Unit 1 (drug classes and controlled substances)

What does a MAR (Medication Administration Registration include)?

• Allergies

• Route of administration

• Drug name

• Time of administration

What is a pharmacological class?

Drugs mechanisms of action

Differentiate between desirable and undesirable actions

• Desirable: Therapeutic response (drugs goal)

• Undesirable: Adverse effect

What is a therapeutic class?

Based on how a drug is used clinically

Ex: Antihypertensive lowers BP

What is a pharmacologic class?

More specific than a therapeutic class

Ex: Targets are inhibitors

What is a prototype drug?

Usually FIRST in the class and later gets replaces by better drugs in the same class

What are chemcial drugs responsible for describing?

A drugs molecular structure

Ex: 7-chloro-1, 3-dihydro-1-methyl-5- phenyl-2H-1, 4-benzodiazepin-2-one

What does the generic name describe?

Provides common global language for medications and less expensive than the brand name.

Ex: diazepram (always lowercase)

What does the trade name describe?

The company that makes the drug creates this name. copyrighted

Ex: Valium (Uppercase)

What are some another names for trade name?

• Proprietary

• Patent

• Brand name

What are 4 differences between brand versus generic?

• Bioavailability

• States differ on how community pharmacies fills the Rx

• Negative formula list

• FDA orange book

Describe bioavailability.

• Active ingredient in medications may be the same, but fillers forming the rest of the drug are different.

• This can affect meds dissolving and absorption

How does SC handle filling Rx in community pharmacies?

• They sign the bottom two lines stating that a certain medication can be substituted if needed

What is a negative formula list?

• List of trade name drugs that CAN’T be automatically switched for generic drugs

What does the FDA orange book include?

• bio equivalent data

What does the FDA purple book contain?

Bio similar drugs

What does LASA drugs stand for?

Look Alike, Sound Alike drugs

What can help you differentiate LASA drugs?

• Tall man letters (hydOXYzine and hydrALAzine)

• Packaging (color coded)

• Black box warnings (harm has been noticed and special care should be noted)

• The Joint commission “Do Not Use” list

• Special instructions

Where do you find black box warnings?

In the medication leaflet

What are the nursing responsibilities when it comes to administering medication?

• Understand brand names/generic names

• Understand action of drug and why it may have been ordered

• Normal dose (most are 1-2 tabs)

• Contraindications (who should NOT get this drug?)

• Critical assessment (check pulse, BP, BS)

• Evaluation

Are controlled C-drug overseen by the DEA (drug enforcement administration)?

YES!!!

Describe Schedule I drugs (C-I)

• Healthcare providers CANNOT prescribe these

• Highest potential for abuse and addiction

• No therapeutic use

• High physical and psychological dependence (headache, tremors, pain relief depends on drug)

• Used for research

Examples of C-I drugs

• Heroin

• LSD

• peyote

• Psil

• Methaqualon

• Marajuana

Describe schedule II drugs (C-II)

• Stored in locked rooms, cabinets, and drawers AT ALL TIMES

• High potential for abuse

• High physical and psychological dependence (headache, tremors, pain relief depends on the drug)

• Written prescription, NO REFILLS (prescriber must be registered with DEA)

Example of schedule C-II drugs

• Oxycodone

• Morphine

• Cocaine (nose bleeds)

• Metaenphetamine

• Dilaudid

• Dexedrine

• Amytal

• Percodan

• Biphetamine

Describe schedule III drugs (C-III)

• Kept under double lock and key

• Moderate abuse with potential physical dependency

• High psychological dependence (feel like you need them) (mental desire/craving to reduce pain or stress)

• Limited refills permitted (5 refills within 6 months)

Examples of C-III durgs

• Codeine

• Antibiotic steroids

• Hydrocodone

• Ketamine

• Apetite suppresents (ozempic)

Describe schedule IV drugs (C-IV)

• low potential for abuse and dependence

• Less restrictive with phone orders

• Limited refills (up to 5 within 6 months)

Examples of C-IV drugs

• Ativan (anti-depressant)

• Restoril

• Tramadol

Describe schedule V drugs (C-V)

• Lowest abuse potential and dependence

• Least restrictive with prescriber determiners access/refills

Examples of C-V drugs

• Lyrica (treats nerve pain)

• Robafen (cough syrup)

• Lomotil (slows intestinal movement)

• Robitussin (cough syrup)

What “drugs” with abuse potential are not regulated?

• Tobacco

• Alcohol

• Coffee

What does it mean to be teratogenic?

A mother not knowing their child is developing problem in the fetus until their child is born. This is due to substance abuse and taking unsafe dugs while pregnant.

What are the most dangerous time of pregnancy when you are at higher risk of harming fetus?

• 1st trimester: Babies undergo rapid cell division during this time

• Last trimester: Blood flow to fetus increase