Pharmacy Drug Definitions and Standards

Drug Definitions, Standards, and Information Sources

• Official Drug Name: The name a drug is listed under by the US Food and Drug Administration (FDA).
• Brand/Trademark Name: The name given to a drug by its manufacturer.
• Generic/Nonproprietary Name: Provided by the United States Adopted Names Council.
• Nutritional Supplement Information Source: The United States Pharmacopoeia/National Formulary (USP NF).
• Drug Monographs for Therapeutic Classes: Drug Facts and Comparisons
• Comprehensive Drug Information (Approved & Unapproved Uses): AHFS Drug Information.
• Online Drug Reference: DailyMed.
• Legislation For Drug Safety: The Federal Food, Drug, and Cosmetic Act (1938) authorizes the FDA to determine drug safety before marketing.
• Drug Scheduling:
  • Schedule I: High potential for abuse, no recognized medical use.
  • Schedule II: High potential for abuse; currently accepted in the U.S.; use may lead to severe psychological or physical dependence.
  • Schedule III: Some potential for abuse; use may lead to low to moderate physical dependence or high psychological dependence.
  • Schedule IV: Low potential for abuse; use may lead to limited physical or psychological dependence.
  • Schedule V: Limited physical or psychological dependence; abuse potential low.
• Examples of Schedule II drugs: Meperidine (Demerol), Percodan.
• Examples of Schedule III drugs: Fiorinal
• Examples of Schedule IV drugs: Flurazepam
• Expedited Drug Development: The FDA may fast-track investigational drugs during a crisis (e.g., a smallpox outbreak).
• Over-the-Counter (OTC) Drugs: OTC drugs are sold without a prescription.
• Injectable Drug Reference: Handbook on Injectable Drugs

Basic Principles of Drug Action and Drug Interactions

• Allergic Reactions: Characterized by hives/urticaria.
• Idiosyncratic Reactions: Unusual, abnormal reactions to a drug.
• Drug Interactions: The alteration of one drug's effect by another drug.
• Synergistic Effects: The effect of two drugs combined is greater than the sum of individual effects.
• Displacement Interactions: One drug displaces another from receptor sites, increasing the first drug's activity.
• Drug Blood Levels: Measure the amount of drug in the body, crucial for maintaining therapeutic ranges.
• Drug Distribution: The process of circulating drugs to receptor sites, metabolism, and excretion.
• Drug Absorption: Moving a drug from its entry point to circulating fluids. Crucial for faster absorption are: intravenous (IV), intramuscular (IM), inhalation/sublingual. The slowest absorption is intradermal. Absorption depends on the pH of the environment and the blood flow to the gastric mucosa.
• Drug Metabolism: The activation of a drug is accomplished through biotransformation.
• Drug Excretion: Removing drugs from the body. Major excretion routes are the GI tract (feces), the genitourinary tract (urine), and the respiratory system (exhalation).
• Half-life: The time needed for 50% of a drug to be eliminated from the body.

The Nursing Process and Pharmacology

• Nursing Assessment: Identifying patient responses to health problems.
• NANDA-I Taxonomy: Identifies human response patterns. It's used for nursing diagnoses.
• Nursing Diagnoses: Describe patient problems that nurses treat.
• Actual Diagnoses: Identify existing problems with defining characteristics (symptoms).
• Risk Diagnoses: Identify potential problems.
• Outcome Statements: Patient-oriented, measurable, with a defined time frame.
• Independent Nursing Actions: Actions performed by the nurse alone (e.g., assessing lung sounds).
• Interdependent Nursing Actions: Actions requiring collaboration with other healthcare professionals (e.g., medication administration).
• Patient History: Primary source of information for the nurse.
• Critical Care Pathway: A standardized plan for patients in critical care.

Drug Action Across the Life Span

• Geriatric Patient Considerations: Lower dosages, altered absorption/metabolism/excretion rates due to age-related changes.
• Pediatric Patient Considerations: Different dosages, potential for rapid absorption and reactions.
• Pregnant Patient Considerations: Avoid certain medications, and consider potential teratogenicity (birth defects).
• Lactating Patient Considerations: Medications may pass into breast milk; timing is critical.
• Drug Blood levels: Peak and trough are essential for monitoring drug levels and adjusting dosages accordingly.