Pharmacology Basics, part 1: Introduction, Drug Names, Medication Regulation and Reconciliation
by Cathy Parkes August 09, 2021 Updated: January 25, 2022 9 min read
What's the difference between Pharm Basics and Pharmacology?
The Pharmacology Basics video series, and our Pharmacology Basics and Safe Medication Administration Flashcards for Nursing Students will teach you about medications, pharmacokinetics, prescriptions, routes of administration, and the key facts and concepts you need to know to build a strong foundation to excel in Pharmacology on the ATI, HESI or NCLEX.
This series won't cover specific medications. If you have established your baseline education in Pharmacology and are ready to move on to learning specific medications, check out our Nursing Pharmacology series and our Pharmacology Flashcards for Nursing Students.
Drugs have a chemical name, a generic name, and a brand name.
The chemical name of a drug conveys the exact chemical constitution of a medication including the placement of atoms. If you had to take an organic chemistry class as a prerequisite for nursing school, then you may be familiar with these types of names.
The good news is, as a nursing student and a practicing nurse, you do not have to know chemical names.
For example, N-acetyl-p-aminophenol is the chemical name for acetaminophen.
The generic name of a drug can be used by any country or manufacturer, and the first letter of that drug name is not capitalized because it is not a proper noun.
When studying, we encourage you to focus on the generic names of medications because when you're taking a test, the generic name of a medication will always be given. However, you will not always be given the brand name. If you learn a brand name and not the generic name, and then that generic name shows up on a test, you're going to be out of luck. So make sure that you learn the generic names.
For example, acetaminophen is the generic name for Tylenol.
The use of a brand name of a drug is restricted to only that manufacturer of that drug, and it is capitalized as a proper noun.
For example, Tylenol is just one brand name under which acetaminophen is sold.
In the United States, medication is regulated by the federal government, primarily the Food and Drug Administration (FDA), who also works with other federal agencies, like the Drug Enforcement Administration (DEA) and Department of Health and Human Services (HHS).
For the purposes of Pharmacology Basics, the key medication regulations you need to know about are the US Drug Schedule and the Drug Risk Classification for Pregnancy.
US Drug Schedule
The US Drug Schedule was put forth by the Controlled Substances Act (CSA), a federal statute. This act created five schedules (classifications or categories) for drugs depending on their potential for abuse, currently accepted medical use, safety and potential for addiction.
What are the different US drug schedules?
The CSA defines five different schedules of controlled substances, numbered I-V.
- Schedule I
- Schedule II
- Schedule III
- Schedule IV
- Schedule V
Schedule I drugs have the highest potential for abuse and include illegal drugs like heroin or LSD (acid).
Schedule V drugs have a lower risk of abuse, but still a potential for abuse. Some examples of Category V medications include cough medicines with codeine, and pregabalin (Lyrica).
What is a scheduled drug?
If a drug falls into Schedule I, II, III, IV, or V as defined by the CSA, it is considered "a scheduled drug."
Are all drugs scheduled?
No. It's important to note that these categorizations are not used for all possible drugs (e.g., aspirin). The US Drug Schedules are used only for the drugs that are considered controlled substances because they meet the criteria outlined for Schedules I-V as defined by the CSA.
How are the US drug schedules defined?
The CSA defines the different drug schedules based on these questions:
- How likely is the drug to be abused?
- Is this drug used as a treatment by medical providers in the US?
- Is this drug safe? How likely is the drug to cause addiction? And if it will, what kinds of addiction?
Based on the answers to these questions, the drug is grouped into Schedule I, Schedule II, III, IV, or V.
What you need to know about scheduled drugs for nursing
Regulations surrounding scheduled drugs may vary across states, but in general, telephone orders are not acceptable. The provider must write and sign the order for scheduled drugs.
Also, no prescription refills are allowed on scheduled drugs, and if a patient needs more of one of these medications, they will need to go visit the provider first, who will write a new prescription.
Drug Risk Classification in Pregnancy
Drug risk classification in pregnancy is the FDA's system for classifying how safe a medication is for the mother and baby during pregnancy. These classifications come in A, B, C, D, and X.
