Transcript Chapter 7 Body Systems

Drug Information and Drug Forms
1. What are local and systemic actions of medications?
2. Mrs. Jones daughter is concerned about the size of a
capsule found with the medication ordered by the physician.
She is aware that her mother has difficulty swallowing
capsules because they stick to her tongue; large tablets are
also a problem because they dissolve in her mouth. What
could be a reason that Mrs. Jones has a problem with
capsules? What type of tablets might make swallowing of the
tablet easier for Mrs. Jones?
3. Sarah, an allied health student, is on externship and is
asked to administer a medication to a patient in the
ambulatory care setting. The medication is not one that she
has administered before and is a new medication that she has
not yet studied. What materials could Sarah find in the setting,
and how important is it that Sarah is aware of the indications
for and manifestations of the medication?
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Learning Objectives
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Determining the different means of classifying
medications
Discussing what is meant by off-label
medications
Contrasting drug names – generic, legend,
over-the-counter, and chemical
Using main sources of drug information
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Slide 1
Learning Objectives (cont’d.)
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Using the Physicians’ Drug Reference®
(PDR®) or other drug reference guide to list
brand and generic names, drug
classifications, product identification by shape
and color, major precautions, available forms,
dosage, and manufacturer.
Identifying and describing drug forms.
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Drug Classifications
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Complex system
Drug may be classified by
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Therapeutic action on body organs
 General use
 Families of drugs
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One drug may have more than one
classification and may affect more than one
body system
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Off-Label Uses of Medications
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“Off-label” – label lists medication’s FDAapproved purpose but not its alternative use.
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The desired use may be therapeutic although it is
not an approved use.
Physicians report unrelated effects of medications
on patients and use the drug for that therapeutic
effect
Example – Rogaine was developed as an
antihypertensive but it has an off-label use of
prevention of balding
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Drug Nomenclature
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Chemical name
Name that identifies the exact chemical compound
and its molecular structure
Example – (ibuprofen)
2-(4-isobutylphenyl)propionic acid
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Generic or nonproprietary name – drug’s
official name found in the United States
Pharmacopoeia (USP)
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Not protected by a trademark
May be used on all products that are the same
Example - ibuprofen
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Drug Nomenclature (cont’d.)
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Brand or proprietary name
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May also be called trade name or brand name
Belongs to the manufacturer
Marked with an ®
Example – Motrin, Advil designed to be easily
remembered
first letter always capitalized
after 20 years, other companies can
manufacture the drug; cannot use original
brand name
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Slide 6
Drug Nomenclature (cont’d.)
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Legend drug
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Drug sold by prescription
OTC drug
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Does not require a prescription
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Drug Information Sources
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USP/NF – official drug list recognized by U.S.
government
USP/DI – United States Pharmacopoeia/
Dispensing Information
Package Inserts
Physician’s Desk Reference (PDR)
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Slide 8
PDR (cont’d.)
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Seven sections
Section I (white) – manufacturer index
 Section II (pink) – brand and generic names
 Section III (blue) – product category index
 Section IV (gray) – product identification guide
• Includes full-color, actual-size photos of drugs
 Section V (white) – production information section
 Section VI (white) – diagnostic product information
 Section VII (white) – miscellaneous information
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Slide 9
Other Drug Resources
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GenRx – published by Elsevier
Drug Facts and Comparisons
Drug Reference Manuals
 Include most frequently used drugs in easy-to-read form
Reliable Web sites such as Rxlist.com or epocrates.com
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Drug Forms and Drug Delivery
Systems
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solid
semisolid
liquid
gas
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Oral Medications
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solid, liquid, powder forms
convenient, economical, safe
absorbed slowly at unpredictable rate
affected by:
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peristalsis
gastric secretions
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Solid Oral Preparations
Tablets:
 enteric-coated
 sustained-release
 chewable
 sublingual
 Buccal
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buffered
caplets
oral dissolving
unscored tablets
scored tablets
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Safe Administration of Tablets
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Solid Oral Preparations (cont’d.)
