Medication Classifications and Frequently Prescribed Medications

MEDICATION CLASSIFICATIONS

Professionalism Tip: Reliability

• Definition of Reliability:
  • A pharmacy technician demonstrates reliability through consistent accuracy, punctuality, and dependability in completing tasks and resolving issues.
• Example of Reliability:
  • A pharmacy technician consistently arrives on time for shifts, accurately manages medication inventory, and effectively handles complex insurance claim issues as entrusted by a pharmacist.

Case Study: Biosimilar Medications

• Scenario Overview:
  • Sima, a pharmacy technician, receives a prescription for insulin glargine-aglr (Rezvoglar) for a patient previously prescribed insulin glargine (Lantus).
  • The pharmacist explains that insulin glargine-aglr is a biosimilar product and notes that while the pharmacy does not stock this specific product, they can dispense an interchangeable product, insulin glargine-yfgn (Semglee). The dosing and directions remain unchanged.
• Key Question:
  • Can insulin glargine be dispensed without a prescription?
  • Answer: No, insulin glargine is a prescription medication (legend drug). Only insulin regular and insulin isophane (NPH) may be dispensed without a prescription.
• Role of Pharmacy Technicians:
  • Pharmacy technicians should possess a general knowledge of common medications, their uses, expected patient reactions, and should direct more complex queries to pharmacists.
• Importance of Knowledge:
  • Understanding the most common medications, classifications, dosage forms, mechanisms of action, drug interactions, and immunizations is critical for technicians in any pharmacy setting.

Top 10 Medications Prescribed

• Overview:

• Familiarizing oneself with frequently prescribed medications can enhance efficiency in pharmacy practice. Many pharmacies maintain a shelf of "fast mover" medications, which are high-demand items that improve the filling process by being easily accessible.

• General Classifications:
  • Medications can be classified in various ways, including:
  1. Classifications by Action:
     • Mechanism of Action: Describes how a medication works in the body (e.g., metoprolol blocks beta receptors, reducing heart rate and blood pressure).
     • Therapeutic Indication: The condition a medication treats (e.g., metoprolol is classified as an antihypertensive).
  2. Classification by Body System:
     • Based on the system affected by the medication (e.g., metoprolol affects cardiovascular health).

Therapeutic Equivalence

• Definition:
  • Two medications are considered therapeutically equivalent if they
    a. are bioequivalent,
    b. have the same clinical effect,
    c. share the same safety profile,
    d. contain the same chemical compound,
    e. are prepared in the same dosage form,
    f. distribute in the body at the same site of action when taken at the same dose.
• Reference for Therapeutic Equivalence:
  • The Orange Book is the authoritative guide to determine therapeutic equivalence.

Classification by Body System

• Overview:
  • The body system classification details how medications exert their effects based on their primary system of action. Many medications can belong to multiple classifications.

Examples of Medication Classifications

• Table 3.2: Medication Classifications by Action

Biologics and Biosimilars

• Definitions:
  • Biologics: Large and complex molecules made from living organisms (like bacteria or animal cells).
  • Biosimilars: These are therapeutically equivalent biologic medications that have undergone FDA approval. They are generally less expensive than the original biologics.
• Key Characteristics of Biosimilars:
  • They must be produced in the same way, administered similarly, and expected to have comparable clinical benefits and side effects to their reference products.
  • Each biosimilar product is identified with four lowercase letters after its name for clarity and safety.

FDA References

• Purple Book: Contains listings of biologics, biosimilars, and their interchangeability. Only interchangeable biosimilars can be substituted for the reference product unless additional prescriptions are provided.

Medication Indications

• Definitions:
  • Medication Indication: The specific disease or condition a medication is approved to treat, as detailed in the medication’s labeling.
  • Off-label Use: Refers to when medications are prescribed for conditions not specifically approved by the FDA. Prescribers have this authority if deemed beneficial.

Common Legend Medications and Their Indications