Core Concepts in Pharmacology, 4/E Norm Holland Michael P. Adams solutions manual and test bank

Core Concepts in Pharmacology, 4/E Norm Holland Michael P. Adams solutions manual and test bank

Chapter 2

Drug Classes, Schedules, and Categories

Learning Outcome 1

Discuss the basis for placing drugs into therapeutic and pharmacologic classes.

Core Concepts

1. Drugs may be organized by their therapeutic and pharmacologic classifications.

2. Drugs have more than one name.

3. A drug may be classified by its therapeutic usefulness or how the drug functions pharmacologically.

4. The therapeutic classification deals with what the drug does clinically.

5. The pharmacologic classification deals with a drug’s action or how the drug produces its effect in the body.

Suggestions for Classroom Activities

• Discuss different therapeutic classes of drugs.

• Discuss different types of drug actions and the effect in the body.

Suggestion for Clinical Activities

• Have students identify the therapeutic and pharmacologic classifications of the drugs for their assigned patient.

Learning Outcome 2

Explain the prototype approach to drug classification.

Core Concepts

1. Drugs may be organized by their therapeutic and pharmacologic classifications.

2. Drugs have more than one name.

3. A prototype drug is the original, well-understood drug in a pharmacologic class of drugs from which other drugs in that class have been developed.

Suggestion for Classroom Activities

• Discuss prototype drugs that have been replaced with a new, improved drug in a pharmacologic class.

Learning Outcome 3

Describe what is meant by a drug’s mechanism of action.

Core Concepts

1. The drug’s mechanism of action is how the drug produces its effect in the body at the cellular level.

2. Drugs may have the same therapeutic classification but different mechanisms of action.

Suggestions for Classroom Activities

• Describe different mechanisms of action of drugs.

• Discuss drugs that have the same therapeutic classification but have different mechanisms of action.

• Design a matching quiz involving the mechanisms of action of drugs.

Suggestion for Clinical Activities

• Have students identify the mechanisms of action of drugs on assigned patients.

Learning Outcome 4

Distinguish between a drug’s chemical name, generic name, and trade name.

Core Concepts

1. Most drugs have a chemical name, generic name, and trade name.

2. A drug has a chemical name, assigned by using the standards of nomenclature established by the International Union of Pure and Applied Chemistry (IUPAC), which provides information about the physical and chemical properties of the drug. The name is complicated.

3. A drug has one generic name, assigned by the United States Adopted Name Council, which is less complicated than the chemical name. Only lowercase letters are used in the name.

4. A drug may have several trade names, assigned by the drug company manufacturing and marketing the drug. The name is capitalized.

5. The trade name is proprietary, indicating ownership, and only the drug company manufacturing and marketing the drug can use that name.

6. Combination drugs contain more than one generic active ingredient.

Suggestions for Classroom Activities

• Provide the chemical, generic, or trade name of a drug and have students give the other two names.

• Assign different students a generic, trade, or chemical name. Have the students try to find their correct matches to form a trio.

• Have a timed quiz that asks students to list how many generic and trade names they can come up with for popular drugs. Whoever gets the most in the time frame wins.

Suggestion for Clinical Activities

• Have students identify the chemical, generic, and trade names for the drugs an assigned patient is receiving.

Learning Outcome 5

Explain why generic drug names are preferred to other drug names.

Core Concepts

1. The differences between brand name drugs and their generic equivalents include price, formulations, and, most importantly, bioavailability.

2. The generic name of a drug is preferred because there is only one for each drug, many health-related organizations use the generic name, and the generic name refers to the active ingredients of the drug.

Suggestions for Classroom Activities

• Discuss the advantages and disadvantages for drug companies and patients if only trade name drugs were used.

• Discuss the advantages and disadvantages of using generic name drugs.

Learning Outcome 6

Discuss why drugs are sometimes placed on a restrictive list, and why this is sometimes controversial.

Core Concepts

1. Drugs with a potential for abuse are categorized into schedules.

2. Drug companies claim that there are significant differences between trade name drugs and the generic equivalent and that switching to a generic drug may be harmful for the patient.

3. Bioavailability may be different between a trade name drug and a generic name drug because of different inert ingredients used and different tablet compression, which may change the ability to reach target cells and produce an effect.

4. A negative formulary is a list of trade name drugs that pharmacists may not dispense as generic drugs.

Suggestions for Clinical Activities

• Have available a negative formulary to show students.

• Discuss the advantages and disadvantages of a negative formulary.

• Show students the clinical facilities’ formulary list.

Learning Outcome 7

Explain the meaning of the term controlled substance.

Core Concepts

1. Drugs with a potential for abuse are categorized into schedules.

2. Controlled substances are drugs that are frequently abused or have a potential for addiction.

3. Addiction is the overwhelming feeling that causes a person to use a drug repeatedly.

4. Dependence is a physiologic or psychological need for a drug.

5. Physiologic dependence is an altered physical condition caused by the nervous system adapting to repeated drug use. When the drug is no longer available, the person experiences physical signs of discomfort known as withdrawal.

