Classification of Drugs (To promote the Client’s Functional Health patterns)

Health Pattern

1. Activity and exercise

Class of Drugs

Antihypertensives

Antiarrhythmics

Inotropes

Anticoagulants

Bronchodilators

 

2. Nutrition and metabolism

Drugs

Antibiotics

Antiemetics

Antacids

Insulin

Corticosteroids

Thyroxine

Vitamins and minerals

 

3. Elimination


Drugs 

Laxatives

Antidiarrhoeals

Diuretics

 

4. Sleep, rest, cognition and perception

Drugs

Sedatives, hypnotics

Analgesics

Antipsychotics

 

5. Coping and stress tolerance

Drugs

Anti-anxiety agents

Anti-depressants

 

6. Sexuality and reproduction

Drugs

Ovarian hormones

(Provide hormones replacement, helps in birth control)

 

DRUG FORMS

Medications are manufactured in a variety of forms or preparations to make them more useful or easy to administer. Many medications are made in several forms. The form of drug guides the route of administration. The nurse should be quite sure to use the proper form while administering medication. One form should not be interchanged with another without the specific order from the physician because the rate of absorption or bioavailability (amount available for use by target tissue) may differ among forms

 

Common Forms of Drug Preparation


Form/Preparation

Aqueous solution

Description: one or more drugs dissolved in water

Aqueous suspension

Description: one or more drugs finely divided in a liquid such as water

Caplet

Description: tablet coated with gelatin that gets dissolved in the stomach

Capsule

Description: powder or gel form of drug encased in a hard or soft outer casing that dissolves in the stomach or powdered drugs or liquids within a gelatin container

Elixir

Description: drug dissolved in a clear liquid containing water, varying amounts of alcohol, and a sweetening agent or flavor or a solution containing alcohol, sugar or water; may or may not have active medicines

Emulsion

Description: drug in which one liquid is spread by means of small droplet over another liquid or dispersions of fat globules in water or water globules in fat

Enteric-coated tablet

Description: tablet coated with a substance that blocks absorption of drug, until it reaches the small intestine

Extract

Description: concentrated preparation of a drug from vegetables or animals generally used to preserve a drug for use in medications or highly concentrated form of drug made when the active portion is removed from the other drug components

Fluid extract

Description: alcoholic liquid extracts of drugs made by percolation, so that 1 ml of the fluid extract contains 1 gm of the drug. This is the most concentrated form of all fluid preparations. Only vegetable drugs are used

Glycerite

Description: solution of drug combined with glycerin for external use; contains atleast 50% glycerin

Intraocular disk

Description: a small flexible oval consisting of two soft outer layers and a middle layer containing medication when moistened by ocular fluid; it releases medication for upto 1 week

Liniments

Description: mixture of drugs with oil, soap, water or alcohol that is applied on the skin

Lotion

Description: drugs in liquid suspension intended for external use

Lozenge or troche

Description: drugs in a flavored or sweet base that is released as the base dissolves in the mouth to which a soothing material is added. This helps to relieve the tickling sensation at the back of the throat and stops a cough

Mucilages

Description: aqueous preparations containing viscous substances such as gums and starches

Ointment (slave)

Description: semisolid preparation of a drug or drug in petrolatum (Vaseline) that is applied to and absorbed by the skin

Paste

Description: semisolid form of a drug, thick and stiff than the ointment, that is applied to and absorbed by the skin, but penetrates the skin less than the ointment

Patch (transdermal)

Description: drugs encased in a manufactured material that allows continuous drug absorption through the skin at a steady rate

Pill

Description: drug in powder form mixed in a cohesive material. These are single dose units made by mixing the powdered drug with a liquid such as syrup and rolling the mixture into round or oval shape. It is replaced by tablets and capsules

Powder or granules

Description: a finely ground form of a drug or drugs. Some are used internally and some are used externally

Plaster

Description: solid preparation used as a counter-irritant or as an adhesive externally

Poultice

Description: soft moist preparations that supply moist heat to the body, used externally

