1.3 Drug Classifications and Prototypes
3 min read•june 18, 2024
Drug classifications help organize medications by their effects and actions. Understanding these groupings is crucial for nurses to provide safe, effective care. Prototypes serve as representative examples for each class, simplifying learning and aiding in predicting drug properties.
and explain how drugs move through the body and produce their effects. These concepts are essential for nurses to grasp, as they influence drug dosing, timing, and potential interactions in patient care.
Drug Classifications and Prototypes
Drug categories and classifications
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- Therapeutic classes group drugs based on their clinical use or therapeutic effect
- treat high blood pressure by lowering blood pressure through various mechanisms (, )
- treat depression by altering neurotransmitter levels or activity in the brain (, , TCAs)
- relieve pain by acting on pain receptors or pathways in the body (, , )
- Pharmacologic classes group drugs based on their mechanism of action or chemical structure
- Beta-blockers block beta-adrenergic receptors in the heart and blood vessels, reducing heart rate and blood pressure (, )
- inhibit serotonin reuptake in the brain, increasing serotonin levels and improving mood (, )
- Opioids act on opioid receptors in the brain and spinal cord to produce analgesia and other effects (, , )
Prototype approach for drug classes
- Prototype drugs serve as representative agents within a therapeutic or pharmacologic class
- Exemplify key characteristics, mechanisms of action, and effects of the class
- Allow for comparison and contrast of drugs within the same class
- Help predict properties, side effects, and interactions of similar drugs
- Benefits of the prototype approach include:
- Simplifies learning by focusing on essential features of a drug class (pharmacology, indications, )
- Facilitates understanding of relationships between drugs within a class (similarities, differences)
- Enables educated guesses about unfamiliar drugs based on knowledge of the prototype
- Examples of prototype drugs:
- Atenolol is a prototype for beta-blockers, demonstrating their mechanism of action and cardiovascular effects
- Fluoxetine () is a prototype for SSRIs, illustrating their antidepressant properties and side effect profile
- Morphine serves as a prototype for opioids, showcasing their analgesic effects and potential for abuse and addiction
Federal regulations for controlled substances
-
The (CSA) regulates the manufacture, distribution, and possession of controlled substances
- Categorizes drugs into five schedules based on medical use, abuse potential, and safety
- : High abuse potential, no accepted medical use (, , )
- : High abuse potential, accepted medical use with severe restrictions (morphine, oxycodone, )
- -V: Lower abuse potential, accepted medical use with varying restrictions (, , )
- Categorizes drugs into five schedules based on medical use, abuse potential, and safety
-
Prescribing practices for controlled substances:
- Prescribers must register with the (DEA) to prescribe controlled substances
- Schedule II drugs require a written, signed prescription and cannot be refilled without a new prescription
- Schedule III-V drugs may have oral or written prescriptions and can be refilled with limitations (up to 5 refills in 6 months)
-
Impact on healthcare providers:
- Increased responsibility to prevent abuse, misuse, and diversion of controlled substances
- Thorough documentation and adherence to regulations required when prescribing controlled substances
- Potential for legal consequences, license suspension, or revocation if regulations are violated
- Need for ongoing education and vigilance to ensure safe and appropriate use of controlled substances in patient care
Pharmacokinetics and Pharmacodynamics
- Pharmacokinetics describes how the body processes a drug (absorption, distribution, metabolism, excretion)
- refers to the fraction of an administered drug that reaches systemic circulation
- is the time it takes for the concentration of a drug in the body to decrease by half
- explains how drugs affect the body and produce their therapeutic effects
- compares the dose that produces a desired effect to the dose that causes toxicity
- are unwanted or harmful reactions that occur as a result of drug administration
- occur when one drug affects the activity of another drug when both are administered together
Key Terms to Review (57)
ACE Inhibitors: ACE (Angiotensin-Converting Enzyme) inhibitors are a class of medications that work by blocking the action of the angiotensin-converting enzyme, which is responsible for converting angiotensin I into angiotensin II, a potent vasoconstrictor. By inhibiting this enzyme, ACE inhibitors help lower blood pressure and reduce the workload on the heart.
Acetaminophen: Acetaminophen is a widely used over-the-counter medication primarily used as an analgesic (pain reliever) and antipyretic (fever reducer). It is a key term in the context of drug classifications, pharmacokinetics, pain management, and non-opioid analgesics.
Adverse effects: Adverse effects are unintended and harmful outcomes resulting from medication or other interventions. They can range from mild to severe and may require medical attention.
Adverse Effects: Adverse effects, also known as side effects, are unintended and undesirable consequences that can occur during or after the use of a drug or medication. These effects can range from mild discomfort to serious and potentially life-threatening conditions, and they are an important consideration in the context of drug classifications, pharmacokinetics, pharmacodynamics, drug administration, and the use of specific drug classes like angiotensin II receptor blockers (ARBs).
