Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera...

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Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs

Transcript of Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera...

Page 1: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Dr. DATTEN BANGUN MSc,SpFK

Dept.Farmakologi dan Terapeutik,

Fakultas KedokteranUniversitas Sumatera Utara

Classification and Naming of Drugs

Page 2: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Classification and Naming of Drugs

William Shakespeare:

What is in a name ?

Page 3: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Classification: - no homogenous way / system of classifying drugs that suits the purpose of every user. banyak tergantung kepada sipengguna;

- clinicians- pharmacologists- medicinal chemists

Page 4: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature

• Drugs are categorized under broad subcategories called classifications

• Drugs with several types of therapeutic effects fit under several classifications (Aspirin)

Page 5: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Drugs may be classified by:

body system * alimentary * cardiovascular therapeutic use * receptor blokers * ion channels mode of action * molecular interaction * cellular site molecular structure * glycoside * alkaloid * steroid

Page 6: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Drug NomenclatureDrugs are identified by one of three names:

1. Chemical:

-long name, refers to the chemical structure of the drug

2. Generic:

-shorter preferred name, derived from the chemical name

3. Trade-brand name:

- assigned by the manufacturer

Page 7: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Classifications (cont.)

• The same drug may belong to more than one classification– Propranalol: B-blocker (physiologic action),

antianginal, antiarrhythmic, antihypertensive– Perphenazine: antiemetic =controls N/V,

antipsychotic = anticholinergic side effects (dry mouth, constipation, urinary retention, blurred vision, tachycardia, sedation)

Page 8: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature/Classifications (cont.)

• Prototype Drug = representative of many drugs within the class– Diazepam: Benzodiazepine, sedative/hypnotic,

antianxiety– Similarities: pharmacokinetics,

pharmacodynamics, effects, side effects, adverse reactions, contraindications, drug/food interaction

Page 9: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names

• Generic– Name given to drug before it becomes official– Given by the United States Adopted Names

Council– Typically derived from chemical name– Usually shorter

Page 10: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names (cont.)

*Trade– Name that is registered by the manufacturer– Followed by the trademark symbol®– Can only be used by the manufacturer– May have several trade names (depending

on number of manufacturers)– The first letter of the name is capitalized

*ChemicalGives exact chemical composition of the drug Places atoms or molecular structure

Page 11: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names (cont.)

• Official– Name listed in the United States

Pharmacopoeia-National Formulary– May be the same as the generic name

• = Acetaminophen/N-acetyl-p- aminophenol/Tylenol, Datil

Page 12: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names (cont.)

• When a new drug is produced it is given a generic name

• It must be tested and approved by the FDA• Listed in the USP/NF by an official name• Producing company has an exclusive right for 17

years and other companies can produce the same drug, but will assign own trade name

Page 13: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names (cont.)

• Combination drugs– Have several generic names, but only one

trade name– Darvocet-N-100 = Acetaminophen 650mg,

Propoxypene napsylate, 100mg

Trade names with numbersThe number refers to the amount of one of the generic componentsA differentiating factorNumber represents the amount of the controlled substance

Page 14: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names (cont.)

Trade Name Generic Name

Empirin Aspirin 325mg

Empirin #1 Aspirin 325 mg

Codeine Phosphate 7.5mg

Empirin #2 Aspirin 325 mg

Codeine Phosphate 15mg

The larger the number, the greater the amount of the controlled substance contained therein.

Page 15: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names (cont.)

• Potential med errors– Trade name misinterpreted for the # of

tablets to give– Allergic reaction to one of the generic

components (check for aspirin allergy)– Giving 2 #3’s instead of one #4 (doubles the

dose of aspirin from 325mg to 650mg)

Page 16: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature / Drug Names (cont.)

• Patient Education– Generic and trade name drugs have same basic

ingredients by law

• Trade name drug is more expensive – Advertising– Pharmacy dispension– Though basic ingredients are same, the “fillers” may be

different (fillers may effect speed drug is dissolved or takes effect, some dyes may cause allergic reaction)

Page 17: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Drug Naming

• Chemical Name - describe chemical structure (rarely seen in medical literature)

• Code Name - short letter-number combination used for experimental drugs

• Generic Name - a name assigned to drug that can be used by anyone (not proprietary)

• Trade Name - Proprietary name given to the drug by the manufacturer

Page 18: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Naming Complications

Brand names can change over time as patents expire or companies merge

Most drugs are marketed by numerous names in different countries

Even generic names can differ in different countries

Page 19: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Drug Names• At least 3 names

1. Chemical name– describes molecular structure

2. Generic name– official legal name

3. Trade name– brand name

• Street name ~

Page 20: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Example: Amphetamine

dl-2 amino-1 phenylpropane

dl-amphetamine

Benzedrine

speed, bennies, whites, etc.~

• chemical

• generic

• trade

• street

Page 21: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Example: Valium

7-chloro--1-methyl-5-phenyl-3H-1,4-benzodiazepin-2[1H]-one

diazepam

valium

tranks, downers, blues, yellows

• chemical

• generic

• trade

• street

Page 22: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Drug Equivalence

• Important to know when prescribing

• Chemical equivalence– identical chemical compounds– e.g., Miltown & Equanil (meprobamate)

