1. PHARMACY TECHNICIAN
CHAPTER EIGHTEEN

2. Drug Nomenclature Three different classes of drug nomenclature:
Chemical name—represents the chemical structure of the compound
Generic name—convenient short name used by the public to identify the drug’s active ingredient
Trade or brand name—registered or trademarked to identify a specific producer or manufacturer, and cannot be used by other manufacturers
All drug products have chemical and generic names, but not all drugs have trade names

4. Medication Error
“Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer”
The key elements of this definition are:
The error is preventable
The error may cause harm to the patient
The error occurs while the medication is in the control of the healthcare professional
Defined by The National Coordinating Council for Medication Error Reporting and Prevention

5. Five Rights of Medication Administration
Right Patient—the drug must always go to the correct patient
Right Drug—the right drug must always be chosen
Right Route—the drug must be given via the correct route of administration
Right Dose—the patient must receive the right dose
Right Time—the patient must receive the medication within the prescribed time frame

6. Dosage Formulations
The two primary dosage preparations are liquid and solid
Liquid preparations: syrups, solutions, emulsions, and suspensions
Solid preparations: tablets, capsules, lozenges, ointments (semisolid), and creams (semisolid)
A single medication may be available in multiple dosage forms to accommodate various disease states, age ranges, and desired results

7. Advantages of Solid Dosage Forms
Solid medications have several advantages compared with other forms of medication, including:
Ease of self-administration
Longer shelf life
Ease in packaging, distributing, shipping, and storing
More accurate dosing (because the medication is already in a distinctive unit/measure)
Little or no taste
Release of medication over a longer period of time

8. Disadvantages of Solid Dosage Forms
Solid medications also have certain critical disadvantages, including:
Difficult for some patients to swallow large tablets or capsules
Not an appropriate choice for patients who are unconscious or have nasal/mouth breathing tubes for ventilation
Take longer to be absorbed, broken down, and distributed in the body

9. Advantages of Liquid Dosage Forms
Liquids have several advantages over other dosage forms, including:
Better tolerated by patients who have difficulty swallowing
Faster absorption than solid dosage forms
More flexibility in achieving the proper dosage of the medication

10. Disadvantages of Liquid Dosage Forms
Liquids also have several disadvantages compared to other dosage forms, including:
Shorter life before expiration than other dosage forms
Bad taste
More difficult to administer (liquids can be spilled, thick liquids can be hard to pour)
Harder for patients to measure correctly
May have special storage requirements

11. Solutions, Emulsions, and Suspensions
All liquid dosage forms
Solutions—medication is completely dissolved and evenly distributed in a homogenous mixture
Emulsions—medication is an emollient base comprised of water and oil
Water-in-oil bases—heavy, greasy, emollient, occlusive
Oil-in-water bases—water-washable, nongreasy, nonocclusive
Suspensions—very fine solid particles mixed with a gas, liquid, or solid preparation

12. Ointments and Creams Both are semisolid dosage forms
Ointments—applied externally to the skin or mucous membranes; used to deliver medication to the skin, lubricate the skin, or protect the skin; may or may not contain a medication
Creams—lighter than ointments and can be applied to the skin more easily; soothe, cool, dry, and protect the skin; may or may not contain medication

13. Various routes of administration.

14. Routes of Administration, Part I
Oral—medication is taken by mouth (example: swallowing a caplet or syrup)
Transdermal—a patch is applied to the skin, where it delivers medication to the bloodstream (example: a nicotine patch is applied to the skin)
Inhalation—medication is inhaled through the mouth and absorbed in the lungs (example: using an asthma inhaler)
Nasal—medication is inhaled through the nose and absorbed into the bloodstream, or medication is sprayed into the nose for local effects (example: using a nasal spray for sinus allergy)

15. Routes of Administration, Part II
Parenteral—medication is injected directly into the body, bypassing the gastrointestinal system for absorption and distribution (examples: injecting liquid medications directly into the skin, veins, or muscles)
Topical—medication is administered externally to the skin or mucous membranes (example: rubbing an anesthetic gel onto an aching tooth)
Rectal—medication is administered through the rectum (example: a suppository is inserted into the rectum)

16. Routes of Administration, Part III
Vaginal—medication is administered through the vagina (example: a douche is applied to the vagina)
Ophthalmic—medication is administered through the eye (example: eyedrops are applied for irritation or inflammation of the conjunctiva)
Otic—medication is administered in the ear (example: eardrops are delivered into the ear canal to treat an infection)

