1 Chapter 2 Drug Classes, Schedules, and Categories

2 Objectives  Refer to page 14

3 Therapeutic and Pharmacological Classification  Therapeutic  Organized on the basis of their therapeutic usefulness  Example:  Therapeutic Focus  Cardiac care/ Drugs affecting cardiovascular function

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

5 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

6 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

7 Pharmacological Classification Mechanism of action - Classification Block hormone activity- angiotensin converting enzyme inhibitors Block stress related activity- sympatholytics Dilate peripheral blood vessels- vasodilators

8 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

9 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

10 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

11 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

12 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

13 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

14 Abuse Potential  Terms:  Addiction: overwhelming feeling that drives someone to use a drug repeatedly  Dependency: physiological or psychological need for a substance

15 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

16 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)

17 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

18 Controlled Substances  Drugs restricted by the Controlled Substances Act 1970  Comprehensive Drug Abuse Prevention and Control Act

19 Canadian Drugs  Canadian Food and Drugs Act outlines controlled substances  Schedule G controlled drugs  Schedule H restricted drugs  Schedule F require a prescription

20 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)

21 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)

22 End