Solution

Description: liquid preparations containing one or more substances completely dissolved in a solvent (commonly water). It may be used orally, parenterally, externally or inhaled; can be instilled into a body organ or cavity (must be sterile for parenteral use)

Suppository

Description: a drug or several drugs mixed in a firm base such as glycerinated gelatin and shaped for insertion into the body cavities such as rectum, vagina or urethra. The base melts easily and slowly at body temperature and release the drug

Suspension

Description: undissolved particles or powder placed in a liquid that must be shaken vigorously before use

Sustained-release

Description: solid dosage form that contains small particles of the drug coated with material that requires a varying  amount of time to dissolve

Syrup

Description: drug dissolved in a solution containing water and sugar, often used to disguise unpleasant taste of drugs and soothen the irritated membrane (demulcent effect)

Spansule

Description: a drug made up in a capsule in such a way that there is slow release of its contents

Spirits

Description:  a concentrated alcoholic solution of volatile substance. Also know as essence

Tablet

Description: solid drug that is compressed or moulded into a particular shape and may be swallowed whole, chewed or placed in the cheek or under the tongue, depending on it purpose. Some are readily broken along the a scored line, some are enteric-coated to prevent irritation to gastric mucosa or to prevent the effect of gastric secretions upon the drug

Tincture

Description: alcoholic or hydroalcoholic (water or alcohol base) solution prepared from drugs derived from plants

Transdermal disk or patch

Description: medication contained within semipermeable membrane, disk or patch which allows medication to be absorbed through skin slowly over long periods

Water

Description: saturated solution of volatile oils


 

Administration of Medication – Drugs and Medications, Classification of Drugs – types and forms

Classification of Drugs

Types and Forms of Drugs

Drugs may be classified in several ways: according to their chemical composition, clinical actions, therapeutic effect on body systems, their purpose and uses, by the symptoms relieved by the drug etc.

Nurses categorize the drug with similar characteristics by their class. Each class contains drugs prescribed for similar types of health problems. The class need not be the same. A drug may also belong to more than one class, e.g., aspirin is antipyretic, analgesic and an anti-inflammatory drug.

Nurses should have thorough knowledge about the general characteristics of drugs in each class. Each class of drugs has nursing implications for proper administration and monitoring. Nursing implications of all medications within a class provide guideline for safe and effective care.

 

Classification of Drugs According to Their Action

Analgesics: drugs used to relieve pain

Anaesthetics: drugs which causes loss of sensation

Anthelmintics and vermifuges: drugs which destroy and expel worms

Antipyretics: drugs which reduces fever

Antidotes: substances used to counteract the effects of poison

Anti-infectives: act either to inhibit, kill or retard the growth of micro-organism.

Anti-inflammatory: those help to reduce the inflammation

Anti-coagulants: substances which inhibit or decrease the blood-clotting process, either by inhibiting the formation of the clotting substances in the liver or by interfering with the peripheral action of these substances.

Anti-histamines: the agents which block the effect of histamines therefore used to prevent or relieve allergies

Antacids: substances that react with hydrochloric acid to decrease the activity of the gastric secretions

Anti-convulsants: those used to prevent or treat convulsions therefore it is used in epilepsy

Antibiotics: products of living micro-organisms that have the ability to destroy or inhibit the growth of other organisms

Anti-diarrhetics: agents that are used to treat diarrhea either by detoxicating the noxious substances or by killing the infectious gastrointestinal micro-organisms or merely soothe the irritated bowel mucosa and reduce the spasm

Antitussives: drugs that inhibit the cough reflex, act primarily upon the cough centre in the C.N.S

Anti-asthmatics: drugs which provide symptomatic relief of asthmatic attacks by relaxing the smooth muscles of the bronchioles

Androgens: hormones secreted by the testes and the adrenal cortex. They are steroids which can be synthesized to produce the secondary male characteristics and building up of protein tissue

Anti-pruritics: a drug that relieves itching

Anti-phlogistic: an agent used to prevent the progress of inflammation

Antiseptic: a substance that inhibits the growth of bacteria

Anti-fungal (antimycotic): drugs which prevent the growth of fungi or the destruction of the fungi