Amphetamines: Amphetamines are a class of central nervous system (CNS) stimulant drugs that increase the levels of certain neurotransmitters, primarily dopamine and norepinephrine, in the brain. They are known for their ability to enhance focus, energy, and wakefulness, making them commonly used for the treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy, as well as for their potential for abuse and addiction.
Analgesics: Analgesics are a class of medications that work to relieve pain without causing a loss of consciousness. They are a fundamental component in the management of pain, which is a central focus in the topics of drug classifications and the introduction to pain.
Antidepressants: Antidepressants are a class of medications primarily used to treat depression, but they can also be effective in managing other mental health conditions, such as anxiety, obsessive-compulsive disorder, and chronic pain. These drugs work by altering the levels of certain neurotransmitters in the brain, which can help improve mood, regulate emotions, and enhance overall well-being.
Antihypertensives: Antihypertensives are a class of medications used to lower and control high blood pressure (hypertension) by acting on various mechanisms that regulate blood pressure. These drugs play a crucial role in the management of cardiovascular health and are closely linked to the topics of drug classifications and prototypes.
Atenolol: Atenolol is a cardioselective beta-blocker medication primarily used to treat high blood pressure, angina, and certain heart rhythm disorders. It works by selectively blocking beta-1 adrenergic receptors, which are predominantly found in the heart, reducing the heart's workload and oxygen demand.
Benzos: Benzos, short for benzodiazepines, are a class of central nervous system (CNS) depressant drugs that produce a calming, sedative effect. They are commonly prescribed for the treatment of anxiety, insomnia, seizures, and other conditions related to the modulation of GABA receptors in the brain.
Beta-Blockers: Beta-blockers are a class of medications that work by blocking the effects of the hormone epinephrine (adrenaline) on the body. They are primarily used to treat various cardiovascular conditions, such as hypertension, angina, and heart failure, by reducing the heart's workload and oxygen demand.
Bioavailability: Bioavailability refers to the degree and rate at which a drug or other substance is absorbed and becomes available at the site of action in the body. It is a crucial pharmacokinetic property that determines the effectiveness and safety of a medication.
Codeine: Codeine is a naturally occurring opioid analgesic and antitussive (cough suppressant) drug. It is derived from the opium poppy plant and is commonly used to treat mild to moderate pain and suppress cough. Codeine's effects and uses are closely tied to its classification as a drug, its action as an opioid agonist, and its application as an antitussive medication.
Controlled Substances Act: The Controlled Substances Act is a federal law in the United States that regulates the manufacture, importation, possession, use, and distribution of certain substances. It establishes a framework for classifying drugs and other chemicals based on their potential for abuse and medicinal value, which is crucial in understanding drug classifications and legal considerations surrounding controlled substances.
Drug Enforcement Administration: The Drug Enforcement Administration (DEA) is a United States federal law enforcement agency under the U.S. Department of Justice that is responsible for enforcing the nation's controlled substances laws and regulations. It plays a crucial role in the classification and regulation of drugs, particularly in the context of drug prototypes and their legal status.
Drug prototype: A drug prototype is the original or standard drug in a class that serves as a benchmark for comparing the effects and efficacy of other drugs in the same class. It helps healthcare professionals understand the key characteristics and therapeutic effects of new drugs.
Drug-Drug Interactions: Drug-drug interactions occur when the effects of one drug are altered by the presence of another drug, leading to changes in the intended therapeutic outcome. These interactions can enhance or diminish the effectiveness of the drugs involved, and they are an important consideration in pharmacology, interdisciplinary teams, and nursing practice.
Fentanyl: Fentanyl is a highly potent synthetic opioid analgesic that is used primarily as a pain medication and anesthetic. It is classified as a Schedule II controlled substance due to its high potential for abuse and addiction. Fentanyl is particularly relevant in the contexts of drug classifications and prototypes as well as opioid agonists and antagonists.
Fluoxetine: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) medication primarily used to treat depression, anxiety disorders, and other mental health conditions. It works by inhibiting the reuptake of the neurotransmitter serotonin, leading to increased serotonin levels in the brain and improved mood and emotional regulation.
Half-life: Half-life is the time required for the concentration of a drug in the bloodstream to reduce by half. It helps determine dosing intervals and duration of drug effects.
Half-Life: Half-life is a fundamental concept in pharmacology that describes the time it takes for the concentration or amount of a drug in the body to be reduced by half. It is a crucial factor in understanding the pharmacokinetics and pharmacodynamics of drugs, as well as their dosing and administration.