17. Common Medications for Various Routes of Administration, Part I
Oral—capsules, tablets, caplets, liquids, emulsions
Transdermal—nitroglycerin ointment, transdermal patches for hormone therapy (Climara®, Estraderm®), narcotic analgesics (Duragesic®), birth control (Ortho Evra®), cardiac (nitroglycerin, Catapres®), motion sickness (Transderm-scōp®), medications used to quit smoking (Nicoderm®)
Inhalation—albuterol (Proventil® /Ventolin®), Advair Diskus®, over-the-counter Primatene Mist®

18. Common Medications for Various Routes of Administration, Part II
Nasal—Flonase®, Rhinocort®, Stadol®
Parenteral—injectable liquids, such as Enbrel®, implants such as Norplant®
Topical—ointments, creams, lotions, emulsions; used to treat simple external skin rashes or slightly deeper-layer skin infections
Rectal—suppositories, enemas, aerosol foams, such as Phenergan® suppositories, Fleet® enemas, Proctofoam®

19. Common Medications for Various Routes of Administration, Part III
Vaginal—solutions, suppositories, tablets, topical creams or ointments, such as Terazol®, Mycostatin® tablets, AVC® vaginal suppositories, Massengill® douches
Ophthalmic—solutions, ointments, suspensions, gels, such as Visine®, Xalatan®, antibiotic drops
Otic—solutions, suspensions

20. Advantages of Oral Route
Safer
More convenient
Easier to store
May be more readily available in pharmacies
Generally less expensive
May be available in immediate-release or extended-release dosage forms
Easier to self-administer
Generally do not require additional administration supplies

21. Disadvantages of Oral Route
May not be appropriate for children or elderly patients
May be difficult for patients to swallow
Have to be broken down, absorbed, and then distributed to the body

22. Advantages/Disadvantages of Transdermal Route
Easy to store
Convenient to use
Can remain on the body for a long time
More convenient than taking a tablet on a daily basis
Disadvantages:
May cause skin irritation
May pull on body hair

23. Advantages of Inhalation and Nasal Routes
Inhalation—provides immediate relief for lung conditions
Nasal—provides immediate relief of conditions such as nasal allergies and congestion; medication reaches the bloodstream more quickly than through the traditional oral route of administration

24. Advantages of Parenteral Route
Fast absorption and distribution
Convenient for those who cannot take oral medication
Varied rate of delivery, from a couple of seconds to several hours

25. Disadvantages of Parenteral Route
Action can be immediate
No way to reverse the amount of drug administered
Little or no way to reverse any adverse effects
Very invasive
Can be very painful
Pose an opportunity for bacteria and infection to enter the body

26. Advantages of Other Routes, Part I
Ophthalmic:
Provides quicker relief than the systemic approach
Generally very easy to self-administer
Usually very convenient and easy to store
Rectal:
Used for local or systemic effects
Often used for children when an oral medication is not appropriate
Used when patient cannot tolerate swallowing a medication

27. Advantages of Other Routes, Part II
Otic—medications are directly absorbed to provide immediate relief
Topical—used for local conditions, does not enter bloodstream
Vaginal—may treat local or systemic conditions

28. Parenteral Routes of Administration, Part I
Intradermal—injected into the top layers of the skin
Subcutaneous—injected into the tissue immediately under the skin
Intramuscular—injected directly into muscle
Intravenous—injected directly into the vein

29. Parenteral Routes of Administration, Part II
Implant—temporary or permanent medical device inserted into the body that slowly releases medication
Intra-articular—injected directly within the joints
Intracardiac—injected directly into the heart
Intraperitoneal—injected directly into the abdominal or peritoneal cavity
Intrapleural—injected into the sac (pleura) surrounding the lungs

30. Parenteral Routes of Administration, Part III
Intrathecal—injected within the cerebrospinal fluid surrounding the spinal cord
Intraventricular—injected into the brain cavities, or ventricles (e.g., antibiotics or chemotherapy agents)
Intravesicular—injected directly into the urinary bladder
Intravitreal—injected directly into the vitreous body of the eye

31. Transdermal and Topical Routes
Transdermal—medication is applied to the skin and is absorbed into the bloodstream for systemic distribution
Topical—medication is applied to skin, but effect is local instead of systemic

32. Sublingual and Buccal Routes
Both oral medications are used for medications that are destroyed by stomach acid or poorly absorbed through the GI tract
Sublingual tablets dissolve and are absorbed when placed under the tongue; medication is absorbed through the lining of the mouth into the bloodstream
Buccal tablets dissolve in the buccal pouch of the mouth, located between the gums and the cheek; absorbed through lining of cheek