• Biological equivalence– different chemical compounds– affect the same systems in same way – e.g., Prozac vs. Zoloft ~

Page 23: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Drug Equivalence

• Clinical equivalence– same behavioral effect– different chemical compounds affecting different

systems – e.g., thorazine vs. lithium ~

Page 24: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Nomenclature ( names):

Ada 3 cara / jenis nama 1. full chemical name

2. chosen by official bodies used in pharmacopoeias chosen by official bodies WHO memilih Recommended international Nonproprietary Names (RINN)

Page 25: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Kadang membingungkan kita: - epinephrine; RINN - adrenaline ; BAN

3. proprietary name Commercial property of pharm.company

Page 26: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Exs : 1. 3- (10.11 dihydro – 5 H – dibenz { 6.f } – azepin 5 – yl ) proopydimethy- lamine.

2. imipramine

3. tofranil (UK), Prodepress, Surplix, deprinol etc

Page 27: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Benzodiazepines : generic name proprietary name - diazepam - valium - nitrazepam - mogadon - flurezepam - dalmane

- Adrenoceptor blockers ending in - olol- ACE – inhibitor - pril- Quinolone - floxacin

Page 28: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Bila tidak lagi dibawah “patent restriction Obat dapat diproduksi oleh pabrik apapun dengan nama apa saja.

Kewajiban authority : memastikan bahwa:- Pharmaceutically - Biologically -------------- Keduanya equivalent.

Misalnya: Amoxicillin

Page 29: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Keuntungan menggunakan nonproprietaryname:

1. Clarity : - nortriptyline Allegron - amitriptyline Lentizol

2. Economy: - biasanya lebih murah

3. Convenience : - bagi Apotik

Page 30: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

PROPRIETARY NAMES

- Mahal- biaya promosi- membingungkan dokter- membingungkan pasien

Lasix ( furosemide)Losec ( omeprazole )

Page 31: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

AXT ( zidovudne)Azathiorine

Daonil ( glibenclamide ) De – nol ( bismuth – chelate ) danol ( denazol )

Page 32: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Text: CNS & Behavioral Effects

• CNS Stimulants– Cocaine, amphetamine

• CNS Depressants– Barbiturates, alcohol

• Analgesics– Morphine, codeine

• Hallucinogens– Mescaline, LSD, psilocybin

• Psychotherapeutics– Prozac, thorazine ~

Page 33: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Drug laws & legal classification• Controlled Substances Act of 1970• 5 schedules

– abuse potential

– medicinal value

• Schedule I

– high abuse potential

– no accepted medicinal value ~

Schedule II-high abuse potential- accepted medicinal value

Schedule III- moderate abuse potential

Schedule IV - low abuse potentialSchedule V - abuse potential < IV ~

Page 34: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Classification Problems

• Alcohol effects– General nervous system depressant

• Effects depend on dose– Low dose behavioral excitation– High dose behavioral inhibition

• What are the effects of alcohol?

It depends! ~

Page 35: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Another Example

• Attention Deficit Hyperactive Disorder

• hyperkinesis

• Treatment: Ritalin

• Methylphenidate

– classified as a sedative?

• No, a stimulant ~

Page 36: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Sources of Drugs

• Plants = primary source of substances used in human body– Berries, bark, leaves, resin from trees, roots

• Minerals = from the earth & soil– Iron, sulfur, potassium, silver & even gold

• Animals = substances from the glands, organs & tissues of animals– Pork insulin

• Synthetic = man made (test tube drugs)

Any chemical substance taken into body for the purpose of affecting body function is referred to as a drug

Page 37: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Sources of Drugs• PlantsExample Trade Name

ClassificationChinchona Bark Quinidine Antiarrhythmic

Purple Foxglove Digitalis Cardiotonic

Poppy Plant Paregoric, Antidiarrheal,(Opium) Morphine, Analgesic,

Codeine Analgesic,

Antitussive

Page 38: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Sources of Drugs• MineralsExample Trade Name ClassificationMagnesium Milk of Magnesia Antacid, Laxative

Zinc Zinc Oxide Oint. Sunscreen, Skin Protectant

Gold Solganal, Auranofin Anti-inflammatory; Used in tx

of Rheumatoid

Arthritis

Page 39: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

• AnimalsExample Trade Name

ClassificationPancreas of Cow, Insulin; regular, AntidiabeticHog NPH, PZI Hormone

Stomach of Cow, Pepsin DigestiveHog Hormone

Thyroid Gland Thyroid, USP HormoneOf Animals

Sources of Drugs

Page 40: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Sources of Drugs• SyntheticExample Trade Name ClassificationMeperidine Demerol Analgesic

Diphenoxylate Lomotil Antidiarrheal

Co-Trimoxazole Bactrim, Septra Anti-Infective Sulfonamide;

Used in the treatment of UTI’s

Page 41: Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara Classification and Naming of Drugs.

Questions???