Heroin: Heroin is a highly addictive and potent opioid drug derived from the morphine found in the seedpod of the opium poppy plant. It is classified as a Schedule I controlled substance due to its high potential for abuse and lack of accepted medical use in the United States. Heroin's effects on the body and brain make it a key topic within the context of drug classifications and prototypes.
LSD: LSD, or lysergic acid diethylamide, is a potent psychedelic drug that alters perception, emotions, and sensations. It is classified as a hallucinogen and is known for its profound effects on the user's consciousness and experience of reality.
Marijuana: Marijuana is a psychoactive drug derived from the cannabis plant, known for its recreational and medicinal uses. It contains a variety of chemical compounds, including the primary psychoactive ingredient, tetrahydrocannabinol (THC), which produces the characteristic 'high' associated with its use. Marijuana is classified and studied in the context of drug prototypes and drug classifications.
Metoprolol: Metoprolol is a beta-adrenergic blocking agent, commonly known as a beta-blocker, that is primarily used to treat various cardiovascular conditions, including hypertension, angina, and certain types of arrhythmias. It works by selectively blocking the beta-1 receptors in the heart, reducing the heart's workload and oxygen demand.
Morphine: Morphine is a powerful opioid analgesic medication primarily used for the relief of moderate to severe pain. As a prototype drug for the opioid agonist class, morphine's pharmacological properties and clinical applications are central to understanding key concepts in pharmacology, interdisciplinary teams, nursing practice, drug administration, pharmacokinetics, pharmacodynamics, and the management of opioid effects.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that reduce inflammation, pain, and fever without the use of steroids. They inhibit cyclooxygenase enzymes (COX-1 and COX-2), which are involved in the production of prostaglandins.
NSAIDs: NSAIDs, or Non-Steroidal Anti-Inflammatory Drugs, are a class of medications that are widely used to reduce inflammation, alleviate pain, and lower fever. They work by inhibiting the production of prostaglandins, which are key mediators of the inflammatory response. NSAIDs are commonly employed in the management of various conditions, including arthritis, menstrual cramps, headaches, and post-operative pain.
Opioid Analgesics: Opioid analgesics are a class of medications used to relieve severe pain by binding to opioid receptors in the brain and spinal cord. They are often used in emergency settings for acute cardiac events where pain management is critical.
Opioids: Opioids are a class of drugs that act on the opioid receptors in the body, producing a wide range of effects including pain relief, sedation, and euphoria. They are commonly used in the management of acute and chronic pain, and their use is a critical aspect of pharmacology, interdisciplinary teams, and nursing practice.
Opioids are also classified as a type of drug prototype and their pharmacokinetics and pharmacodynamics are crucial in understanding their therapeutic and adverse effects. Additionally, the introduction and management of pain, a significant health concern, is closely tied to the use of opioid analgesics.
Oxycodone: Oxycodone is a potent opioid analgesic medication used to treat moderate to severe pain. It is a semi-synthetic derivative of thebaine, a chemical found in the opium poppy plant, and acts as a full agonist at the mu-opioid receptor, producing analgesic, euphoric, and sedative effects.
Pharmacodynamics: Pharmacodynamics is the study of how drugs affect the body, including mechanisms of action and drug-receptor interactions. It examines the relationship between drug concentration and effect.
Pharmacodynamics: Pharmacodynamics is the study of the biochemical and physiological effects of drugs and their mechanisms of action within the body. It examines how drugs interact with the body's biological systems to produce their desired therapeutic effects or undesired side effects.
Pharmacokinetics: Pharmacokinetics is the study of how the body affects a drug, including the processes of absorption, distribution, metabolism, and elimination. It examines the movement of drugs within the body and how these processes impact the drug's concentration and duration of action.
Pharmacologic classification: Pharmacologic classification categorizes drugs based on their specific mechanism of action and the physiological effect they have on the body. This classification helps healthcare professionals understand how different drugs work and predict potential interactions.
Pregabalin: Pregabalin is a medication primarily used to treat neuropathic pain, seizures, and anxiety disorders. It is classified as an anticonvulsant and works by modulating the activity of certain neurotransmitters in the brain and nervous system, leading to its therapeutic effects.
Prozac: Prozac, also known as fluoxetine, is a selective serotonin reuptake inhibitor (SSRI) medication used primarily in the treatment of depression, anxiety disorders, and other mental health conditions. It works by increasing the availability of the neurotransmitter serotonin in the brain, which can help regulate mood and improve symptoms associated with various psychological disorders.
Prozac is a prototypical SSRI drug and is considered a key example within the broader drug classification of antidepressants, which are a class of medications designed to alleviate symptoms of depression and related mental health issues.
