Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera...
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Transcript of Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera...
Dr. DATTEN BANGUN MSc,SpFK
Dept.Farmakologi dan Terapeutik,
Fakultas KedokteranUniversitas Sumatera Utara
Classification and Naming of Drugs
Classification and Naming of Drugs
William Shakespeare:
What is in a name ?
Classification: - no homogenous way / system of classifying drugs that suits the purpose of every user. banyak tergantung kepada sipengguna;
- clinicians- pharmacologists- medicinal chemists
Nomenclature
• Drugs are categorized under broad subcategories called classifications
• Drugs with several types of therapeutic effects fit under several classifications (Aspirin)
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
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
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)
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
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
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
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
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
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
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.
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)
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)
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
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
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 ~
Example: Amphetamine
dl-2 amino-1 phenylpropane
dl-amphetamine
Benzedrine
speed, bennies, whites, etc.~
• chemical
• generic
• trade
• street
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
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 ~
Drug Equivalence
• Clinical equivalence– same behavioral effect– different chemical compounds affecting different
systems – e.g., thorazine vs. lithium ~
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)
Kadang membingungkan kita: - epinephrine; RINN - adrenaline ; BAN
3. proprietary name Commercial property of pharm.company
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
Benzodiazepines : generic name proprietary name - diazepam - valium - nitrazepam - mogadon - flurezepam - dalmane
- Adrenoceptor blockers ending in - olol- ACE – inhibitor - pril- Quinolone - floxacin
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
Keuntungan menggunakan nonproprietaryname:
1. Clarity : - nortriptyline Allegron - amitriptyline Lentizol
2. Economy: - biasanya lebih murah
3. Convenience : - bagi Apotik
PROPRIETARY NAMES
- Mahal- biaya promosi- membingungkan dokter- membingungkan pasien
Lasix ( furosemide)Losec ( omeprazole )
AXT ( zidovudne)Azathiorine
Daonil ( glibenclamide ) De – nol ( bismuth – chelate ) danol ( denazol )
Text: CNS & Behavioral Effects
• CNS Stimulants– Cocaine, amphetamine
• CNS Depressants– Barbiturates, alcohol
• Analgesics– Morphine, codeine
• Hallucinogens– Mescaline, LSD, psilocybin
• Psychotherapeutics– Prozac, thorazine ~
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 ~
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! ~
Another Example
• Attention Deficit Hyperactive Disorder
• hyperkinesis
• Treatment: Ritalin
• Methylphenidate
– classified as a sedative?
• No, a stimulant ~
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
Sources of Drugs• PlantsExample Trade Name
ClassificationChinchona Bark Quinidine Antiarrhythmic
Purple Foxglove Digitalis Cardiotonic
Poppy Plant Paregoric, Antidiarrheal,(Opium) Morphine, Analgesic,
Codeine Analgesic,
Antitussive
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
• 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
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
Questions???