one dose of the drug is given but could occur with just one dose; body views drug as antigen (foreign substance).

Could occur immediately or hours or days later.

Signs and symptoms: Itching; skin rashes; hives; wheezing; cyanosis; sudden loss of consciousness; swelling of eyes, lips or tongue. 

Occurs shortly after administration of drug, can be fatal, treat with Epinephrine and other meds., IV fluids, antihistamines, bronchodilators. 

Collection of fluid in subcutaneous tissues causes severe swelling of eyelids, mouth, lips, throat, can cause airway to close.

Unusual, abnormal reaction to drug; different from expected reaction-drug has opposite effect on the patient (sleeping pill makes patient anxious and excited), or drug causes an "over-response"-pt. sleeps for 2 days.

Cause: Believed to be due to genetic deficiency.

Body gets used to a drug, patient has a decreased response to the drug: Requires increased dosage for desired effect.

Example: Narcotics or tranquilizers taken for a long time.

Drug accumulates in body, can happen in patients with liver and kidney disease: Body unable to metabolize and excrete one dose of the drug before next dose is given. 

Dose must be lowered to prevent toxic drug reaction.

Drug is administered in large dosages, blood concentration levels exceed therapeutic levels. 

Occurs because too much of drug is given or kidneys do not excrete properly.

Sometimes can be reversed-To reverse drug toxicity: Administer another drug as antidote; monitor drugs with low safety margin.