Chapter 2: Drug Classes and Schedules

What are the mechanism of action for the following Antihypertensive drugs: 1. Diuretic 2. Calcium channel blocker 3. Angiotensin-converting enzyme inhibitor 4. Adrenergic antagonist 5. Vasodilator

1. Lowers plasma volume 2. Blocks heart calcium channels, decreasing cardiac contractility 3. Blocks hormonal activity 4. Blocks physiological reactions to stress 5. Dilates peripheral blood vessels

Anticoagulant

Influence blood clotting

trade name (page 13)

Is assigned by the company marketing the drug. The name is usually selected to be short and easy to remember. The trade name is sometimes called the proprietary or product or brand name. The term proprietary suggests ownership. In the United States, a drug developer is given exclusive rights to name and market a drug for 17 years after a New Drug Application is submitted to the FDA. Because it takes several years for a drug to be approved, the amount of time spent in approval is usually subtracted from the 17 years.

pharmacoeconomics (page 14)

It deals with decision making relative to proper drug choices. Decisions are often based on costs (resources) and the outcomes considered, not only for the patient and family but also for the provider or drug manufacturer. When making therapy- or production-related decisions, the following basic outcomes are generally considered: (1) benefit in dollars, (2) effectiveness in health improvement (e.g., variable of improved circulatory benefit or pain treatment benefit), (3) minimization in terms of the same benefit provided to other patients in a similar group, and (4) improved utility (both quantitative and qualitative benefit).

what is the therapeutic classification of an Antihyperlipidemic

Lower blood cholesterol

what is the therapeutic classification of an Antihypertensive

Lower blood pressure

therapeutic classification (page 12)

One useful method of organizing drugs is based on their therapeutic usefulness in treating particular diseases.

What is a prototype drug, and how does it differ from other drugs in the same class?

Prototype drugs exhibit typical or essential features of the drugs within a specific class. By learning the characteristics of the prototype drug, students may better anticipate the actions and adverse effects of other drugs in the same class.

what is the therapeutic classification of an Antidysrhythmic

Restore normal cardiac rhythm

Why are certain drugs placed in schedules? What does the nurse need to know when a scheduled drug is ordered?

Schedules refer to the potential for abuse. These schedules help the nurse identify the potential for abuse and require the nurse to maintain complete records for all quantities. The higher the abuse potential, the more restrictions are placed on the prescriber and the filling of refills. When educating the patient about a prescription, the nurse should also include this information on any prescription or refills as part of the education.

A pharmacist decides to switch from a trade-name drug that was ordered by the health care provider to a generic-equivalent drug. What advantages does this substitution have for the patient? What disadvantages might be caused by the switch?

The advantages of a generic drug include cost savings to the patient and the fact that the name will remain the same, regardless of which company makes the drug. However, because generic drug formularies may be different, the inert ingredients may be somewhat different and, consequently, may affect the ability of the drug to reach the target cells and produce an effect.

What is the difference between therapeutic and pharmacologic classifications? Identify the following classifications as therapeutic or pharmacologic: beta-adrenergic blocker, oral contraceptive, laxative, folic acid antagonist, and antianginal agent.

The therapeutic classification is a method of organizing drugs based on their therapeutic usefulness in treating particular diseases. The pharmacologic classification refers to how an agent works at the molecular, tissue, and body system levels. A beta-adrenergic blocker is a pharmacologic class; an oral contraceptive is a therapeutic class; laxative is a therapeutic class; folic acid antagonist is a pharmacologic class; antianginal is a therapeutic class.

A nurse is preparing to give a patient a medication and notes that a drug to be given is marked as a Schedule III drug. What does this information tell the nurse about this medication?

This Schedule III drug is a controlled substance restricted by the Controlled Substance Act of 1970 and regulated by the DEA. A Schedule III drug has a moderate potential for abuse and physical dependency and a high potential for psychological dependence.

what is the therapeutic classification of an Antianginal

Treat angina

dependence (page 15)

a physiological or psychological need for a substance. Physical dependence refers to an altered physical condition caused by the adaptation of the nervous system to repeated drug use. In this case, when the drug is no longer available, the individual expresses physical signs of discomfort known as withdrawal.

