Drug Nomenclature and Preparations

Drug Nomenclature

• Chemical name: Describes the drug's atomic and molecular composition.
• Generic name: Assigned by the first manufacturer who develops the drug.
• Official name (monograph): Found in official publications like the United States Pharmacopeia (USP) and National Formulary (NF). Typically the generic name.
• Trade name: Brand name copyrighted by the drug's selling company.

Drug Preparations

• Oral: Capsules, pills, tablets, extended release, elixirs, suspensions, syrups.
• Topical: Liniments, lotions, ointments, suppositories, transdermal patches.
• Injectable: Injected directly into the body.

Drug Classifications

• Classifications based on effect on the body system, chemical composition, or clinical indication/therapeutic action.
• Pharmaceutical class: Focuses on mechanism of action (MOA), physiologic effect (PE), and chemical structure (CS).
• Therapeutic class: Focuses on the clinical indication for the drug or therapeutic action (e.g., analgesic, antibiotic, antihypertensive).

Pharmacokinetics

• Absorption: How the drug enters the bloodstream.
• Distribution: How the drug moves throughout the body.
• Metabolism: How the drug is broken down in the body.
• Excretion: How the drug leaves the body.

Factors Affecting Absorption

• Route of administration: How the drug is given (oral, topical, etc.).
• Lipid solubility: How easily the drug dissolves in fats.
• pH: The acidity or alkalinity of the environment.
• Blood flow: Amount of blood to the area where the drug is administered.
• Local conditions: Factors at the site of administration (e.g., inflammation).
• Drug dosage: Amount of drug given.

Pharmacodynamics

• Drugs alter cell physiology and influence the body.
• They can promote or block responses in the body's processes.
• Drug-receptor interaction: Drugs bind to specific cellular structures to alter cell function.
• Drugs can also combine with other molecules within the body to achieve their effect.
• Some drugs act on the cell membrane or modify the cellular environment.

Adverse Drug Effects

• Allergic effects: Hypersensitivity reactions, including anaphylaxis.
• Drug tolerance: Decreased effect of the drug with repeated use.
• Toxic effect: Harmful or poisonous effects.
• Idiosyncratic effect: Unpredictable and individual-specific reactions.
• Drug interactions: Effects of one drug are altered by another drug.
  • Antagonistic: One drug reduces the effect of another.
  • Synergistic: One drug enhances the effect of another.

Factors Affecting Drug Action

• Developmental considerations: Age and maturity of the patient.
• Weight: Body mass influences drug distribution.
• Gender: Differences in body composition and hormone levels can influence drug effects.
• Genetic and cultural factors: Variations in metabolism and responses can be influenced by these factors.
• Psychological factors: Mental state can influence drug perception.
• Pathology: Existing medical conditions can affect drug action.
• Environment: Temperature, humidity, and other environmental factors can impact drug effects.
• Timing of administration: When the drug is given can influence its absorption and effectiveness.

Drug Dose and Serum Drug Levels

• Therapeutic range: Ideal drug concentration in the blood for effectiveness without toxicity.
• Trough level: Lowest concentration in the blood, indicating the rate of elimination.
• Half-life: Time it takes for 50% of the drug to be eliminated from the body.

Metric System Conversions

• To convert a larger unit to a smaller unit, move the decimal point to the right.
• To convert a smaller unit to a larger unit, move the decimal point to the left.
  • 1 kilogram = 1,000 grams
  • 1 gram = 1,000 milligrams
  • 1 milligram = 1,000 micrograms
  • 1 liter = 1,000 milliliters or cubic centimeters

Controlled Substances

• Required information: Patient name, amount of narcotic used, time of administration, prescribing physician, and administering nurse.

Three Checks of Medication Administration

• When reaching for the medication.
• When preparing the medication.
• Before giving the medication to the patient.

Medication Errors

• Action: Immediately assess the patient for adverse effects.
• Reporting: Inform the nurse manager and primary care provider.
• Documentation: Record the error, remedial actions taken in the medical record.
• Facility reporting: Use a designated error reporting form.

Intramuscular Injection Sites

• Adults: Ventrogluteal or deltoid muscle.

Preparing Medications for Injection

• Ampules: Single-dose glass containers.
• Vials: Multiple-dose glass containers.
• Prefilled cartridges or syringes: Ready-to-administer medication.
• Mixing medications: Combining drugs in one syringe.
• Reconstituting powdered medications: Adding liquid to powdered medication to form a solution.

Intradermal Injections

• Administration: Injected into the dermis just below the epidermis.
• Absorption: Longest absorption time among parenteral routes.
• Uses: Sensitivity tests, local anesthesia.
• Common sites: Inner forearm, upper back (under the scapula).
• Needle: 1/4″ to 1/2″, 25- or 27-gauge needle.
• Angle: 5 to 15 degrees.
• Dosage: Usually less than 0.5 mL.

Subcutaneous Injections

• Administration: Injected into the adipose tissue layer beneath the skin.
• Common sites: Upper arm, abdomen, anterior thigh, upper back, upper ventral or dorsogluteal area.

Intravenous Administration

• Delivery: Directly into the bloodstream.
• Effect: Immediate drug action.
• Use: Emergencies.

Topical Administration

• Skin applications: Creams, lotions, ointments.
• Eye instillations and irrigations: Eye drops and washes.
• Ear instillations and irrigations: Ear drops and washes.
• Nasal instillations: Nasal sprays.
• Vaginal applications: Suppositories, creams.
• Rectal instillations: Suppositories, enemas.

Medical Record Documentation

• Medication: Name, dosage, route, and time of administration.
• Administering person: Nurse's name.
• Injection site: Site used for injections.
• Omitted or refused medications: Reason for omission or refusal.
• Medication errors: Description of the error and steps taken to correct it.

Patient Teaching

• Medication administration: Techniques for self-administration.
• Dosage and duration: Instructions to take medication as prescribed.
• Dosage alterations: Warning against dosage changes without physician approval.
• Sharing medications: Recommendation against sharing medications.