6. With psychological dependence there is an intense compelling desire to continue drug use, but few signs of physical discomfort occur when the drug is withdrawn.

Suggestions for Classroom Activities

• Discuss drugs that have a high potential for abuse and addiction. In what therapeutic classification(s) are these drugs?

• Describe characteristics of physiologic dependence, psychological dependence, and withdrawal.

Suggestion for Clinical Activities

• Assign students to observe at a drug treatment center or clinic.

Learning Outcome 8

Explain the U.S. Controlled Substance Act of 1970 and the role of the U.S. Drug Enforcement Agency (DEA) in controlling drug abuse and misuse.

Core Concepts

1. In the United States, the Controlled Substance Act of 1970, also known as the Comprehensive Drug Abuse Prevention and Control Act, restricts the use of a controlled substance.

2. The DEA determines the schedule of controlled substances, establishes production quotas for controlled substances, prevents the diversion of controlled substances to unlawful channels, and requires health care practitioners, hospitals, and pharmacies to be registered with the DEA to order and purchase controlled substances.

3. Hospitals and pharmacies must use assigned registration numbers to purchase controlled (scheduled) drugs and must maintain records of all quantities purchased and sold.

4. Schedule II drugs, which have a high abuse potential, require a written and signed order (no telephone orders) by a health care practitioner. No refills are permitted.

5. Anyone convicted of unlawfully manufacturing, distributing, and dispensing controlled substances faces severe penalties.

Suggestion for Classroom Activities

• Discuss how this act is different from the Harrison Narcotic Act of 1914.

Suggestion for Clinical Activities

• Have students observe how the records for controlled substances are kept and managed.

Learning Outcome 9

Identify the five drug schedules, and provide examples of drugs at each level.

Core Concepts

1. Drugs with a potential for abuse are categorized into schedules.

2. There are five classes of scheduled drugs based on their potential for abuse.

3. Schedule I drugs have the highest potential for abuse and have little or no therapeutic use. They are only intended for research purposes. Examples of Schedule I drugs are heroin, LSD, marijuana, and methaqualone.

4. Schedule II drugs have a high potential for abuse and dependency, a therapeutic value, and require a prescription. Examples of Schedule II drugs are morphine, PCP, cocaine, methadone, and methamphetamine.

5. Schedule III drugs have a moderate potential for abuse and dependency and are used therapeutically with a prescription. Examples of Schedule III drugs are anabolic steroids, codeine, and hydrocodone with aspirin or Tylenol and some barbiturates.

6. Schedule IV drugs have a lower potential for abuse and dependency than Schedule III drugs and are used therapeutically with a prescription. Examples of Schedule IV drugs are Darvon, Talwin, Equanil, Valium, and Xanax.

7. Schedule V drugs have the lowest potential for abuse and dependency and some may be used therapeutically without a prescription because the quantities of the controlled substance are so small. An example of a Schedule V drug is over-the-counter (OTC) cough medicines with codeine.

Suggestions for Classroom Activities

• Develop a matching quiz with schedule classes and examples of drugs in each class.

• Discuss why these scheduled drugs have the potential for abuse and dependency.

• Discuss why all drugs with an abuse potential, such as tobacco, alcohol, and caffeine, are not regulated or placed in schedules.

Suggestion for Clinical Activities

• Discuss signs and symptoms of withdrawal or abuse in a patient.

Learning Outcome 10

Identify the five pregnancy categories, and explain what each category represents.

Core Concepts

1. In order to protect the unborn, all prescription drugs are classified according to safety in pregnancy categories.

2. Pregnant women should not take any prescribed, illegal, or OTC drug or any herbal or dietary supplement without the advice of a health care practitioner because it may have a teratogenic effect on the developing fetus.

3. Prescription drugs are placed into one of five categories based on how safe they are for the pregnant woman and to protect the unborn from the teratogenic effects of the drugs.

4. There are five pregnancy categories, A, B, C, D, and X, based on degrees a drug has been proven to cause birth defects. These labels appear within package inserts.

Suggestion for Classroom Activities

• Discuss the risks of each pregnancy category and give examples of drugs for each category.

General Chapter Considerations

1. Have students study and learn the key terms listed at the beginning of the chapter.

2. Have students complete the end of chapter exercises either in their book or on the Student Resource site.

3. Use the Classroom Response Questions provided in PowerPoint to assess students prior to the lecture.

References

• U.S. Governmental Drug Regulation: http://www.usdoj.gov/dea/index.htm

Student Resource Site (nursing.pearsonhighered.com)

• Media Links

• Key Terms

• Review Questions

• Case Studies

• Nursing Process Focus Charts

Student Workbook and Resource Guide

• Chapter 2 activities

• Separate purchase

Pearson Nurse’s Drug Guide

• Separate purchase

Classroom Response Question PowerPoints

Testbank