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Chapter 2

Drug Classes, Schedules, and Categories

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Objectives

Refer to page 14

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Therapeutic and Pharmacological Classification Therapeutic Organized on the basis of their therapeutic

usefulness Example: Therapeutic Focus Cardiac care/ Drugs affecting

cardiovascular function

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Therapeutic Classification

Use Classification Influence blood clotting anticoagulants Lower cholesterol antihyperlipidemics Lower blood pressure antihypertensives Treat abnormal rhythm antidysrhythmics Treat chest pain antianginal drugs

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Pharmacological Classification

Pharmacological Organized on the basis of how they work

pharmacologically (mechanism of action) More specific Prototype drug is the original drug model,

from which other medications are formulated; similar actions, adverse effects

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Pharmacological Classification

Focus: applied therapy – therapy for high blood pressure may be achieved by:

Mechanism of action - Classification Lower plasma volume - diuretics Block heart calcium channels- calcium

channel blockers

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Pharmacological Classification

Mechanism of action - Classification

Block hormone activity- angiotensin

converting enzyme inhibitors

Block stress related activity- sympatholytics

Dilate peripheral blood vessels- vasodilators

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Drug Names

Chemical: name is derived from strict nomenclature established by International Union of Pure and Applied Chemistry (IUPAC)

A drug has only one chemical name

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Drug Names

Name conveys a clear and concise meaning about the nature of the drug

Name is most always complicated, difficult to pronounce and remember

Chemical and physical properties as well as bioavailability and action can be predicted

Classified by chemical group name

Example: phenothiazines-antipsychotics

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Drug Names

Generic

Nonproprietary name of a drug assigned by the government

United States Adopted Name Council

Preferred and less complicated

FDA, USP, WHO routinely prescribe using generic names

Examples: Aspirin, Ibuprofen

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Drug Names

Trade or proprietary name

Assigned by the company marketing the drug

By using a slogan name

Company rights to the name is for 17 years, of which 7 are spent in the approval process

Competing companies can produce a generic equivalent with FDA approval

Examples: Anacin, Ecotrin

Advil, Motrin

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Drug Names

Combination drugs- drugs with more than one generic active ingredient

Rule of thumb that active ingredient in a medication is described by their generic name

How are they identified?

Generic – written lower case

Trade name – capitalized

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Expense Versus Bioavailability

Generic are less expensive than brand names

Substitution is made by the physician or by the pharmacist with approval

Drug formulations are not always identical

Inert ingredients – alter how quickly the drugs reach the target tissues, preparation may be different, thus affecting bioavailability

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Abuse Potential

Terms: Addiction: overwhelming feeling that drives

someone to use a drug repeatedly Dependency: physiological or

psychological need for a substance

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Abuse Potential

Physical dependency: an altered physical condition caused by CNS adaptation to repeated drug use

Withdrawal: physical signs of discomfort when the drug is no longer available

Psychological dependency: little or no physical discomfort, the individual feels a need to continue the drug

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Schedules

Five categories: delineates drugs that have a potential for abuse and restricted for medical necessity

Classified by their potential for abuse Schedule I - the highest potential (heroin,

LSD, marijauna, methaqualone) Schedule II – high (morphine, cocaine,

PCP, methadone, methamphetamine)

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Schedules

Schedule III – moderate (anabolic steroids, barbiturates, codeine)

Schedule IV – lower (Darvon, Valium, Xanax, Talwin)

Schedule V - the least potential (OTC cough meds with codeine

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Controlled Substances

Drugs restricted by the Controlled Substances Act 1970

Comprehensive Drug Abuse Prevention and Control Act

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Canadian Drugs

Canadian Food and Drugs Act outlines controlled substances

Schedule G controlled drugs Schedule H restricted drugs Schedule F require a prescription

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Pregnancy Categories

A : lowest risk – studies have not shown a risk to women or fetus (Synthroid)

B : animal studies have not shown risk to fetus or in women if they have they have not been confirmed (Amoxil, Insulin, Prozac)

C : animal studies show risk to fetus, controlled studies have not been done in women ( Zovirax, Lasix)

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Pregnancy Categories

D : may cause harm to fetus, but may benefit the mother in life-threatening situation, another safe treatment is not available (tetracycline, Elavil)

X : significant risk to fetus and the women

( Ortho-Novum, castor oil)

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End