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Capsules
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sustained-release capsules
Delayed-release capsules
Gelcaps (semisolid, capsule containing liquid)
Troches or lozenges
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Facts for Administering Capsules
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Liquid Oral Preparations
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active ingredients in liquid medium
two major categories
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Solutions: active ingredient dissolved in liquid
 Dispersions (suspensions): medication particles
suspended in liquid
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Liquid Oral Preparations (cont’d.)
Solutions:
 syrups: aqueous-based solutions, sweetened
with sugar or sugar substitutes
 elixirs: solutions that contain sweetener,
alcohol, and water
 extracts: highly concentrated preparations
achieved through evaporation of a solution
 tinctures: very potent therapeutic medications
 spirits: alcoholic or hydroalcoholic solutions
containing volatile aromatic ingredients
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Liquid Oral Preparations (cont’d.)
Dispersions:
 medication not dissolved in liquid; distributed
throughout liquid
 classified by size of ingredients
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large particles
• suspensions, emulsions
fine particles
• gels, magmas, milks (minerals in liquids)
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Miscellaneous Oral Medications
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Granules
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Finely ground drug particles
Effervescent powders
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Coarsely ground drug agents that are mixed with
an effervescent salt that releases carbon dioxide
when mixed in a liquid
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Percutaneous Medications
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liniments
colloids
tinctures
lotions
creams
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ointments
pastes
gels or jellies
plasters
aerosol foams
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Topical vs Transdermal Medications
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Topical
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Applied directly to skin
Transdermal
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Absorption of drug through skin from patch or
paper impregnated with medication
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Percutaneous Medications (cont’d.)
Transdermal patches:
 drug-infused patch applied to skin for
absorption
 drug’s molecules are different sizes to allow
absorption over various time periods
 Used for:
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angina
smoking cessation
chronic pain
estrogen replacement therapy
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Percutaneous Medications (cont’d.)
Ophthalmic preparations:
 must be in sterile solution or ointment
 Ocular inserts: small transparent
membranes placed between the eye and
lower conjunctiva (pilocarpina)
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Percutaneous Medications (cont’d.)
Otic preparations:
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Drops administered for
infections, or as a
local anesthetic agent.
Warm eardrops to
body temperature to
prevent vertigo.
Tilt head away from
affected side to
prevent medication
from draining from ear.
Ear drop administration.
From Potter PA, Perry AG (2001). Fundamentals of
nursing (5th ed.). St. Louis: Mosby.
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Slide 25
Percutaneous Medications (cont’d.)
Suppositories:
 medication housed
in cocoa butter,
vegetable oil,
glycerinated gelatin
 solid for insertion—
may need
refrigeration
 melts at body
temperature
Figure 3-12.
Typical shapes of suppositories.
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Percutaneous Medications (cont’d.)
Respiratory medications:
 nasal sprays: emit fine dispersion of liquids
 aerosols: liquids in pressured container
 metered dose inhalers: deliver fine
medication mist into respiratory tract
 nebulizers: deliver fine powder spray into
respiratory tract
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Inhalants are being increasingly used to treat
respiratory conditions as well as for local effects.
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Parenteral Medications
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medications given by injection
must be sterile
stored in vials, ampules, premeasured
cartridges
Figure 3-6.
Typical containers for
injectable medications.
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Parenteral Medications (cont’d.)
Reconstituted medications:
 Used with medications unstable as liquids
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powders mixed with sterile liquid
 limited shelf life after reconstitution
 use sterile water or sterile normal saline as
reconstitutional agent
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Record date, time, strength of reconstitution,
and the initials of person reconstituting the
medication.
Gently mix medication until no sediment is
visible.
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Other Forms of Medication
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implants or pellets: placed under skin for
long-term, controlled release
tampons: drug-impregnated cotton packs,
pads, and plugs
douches: water-based solutions to irrigate
any body part or cleanse surgical wounds
enemas: liquids administered via the rectum
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Packaging for Patient Compliance
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Novolin pens: automatic insulin-delivery
system
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Useful for patients with visual problems and
arthritis
Cartridge of insulin that is attached to pen and
remains attached throughout use
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