The Controlled Substances Act

also called the Comprehensive Drug Abuse Prevention andControl Act. Hospitals and pharmacies must register with the Drug Enforcement Administration (DEA) and then use their assigned registration numbers to purchase scheduled drugs. Hospitals and pharmacies must maintain complete records of all quantities purchased and sold. Health care provider, nurse practitioners, and others with prescriptive authority must also register with the DEA and receive an assigned number before prescribing these drugs. Drugs with higher abuse potential have more restrictions

scheduled drugs (page 15)

are classified according to their potential for abuse: Schedule I drugs have the highest potential for abuse, and Schedule V drugs have the lowest potential for abuse. Schedule I drugs are restricted for use in situations of medical necessity, if at all allowed. They have little or no therapeutic value or are intended for research purposes only. Drugs in the other four schedules may be dispensed only in cases in which therapeutic value has been determined. Schedule V is the only category in which some drugs may be dispensed without a prescription because the quantities of the controlled drug are so low that the possibility of causing dependence is extremely remote

combination (drug page 13)

contains more than one active generic ingredient.

mechanism of action (page 12)

how a drug produces its physiological effect in the body

controlled substance (page 15)

is a drug whose use is restricted by the Controlled Substances Act of 1970 and later revisions.

negative formulary list

is a list of trade-name drugs that pharmacists may not dispense as generic drugs. These drugs must be dispensed exactly as written on the prescription, using the trade-name drug the health care provider prescribed. In some cases, pharmacists must inform or notify patients of substitutions.

teratogen

is a substance that has the potential to cause a defect in an unborn child during pregnancy. A small number of drugs have been shown to be teratogenic, either in humans or in laboratory animals.

generic name (page 13)

is assigned by the U.S. Adopted Name Council. With few exceptions, generic names are less complicated and easier to remember than chemical names. Many organizations, including the Food and Drug Administration (FDA), the U.S. Pharmacopoeia, and the World Health Organization (WHO), routinely describe a medication by its generic name. There is only one generic name for each drug.The rule of thumb is that the active ingredients in a drug are described by their generic name. The generic name of a drug is usually lowercased, whereas the trade name is capitalized.

chemical name (page 13)

is assigned using standard nomenclature established by the International Union of Pure and Applied Chemistry (IUPAC). A drug has only one chemical name, which is sometimes helpful in predicting a substance's physical and chemical properties. Although chemical names convey a clear and concise meaning about the nature of a drug, they are often complicated and difficult to remember or pronounce.

bioavailability (page 14)

is the physiological ability of the drug to reach its target cells and produce its effect. Bioavailability may indeed be affected by inert ingredients and tablet compression. Anything that affects absorption of a drug, or its distribution to the target cells, can certainly affect drug action. Measuring how long a drug takes to exert its effect gives pharmacologists a crude measure of bioavailability.

prototype drug (page 12)

is the well-understood drug model with which other drugs in its representative class are compared. By learning the characteristics of the prototype drug, students may predict the actions and adverse effects of other drugs in the same class. For example, by knowing the effects of penicillin V, students can extend this knowledge to the other drugs in the penicillin class of antibiotics. The original drug prototype is not always the most widely used drug in its class.

teratogenic risk (page 16)

places drugs into categories A, B, C, D, and X. Category A is the safest group of drugs while Category X poses the most danger to the fetus. Birth defects are most probable in the first trimester; thus, nurses must be mindful of the risks of various drugs.

addiction

refers to the overwhelming feeling that drives someone to use a drug repeatedly.

pharmacologic classification (page 12)

refers to the way a drug works at the molecular, tissue, and body system levels. Both types of classification are widely used in categorizing the thousands of available drugs.

psychologically dependent

there are few signs of physical discomfort when the drug is withdrawn; however, the individual feels an intense compelling desire to continue drug use

withdrawal (page 15)

when the drug is no longer available, the individual expresses physical signs of discomfort