What is in a name

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Transcript What is in a name

Classification and Naming of Drugs
Dr. DATTEN BANGUN MSc,SpFK
Dept.Farmakologi dan Terapeutik,
Fakultas Kedokteran
Universitas Sumatera Utara
Classification and Naming
of Drugs
William Shakespeare:
What is in a name ?
Classification:
- no homogenous way / system of
classifying drugs that suits the purpose
of every user.
 banyak tergantung kepada
sipengguna;
- clinicians
- pharmacologists
- medicinal chemists
Nomenclature
• Drugs are categorized under broad
subcategories called classifications
• Drugs with several types of
therapeutic effects fit under several
classifications (Aspirin)
Drugs may be classified by:
 body system 
* alimentary
* cardiovascular
 therapeutic use  * receptor blokers
* ion channels
 mode of action  * molecular
interaction
* cellular site
 molecular structure * glycoside
* alkaloid
* steroid
Drug Nomenclature
Drugs are identified by one of three names:
1. Chemical:
-long name, refers to the chemical
structure of the drug
2. Generic:
-shorter preferred name, derived from the
chemical name
3. Trade-brand name:
- assigned by the manufacturer
Classifications (cont.)
• The same drug may belong to more than one
classification
– Propranalol: B-blocker (physiologic action),
antianginal, antiarrhythmic, antihypertensive
– Perphenazine: antiemetic =controls N/V,
antipsychotic = anticholinergic side effects (dry
mouth, constipation, urinary retention, blurred
vision, tachycardia, sedation)
Nomenclature/Classifications (cont.)
• Prototype Drug = representative of many
drugs within the class
– Diazepam: Benzodiazepine, sedative/hypnotic,
antianxiety
– Similarities: pharmacokinetics,
pharmacodynamics, effects, side effects,
adverse reactions, contraindications, drug/food
interaction
Nomenclature / Drug Names
• Generic
– Name given to drug before it becomes official
– Given by the United States Adopted Names
Council
– Typically derived from chemical name
– Usually shorter
Nomenclature / Drug Names (cont.)
*Trade
–
–
–
–
Name that is registered by the manufacturer
Followed by the trademark symbol®
Can only be used by the manufacturer
May have several trade names (depending
on number of manufacturers)
– The first letter of the name is capitalized
*Chemical
Gives exact chemical composition of the drug
Places atoms or molecular structure
Nomenclature / Drug Names (cont.)
• Official
– Name listed in the United States
Pharmacopoeia-National Formulary
– May be the same as the generic name
•
= Acetaminophen/N-acetyl-paminophenol/Tylenol, Datil
Nomenclature / Drug Names (cont.)
• When a new drug is produced it is given a generic
name
• It must be tested and approved by the FDA
• Listed in the USP/NF by an official name
• Producing company has an exclusive right for 17
years and other companies can produce the same
drug, but will assign own trade name
Nomenclature / Drug Names (cont.)
• Combination drugs
– Have several generic names, but only one
trade name
– Darvocet-N-100 = Acetaminophen 650mg,
Propoxypene napsylate, 100mg
Trade names with numbers
The number refers to the amount of one of the
generic components
A differentiating factor
Number represents the amount of the controlled
substance
Nomenclature / Drug Names (cont.)
Trade Name
Empirin
Empirin #1
Generic Name
Aspirin 325mg
Aspirin 325 mg
Codeine Phosphate 7.5mg
Empirin #2
Aspirin 325 mg
Codeine Phosphate 15mg
The larger the number, the greater the amount of the
controlled substance contained therein.
Nomenclature / Drug Names (cont.)
• Potential med errors
– Trade name misinterpreted for the # of
tablets to give
– Allergic reaction to one of the generic
components (check for aspirin allergy)
– Giving 2 #3’s instead of one #4 (doubles the
dose of aspirin from 325mg to 650mg)
Nomenclature / Drug Names (cont.)
• Patient Education
– Generic and trade name drugs have same basic
ingredients by law
• Trade name drug is more expensive
– Advertising
– Pharmacy dispension
– Though basic ingredients are same, the “fillers” may be
different (fillers may effect speed drug is dissolved or
takes effect, some dyes may cause allergic reaction)
Drug Naming
• Chemical Name - describe chemical structure
(rarely seen in medical literature)
• Code Name - short letter-number combination
used for experimental drugs
• Generic Name - a name assigned to drug that can
be used by anyone (not proprietary)
• Trade Name - Proprietary name given to the drug
by the manufacturer
Naming Complications
Brand names can change over time as
patents expire or companies merge
Most drugs are marketed by numerous
names in different countries
Even generic names can differ in
different countries
Drug Names
• At least 3 names
1. Chemical name
–
describes molecular structure
2. Generic name
–
official legal name
3. Trade name
–
•
brand name
Street name ~
Example: Amphetamine
• chemical
dl-2 amino-1
phenylpropane
• generic
dl-amphetamine
• trade
Benzedrine
• street
speed, bennies, whites,
etc.~
Example: Valium
• chemical
7-chloro--1-methyl-5-phenyl-3H-1,4benzodiazepin-2[1H]-one
• generic
diazepam
• trade
valium
• street
tranks, downers, blues, yellows
Drug Equivalence
• Important to know when prescribing
• Chemical equivalence
– identical chemical compounds
– e.g., Miltown & Equanil (meprobamate)
• Biological equivalence
– different chemical compounds
– affect the same systems in same way
– e.g., Prozac vs. Zoloft ~
Drug Equivalence
• Clinical equivalence
– same behavioral effect
– different chemical compounds affecting different
systems
– e.g., thorazine vs. lithium ~
Nomenclature ( names):
 Ada 3 cara / jenis nama
1. full chemical name
2. chosen by official bodies
 used in pharmacopoeias
 chosen by official bodies
 WHO memilih Recommended
international Nonproprietary
Names (RINN)
 Kadang membingungkan kita:
- epinephrine; RINN
- adrenaline ; BAN
3. proprietary name
 Commercial property of
pharm.company
Exs : 1. 3- (10.11 dihydro – 5 H – dibenz
{ 6.f } – azepin 5 – yl ) proopydimethylamine.
2. imipramine
3. tofranil (UK), Prodepress, Surplix,
deprinol etc
Benzodiazepines :
generic name
- diazepam
- nitrazepam
- flurezepam
proprietary name
- valium
- mogadon
- dalmane
- Adrenoceptor blockers  ending in - olol
- ACE – inhibitor