Schedule I: Schedule I drugs are substances classified by the DEA as having a high potential for abuse and no accepted medical use. These drugs are illegal to manufacture, distribute, or possess.
Schedule I: Schedule I is a classification of controlled substances in the United States that have a high potential for abuse, no currently accepted medical use, and a lack of accepted safety for use under medical supervision. Substances in this schedule are subject to the most stringent regulations and restrictions.
Schedule II: Schedule II drugs are substances that have a high potential for abuse, which may lead to severe psychological or physical dependence. They have accepted medical uses but are strictly regulated.
Schedule II: Schedule II is a drug classification system used in the United States that categorizes certain controlled substances based on their accepted medical uses, potential for abuse, and risk of physical or psychological dependence. This classification is particularly relevant in the context of drug prototypes and drug classifications.
Schedule III: Schedule III drugs are substances with a moderate to low potential for physical and psychological dependence. They have accepted medical uses and require a prescription from a healthcare provider.
Schedule III: Schedule III is a classification system used in the United States to categorize certain controlled substances based on their potential for abuse, accepted medical use, and degree of dependence. This classification is particularly relevant in the context of drug classifications and prototypes.
Schedule IV: Schedule IV drugs are controlled substances that have a low potential for abuse relative to substances in Schedule III. They are accepted for medical use and may lead to limited physical or psychological dependence.
Schedule IV: Schedule IV is a classification of controlled substances in the United States that have a low potential for abuse and dependence, and are considered to have a currently accepted medical use. This term is relevant in the context of drug classifications and prototypes, as it helps categorize and regulate the use of certain medications.
Schedule V: Schedule V drugs are substances with a lower potential for abuse relative to Schedule IV drugs and consist primarily of preparations containing limited quantities of certain narcotics. These drugs are generally used for antidiarrheal, antitussive, and analgesic purposes.
Schedule V: Schedule V is a classification of drugs under the Controlled Substances Act in the United States. Drugs in this schedule have a low potential for abuse and dependence, and are typically used for legitimate medical purposes with minimal risk of addiction or harm.
Selective serotonin reuptake inhibitors (SSRIs): Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used primarily to treat depression by increasing serotonin levels in the brain. They work by blocking the reabsorption (reuptake) of serotonin into neurons, making more serotonin available.
Serotonin norepinephrine reuptake inhibitors (SNRIs): Serotonin norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressants that increase the levels of serotonin and norepinephrine in the brain by inhibiting their reabsorption (reuptake) into neurons. They are commonly prescribed for major depressive disorder, anxiety disorders, and certain chronic pain conditions.
Sertraline: Sertraline is a selective serotonin reuptake inhibitor (SSRI) medication primarily used to treat depression, anxiety disorders, and certain other mental health conditions. It works by increasing the availability of the neurotransmitter serotonin in the brain, which can help alleviate symptoms associated with these disorders.
SNRIs: SNRIs, or Serotonin-Norepinephrine Reuptake Inhibitors, are a class of medications primarily used as antidepressants and for the management of various other conditions, such as chronic pain, migraine headaches, and anxiety disorders. These drugs work by inhibiting the reuptake of both serotonin and norepinephrine, two important neurotransmitters in the brain, leading to increased levels and improved signaling between neurons.
SSRIs: SSRIs, or Selective Serotonin Reuptake Inhibitors, are a class of medications primarily used to treat depression and other mental health conditions. They work by selectively inhibiting the reuptake of the neurotransmitter serotonin, which is believed to play a crucial role in regulating mood, sleep, appetite, and other physiological processes.
Therapeutic classification: Therapeutic classification categorizes drugs based on their therapeutic use and the conditions they treat. It helps healthcare professionals understand the primary purpose of a medication.
Therapeutic index: Therapeutic index (TI) is the ratio of the toxic dose to the therapeutic dose of a drug, indicating its safety margin. A higher TI means a greater margin between effective and toxic doses, making the drug safer.
Therapeutic Index: The therapeutic index, also known as the therapeutic ratio, is a measure of the relative safety of a drug. It is the ratio between the dose that causes a toxic effect and the dose that produces the desired therapeutic effect. A higher therapeutic index indicates a wider margin of safety for a drug, meaning it has a lower risk of causing adverse effects when used at the recommended therapeutic dose.
Tricyclic antidepressants (TCAs): Tricyclic antidepressants (TCAs) are a class of medications used primarily to treat depression. They work by increasing the levels of norepinephrine and serotonin in the brain.
Tricyclic Antidepressants (TCAs): Tricyclic antidepressants (TCAs) are a class of medications primarily used to treat depression, but they also have applications in managing other mental health conditions and certain types of chronic pain. These drugs are named for their chemical structure, which features three interconnected rings of atoms.