Orientation to Medications Medical Math Chapter 1 Buffy Ryan, RN

Pharmacology Drugs are chemical substances used to dx, tx, cure, or prevent disease Therapeutic effect is the desired or predicted physiological response Side effects are desirable or undesirable effects apart from primary reason for giving drug

Drug Sources Plants Animals Minerals Chemicals (Synthetic Drugs)

Plants Wildflower / Purple Foxglove – Digitalis Poppy Plant – Morphine & Codeine Gum tree – Psyllium seed Oil – Castor Oil

Animals Extracting hormones from tissue & organs Insulin – taken from pancreas of cattle & pigs Heparin – intestinal lining of cattle & pigs

Minerals Derived from rocks & crystals Iron, Iodine, Calcium, Sodium Chloride, Magnesium (MOM, Epsom Salt)

Chemicals (Synthetic) Made in the lab Less Expensive (mass production) Sulfonamide drugs – Bactrim & Septra

Drug Uses Prevention or Prophylactic (vaccines) Treatment (aspirin, antihistamines) Diagnosis (radiopaque dye) Cure (antibiotics) Contraceptive (prevent pregnancy) Health Maintenance (vitamins) Palliative (improve quality of life)

Drug Uses Can have more than one use EX: Phenergan (Promethazine hydrochloride) Control allergic reactions, treat motion sickness, prevent vomiting

Drug Standards Required by law All drugs called by the same name must be of uniform strength, quality, and purity. Enforced by FDA

Drug Names 1. Chemical Name: comes from the chemical compound of the drug 2. Generic Name: assigned by drug manufacturer 3. Official Name: usually same as generic; used in publication 4. Trade Name: name used for marketing

Drug Names Chemical (Acetylsalicylic acid) Generic (aspirin) Official name (same as generic) Brand name (Bufferin)

Do you know these drugs? Brompheniramine Dimetapp!!!! Acetaminophen Tylenol!!!! Minoxidil Rogaine!!! Ranitidine Hydrochloride Zantac!!!!

Drug References PDR – Physicians Desk Reference USPDI – United States Pharmacopeia Dispensing Information Nursing drug references Tylenol

Drug References References are written in medical language Information constantly changing Package inserts

Drug Cards Quick reference Online resources

Drug Legislation 1 st Law – Pure Food and Drug Act – 1906 Food, Drug, & Cosmetic Act 1938 Orphan Drug Act of 1983 Controlled Substances Act 1990 Nutrition Facts of 2003 Patriot Improvement & Reauthorization Act 2005

Controlled Substance A drug or chemical whose manufacture, possession, or use is regulated by a government, such as illicitly used drugs or prescription medications that are designated a controlled Drug

Schedule I Drugs No accepted medical use Heroin (diacetylmorphine) LSD (Lysergic acid diethylamide) Marijuana (cannabis, THC) Mescaline (Peyote) a hallucinogenic and intoxicating compound present in mescal buttons from the peyote cactus

Schedule I Drugs MDMA (3,4 methylenedioxymeth- amphetamine or “ecstasy”) GHB (gamma-hydroxybutyric acid)date rape drug Psilocybin

Schedule II Drugs High Potential for abuse No refills without new written prescription Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin) Cocaine Methamphetamine

Schedule II Drugs Methadone Hydromorphone (Dilaudid) Meperidine (Demerol) Oxycodone (OxyContin) Fentanyl Dexedrine Adderall and Ritalin

Schedule III Moderate potential for abuse Can be refilled 5 times in 6 months if ordered Thiamyl (Surital®) Thiopental (Pentothal®). Vicodin (??), Tylenol with codeine Anabolic steroids Testosterone

Schedule IV Lower potential for abuse – limited psychological and physical dependence Valium, Ativan, Xanax, Ambien

Schedule V Low potential for abuse OTC narcotics, buyer must be 18 Cough syrups with codeine, lomotil

Prescribing Scheduled Drugs MD must have DEA number If they keep meds in office, must have special order forms and written records Drugs can change under each schedule (be aware)

Prescriptions Never leave prescription blanks unattended Most offices will make a copy of any controlled substance prescription for chart If a refill request is called to office, make sure to have the pt. chart or access ready for MD to review You cannot call in Schedule II or III drugs

The 7 “RIGHTS” of Medication Administration 1. Right drug 2. Right dose 3. Right time 4. Right patient 5. Right route 6. Right technique 7. Right documentation