Antispasmodics: an agent that relieves the spasmodic pains or spasm of the muscles

Antiemetics: drugs relieving or preventing nausea and vomiting

Anti-tubercular: the specific drugs used in the treatment of tuberculosis

Antirheumatic: drugs used to treat rheumatism

Astringent: a drug that causes the contraction of tissues and arrest discharges

Bronchodilators: medicines which relax muscles of the bronchioles by reducing the smooth muscle spasmor mucosal oedema

Bitters: a class of chemically bitter tasting substance that belong to the group of silagogue (increase the secretion of saliva and stomachics)

Biologicals: medicinal preparations of a complex biologic nature. Their action depends on numerous phases of immunity. They include serums, vaccines, antitoxins and antigens

Coagulants: those drugs that help in the clotting of blood either by the increased formation of the liver precursors or by the clotting factors present in the drug administered

Carminatives: drugs which cause expulsion of gas from the stomach and intestines

Cathartics: drugs used to cause intestinal evacuation. They are subdivided as follows:

Laxative: have a mild action

Purgatives: are more powerful than laxatives

Drastics: have a violent action

Hydragogues: produce copious watery stool

 

Cholagogues: drugs which are supposed to increase the amount of bile secreted

Cortico-steroids: hormonal drugs extracted from the adrenal cortex

They are grouped as:

Gluco-corticoids: which stimulate the conversion of proteins to carbohydrate

Mineralo-corticoides: which regulate the sodium and potassium metabolism

Androgens: which have male sex hormone activity

 

Caustics: substances that is destructive to living tissue

Diaphoretics: drug which increase the action of sweat glands and induce perspiration

Diuretics: which increases the flow of urine

Demulcents: substances that soften soothe and protect mucus membrane

Detergents: a cleansing agent

Digestants: an agent that promotes digestion

Emetics: drug that produce vomiting

Ecbolics or Oxytocics: drugs that stimulate uterine contractions

Expectorants: increase the bronchial secretions and aid in the expulsion of the mucus (see sedative expectorant and stimulant expectorants)

Emnagogues: a drug that stimulates or favors the menstrual discharge

Emollient: substances that smoothen, soften and protect the skin

Galactagogue: substances that increase the flow of milk

Hypnotics: drugs that produce sleep

Haemostatics: an agent to check haemorrhage

Hypotensive: any substance capable of lowering blood pressure. It implies a persistent effect as opposed to the fleeting effect of a depressor

Hypoglycaemics: drugs that lower the blood sugar level

Haematinics: an agent which tends to increase the haemoglobin content of the blood

Hormones: they are the substitutes for body hormones

Inotropes: they are the drugs that strengthen cardiac contraction

Keratolytics: drugs which softens the horny layer of the skin and helps its removal

Mydriatics: dilate the pupil of the eye

Myotics: contract the pupil of the eye

Muscle relaxants: agents used for diminution of tension or functional activity of muscles

Nasal decongestants: drugs which produce shrinkage of the engorged nasal mucosa and relieve the nasal congestion

Narcotics: a drug that produces stupor or complete insensibility

Scabicides: a class of topical anti-infectives used in the treatment of scabies

Styptics: an agent that checks haemorrhage

Sedative expectorants: drugs which lessen paroxysmal cough and make it more effective by soothing the inflamed respiratory mucosa

Stimulant expectorant: drugs used to increase the bronchial secretion by irritating the bronchial mucosa

Sulphonamides: antibacterial drugs which have a chemical resemblance to para amino-benzoic acid (PABA), a substance needed for the metabolism of micro-organisms. Normal utilization of PABA  is inhibited when sulphonamide are present

Sedatives: substances which lessen the body activity

Stimulants: increase the functional activity of an organ or system

Specific: have a specific curative action in certain diseases

Stomachics or gastric tonics: drugs which increase appetite and promote digestion

Transqullizers: these are a class of drugs whose principal effect is to calm nervous, anxious, excited or disturbed clients without affecting the clarity of consciousness

Thyroid: the cleaned, dried and powdered thyroid gland administered orally in the treatment of thyroid deficiency state

Urinary antiseptics: any one of the organic or inorganic compounds when administered, is secreted by the kidneys and either stops or inhibits the growth of bacteria in the urinary tract

Vesicants: a blistering agent

Vermifuge: a drug that expels worms or intestinal parasites

Vasodilators: drugs which dilate the blood vessels and consequently lowering the blood pressure, but do not affect the action of the autonomic nervous system

Vasoconstrictors: drugs or agents that cause constriction of the blood vessels with the effect of raising the blood pressure


 

Clients with acute or chronic alternations in their health may have to use a variety of medications.