- pril
- Quinolone

- floxacin
Bila tidak lagi dibawah “patent restriction
Obat dapat diproduksi oleh pabrik apapun
dengan nama apa saja.
Kewajiban authority : memastikan bahwa:
- Pharmaceutically
- Biologically
-------------- Keduanya equivalent.
Misalnya: Amoxicillin
Keuntungan menggunakan nonproprietary
name:
1. Clarity :
- nortriptyline  Allegron
- amitriptyline  Lentizol
2. Economy:
- biasanya lebih murah
3. Convenience :
- bagi Apotik
PROPRIETARY NAMES
- Mahal
- biaya promosi
- membingungkan dokter
- membingungkan pasien
Lasix ( furosemide)
Losec ( omeprazole )
AXT ( zidovudne)
Azathiorine
Daonil ( glibenclamide )
De – nol ( bismuth – chelate )
danol
( denazol )
Text: CNS & Behavioral Effects
• CNS Stimulants
– Cocaine, amphetamine
• CNS Depressants
– Barbiturates, alcohol
• Analgesics
– Morphine, codeine
• Hallucinogens
– Mescaline, LSD, psilocybin
• Psychotherapeutics
– Prozac, thorazine ~
Drug laws & legal classification
• Controlled Substances Act of 1970
• 5 schedules
– abuse potential
– medicinal value
• Schedule I
– high abuse potential
– no accepted medicinal value ~
Schedule II
-high abuse potential
- accepted medicinal value
Schedule III
- moderate abuse potential
Schedule IV - low abuse potential
Schedule V - abuse potential < IV ~
Classification Problems
• Alcohol effects
– General nervous system depressant
• Effects depend on dose
– Low dose  behavioral excitation
– High dose  behavioral inhibition
• What are the effects of alcohol?
It depends! ~
Another Example
• Attention Deficit Hyperactive Disorder
• hyperkinesis
• Treatment: Ritalin
• Methylphenidate
– classified as a sedative?
• No, a stimulant ~
Sources of Drugs
Any chemical substance taken into body
for the purpose of affecting body function
is referred to as a drug
• Plants = primary source of substances used in
human body
– Berries, bark, leaves, resin from trees, roots
• Minerals = from the earth & soil
– Iron, sulfur, potassium, silver & even gold
• Animals = substances from the glands, organs
& tissues of animals
– Pork insulin
• Synthetic = man made (test tube drugs)
Sources of Drugs
• Plants
Example
Trade Name
Classification
Chinchona Bark
Quinidine
Antiarrhythmic
Purple Foxglove
Digitalis
Cardiotonic
Poppy Plant
(Opium)
Paregoric,
Morphine,
Codeine
Antidiarrheal,
Analgesic,
Analgesic,
Antitussive
Sources of Drugs
• Minerals
Example
Trade Name
Classification
Magnesium
Milk of Magnesia
Antacid, Laxative
Zinc
Zinc Oxide Oint.
Sunscreen, Skin
Protectant
Gold
Solganal, Auranofin Anti-inflammatory;
Used in tx of
Rheumatoid
Arthritis
Sources of Drugs
• Animals
Example
Trade Name
Classification
Pancreas of Cow,
Hog
Insulin; regular,
NPH, PZI
Antidiabetic
Hormone
Stomach of Cow,
Hog
Pepsin
Digestive
Hormone
Thyroid Gland
Hormone
Of Animals
Thyroid, USP
Sources of Drugs
• Synthetic
Example
Trade Name
Classification
Meperidine
Demerol
Analgesic
Diphenoxylate
Lomotil
Antidiarrheal
Co-Trimoxazole
Bactrim, Septra
Anti-Infective
Sulfonamide;
Used in the
treatment of
UTI’s
Questions???