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Classification and Naming of Drugs Dr. DATTEN BANGUN MSc,SpFK Dept.Farmakologi dan Terapeutik, Fakultas Kedokteran Universitas Sumatera Utara 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 Nomenclature Drugs 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 *Chemical Gives 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-paminophenol/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 numbers The number refers to the amount of one of the generic components A differentiating factor Number represents the amount of the controlled substance Nomenclature / Drug Names (cont.) Trade Name Empirin Empirin #1 Generic Name Aspirin 325mg 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 • chemical dl-2 amino-1 phenylpropane • generic dl-amphetamine • trade Benzedrine • street speed, bennies, whites, etc.~ Example: Valium • chemical 7-chloro--1-methyl-5-phenyl-3H-1,4benzodiazepin-2[1H]-one • generic diazepam • trade valium • street tranks, downers, blues, yellows 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 ) proopydimethylamine. 2. imipramine 3. tofranil (UK), Prodepress, Surplix, deprinol etc Benzodiazepines : generic name - diazepam - nitrazepam - flurezepam proprietary name - valium - mogadon - 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 nonproprietary name: 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 potential Schedule 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 Any chemical substance taken into body for the purpose of affecting body function is referred to as a drug • 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) Sources of Drugs • Plants Example Trade Name Classification Chinchona Bark Quinidine Antiarrhythmic Purple Foxglove Digitalis Cardiotonic Poppy Plant (Opium) Paregoric, Morphine, Codeine Antidiarrheal, Analgesic, Analgesic, Antitussive Sources of Drugs • Minerals Example Trade Name Classification Magnesium Milk of Magnesia Antacid, Laxative Zinc Zinc Oxide Oint. Sunscreen, Skin Protectant Gold Solganal, Auranofin Anti-inflammatory; Used in tx of Rheumatoid Arthritis Sources of Drugs • Animals Example Trade Name Classification Pancreas of Cow, Hog Insulin; regular, NPH, PZI Antidiabetic Hormone Stomach of Cow, Hog Pepsin Digestive Hormone Thyroid Gland Hormone Of Animals Thyroid, USP Sources of Drugs • Synthetic Example Trade Name Classification Meperidine Demerol Analgesic Diphenoxylate Lomotil Antidiarrheal Co-Trimoxazole Bactrim, Septra Anti-Infective Sulfonamide; Used in the treatment of UTI’s Questions???