Role of Nurse in Medication


The role of nurse in the administration of medication has become increasingly complex and diversified.  Administration of correct medication and dosage by the specified route, using proper technique and taking appropriate precautions were once all that was expected of a nurse.

Besides administering medication, a nurse has to observe and interpret the client’s response to therapy, so as to recognize possible incompatibilities and interactions of medication. The nurse should have thorough knowledge about the actions and side effects of medications, and about the moral, ethical and legal aspects of drug therapy. For safe medication, she/he should be familiar with the sources of medication information, when and how to use them, ability to recognize unsafe and unclear medication orders, knowledge about what to do when such an order is encountered and also various components of safe administration of medication.

Administration of medication is a basic nursing function that involves knowledge and skill. The safe and accurate administration of medication is one of the most important responsibilities of a nurse. Improper administration of medication can cause harmful effects. The nurse administering medication should have the basic knowledge regarding drugs which include the following:

1. Name of the drug


2. Classification


3. Route and time of administration


4. Principles of drug action


5. Dosage


6. Medication standards


7. Types and forms of drugs


8. Sources of information about medication


9. System of medication distribution


10. Medication order


11. Prescription and non-prescription medication


12. Weights and measures used


13. Preparations of solution and calculation of fractional doses


14. Storing of medications


15. Factors affecting safety in the administration of medications


16. Abbreviations and symbols used


17. Rules of administration of medicine


18. Legal aspects of medication administration


19. Nurse practice acts


20. Institutional medication policies


21. Client’s rights


22. Substance abuse


23. Nurse’s role in administration of medication

 

DRUGS AND MEDICATIONS

A drug is any substance that alters physiologic function, with the potential for affecting health. Medicine may be defined as a substance used to promote health, to prevent illness, to diagnose, to alleviate or cute diseases. A medication is a substance used in the diagnosis, treatment, relief or prevention of health alternations. A drug is a chemical substance that modifies body function when taken into the living organism, which may or may not have a therapeutic effect. A medication is a drug administered for its therapeutic effects. Thus, all medications are drugs, but not all drugs are medications.

 

Name of the Drugs (Nomenclature)

Drugs may be known by several names.

 

1. Chemical name is the name by which a drug is known as chemists; usually it indicates the ingredients of the drug. It identifies the molecular structure. It describes in chemist’s terms, the placement of atoms or atomic groupings. For example, the chemical name of the anti-inflammatory agent ibuprofen is 2-4 (iso butyl phenyl propionic acid)


2. Generic name or non-proprietary name is the name assigned by the manufacturer who first developed the drug and is assigned by the United States Adopted Names Council. Subsequent manufacturers of the drug use the same generic name. Often the generic name is derived from the chemical name. Each drug has only one generic name, which is simpler than the chemical name, from which it is derived. Examples of drugs known by their generic name include morphine sulphate, ibuprofen etc.


3. Official name is the name by which the drug is identified in the official publications. For example, BP (British Pharmacopeia), USP (United State Pharmacopeia), NF (National Formulary), publications officially approved by FDA. Official name is the name assigned by the food and drug administration (FDA) after approval of a drug and is often the same as the generic name.


4. Trade name or brand name or proprietary name is the registered name assigned by the manufacturer and is copyrighted. Brand names are  nouns with the first letter capitalized and marked with a circled R (®). One drug may be manufactured by several companies and so may be known by several different trade names. For example, Paracetamol (chemical name) have different trade names, such as crocin, calpol, ifimol, metacin etc. 

administration of medication - classification and types

AUTHOR: SAJU MONZ