Diseases and Drugs I

Schedule I Drug

Drugs that have no accepted medical use, have lack of accepted safety, and have high abuse potentials: heroin, lysergic acid diethylamide (LSD), 3,4-methylenedioxy-methamphetamine (MDMA or ecstasy), mescaline, and peyote.

Schedule II Drug

Drugs that are used medically and have high abuse potentials: opioid analgesics (e.g., codeine, hydromorphone, methadone, meperidine, morphine, oxycodone), central nervous system (CNS) stimulants (e.g., cocaine, methamphetamine), and barbiturate sedative–hypnotics (e.g., pentobarbital).

Schedule III Drugs

Drugs with less potential for abuse than those in Schedules I and II, but abuse of which may lead to psychological or physical dependence: androgens and anabolic steroids, some depressants (e.g., ketamine, pentobarbital), some CNS stimulants (e.g., methylphenidate), and mixtures containing small amounts of controlled substances (e.g., codeine, barbiturates not listed in other schedules). These drugs and substances have an accepted medical use in the United States.

Schedule IV Drugs

Drugs with an accepted medical use in the United States but with some potential for abuse: benzodiazepines (e.g., diazepam, lorazepam), other sedative–hypnotics (e.g., phenobarbital, chloral hydrate), and some prescription appetite suppressants (e.g., phentermine).

Schedule V Drugs

Products containing moderate amounts of controlled substances. They may be dispensed by the pharmacist without a physician’s prescription but with some restrictions regarding amount, record keeping, and other safeguards. Included are cough suppressants containing small amounts of codeine and antidiarrheal drugs, such as diphenoxylate and atropine (Lomotil).

error reduction practices

• Having a “quiet zone” to prepare medications

• Placing “quiet zone” signs at the entrance to the medication room or above the automated medication-dispensing system

• Following protocols and checklists outlining medication administration

• Wearing a sash or vest to signal others to avoid interrupting the nurse during medication administration

• Educating staff to reduce interruptions of nurses administering medications

• Having a drug guide available during drug administration

• Verifying two patient identifiers to prevent instances of misidentification and near-miss error. The Joint Commission requires that two identifiers—such as a patient’s full name, date of birth, and/or medical identification (ID) number—be used for every patient encounter.

Drug Enforcement Agency

agency that is responsible for the enforcement of controlled substances

Controlled Substances act of 1970

regulates manufacturing, distribution and dispensing of controlled substances

example C-II Drug

morphine

absorption

• how a medication gets from the site of administration to the bloodstream

• Ex: IV straight to bloodstream is fast, oral must go through GI so is slower

distribution

• how a medication gets from the bloodstream to the site of action

• affected by permeability, plasma protein binding, circulation

metabolism

• inactivation of medication by enzymes

• occurs mainly in liver, gi tract, lungs and kidneys

• babies and eldery - impaired metabolism

excretion

• how we eliminate medications from the body

• kidneys, saliva, sweat, tears

rights of medication administration

• the right patient

• the right medication

• the right route

• the right dose

• the right time

therapeutic index

• the minimum effective concentration of a drug (amount of drug we need in body to be effective)

• High TI: large margin in between TI and toxicity like amoxicillin

• Low TI: Small margin, like vancomycin

half-life

amount of time it takes for a medication to be reduced by 50% in the body

ex:

The client is a 6-year-old who is taking 125 mg of amoxicillin every 6 hours. Assuming that the half-life of amoxicillin is 3 hours, approximately how much amoxicillin would be in the child's body at the time of the next administration of the drug?

a: 31 mg

salicylates: aspirin pharmacotherapeutics

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