Category A is the safest during pregnancy, and Category X is the most dangerous during pregnancy.
As a general matter, when in doubt, assume all medications are not safe during pregnancy unless otherwise noted by the provider.
Medication reconciliation is the process of compiling a complete and updated list of all of the medications that your patient is taking, including over-the-counter medications and herbal supplements. This list should be compared to (reconciled against) the provider's orders. This important process helps maintain consistency with the patient's medications and evaluate potential interactions between their prescribed medications, their herbal supplements, and what the provider has ordered.
There are some key herbal supplements that are known to cause interactions with prescribed medications. These supplements to watch out for include garlic, ginger, ginkgo biloba, St. John's wort, valerian, and saw palmetto.
Garlic, Ginger, Ginkgo Biloba
St. John’s Wort
St. John’s Wort increases the risk of serotonin syndrome if a patient is also taking serotonin reuptake inhibitors (SSRIs) like fluoxetine or sertraline. St. John’s Wort also decreases effectiveness of oral contraceptives, anticoagulants, and digoxin.
These medications, including their side effects and administration tips are covered in our Pharmacology Flashcards for Nursing Students.
Valerian (often sold as valerian root extract) increases sedation with CNS depressants like benzodiazepines.
Saw palmetto increases bleeding risk and interferes with hormonal therapies like testosterone and oral contraceptives.
Hi. I'm Cathy with Level Up RN, and this is the first video in our Pharm Basics video playlist. So this playlist is intended to help you build a strong foundation for pharmacology.
We'll be going over information such as medications, pharmacokinetics, prescriptions, as well as routes of administration, and I will be covering the key facts and concepts you need to know to be successful on your nursing exams and on the NCLEX, and it will help you be well-positioned to learn actual medications.
So this video playlist will not be going over specific medications. We have a separate playlist for that information. Again, it's intended to really lay that strong foundation, which is really important.
So during this playlist, I will be following along with our Pharm Basics flashcards. So if you have those flashcards, you're going to be able to follow along very easily. You don't need our flashcards to get value out of this video series; however, they are an excellent resource, and learning all of this information often takes repetition, and that's where our flashcards come in.
So both practical nurses and registered nurses can benefit from this video playlist. So there's a lot of overlap between these two programs. The important thing to remember if you're a practical nurse is your scope of practice. And then, in this video playlist, I'm going to try something new. I'm going to start giving you guys little quizzes at the end of each video to test your knowledge about some of the concepts that I have covered in the video. So I hope you'll like that. Definitely leave me a comment. And if you're new to our channel, be sure to subscribe. We're so happy you're here.
Okay. In this first video, I am going to go over drug names as well as medication reconciliation and regulation.
All right. So let's first talk about drug names. With drugs, we have a chemical name, a generic name, and a brand name.
So the chemical name conveys the exact chemical constitution of a medication including the placement of atoms. So if you had to take an organic chemistry class as a prerequisite for nursing school, then you may be familiar with these types of names. I'm happy to report that as a nursing student and a practicing nurse, you do not have to know chemical names. So if there's a nurse out there watching who's like, "I do have to know chemical names," then leave me a comment and school me on that, and it also will give me a heads-up for what position I don't want to ever have because I am not interested in learning chemical names for drugs.
Then we have our generic names. So the generic name can be used by any country or manufacturer, and the first letter of that drug name is not capitalized. So an example of a generic drug name would be acetaminophen, and acetaminophen is the generic name for Tylenol, and Tylenol is that brand name. So the use of the word Tylenol is restricted to only that manufacturer, and the first letter of the brand name is capitalized.
Now, as a nursing student and a nurse, I highly, highly encourage you to really focus on the generic names of medications because when you're taking a test, the generic name of a medication will always be given. However, you will often not be given the brand name. So if you learn a brand name and not the generic name, and then that generic name shows up on a test, you're going to be out of luck. So definitely learn the generic names of medications.
All right. Next, let's talk about medication regulation, starting with the U.S. Drug Schedule.
So medications that have the potential for abuse are categorized. So we have Category I, Category II, III, IV, and V.
Category I medications have the highest potential for abuse and would include things like heroin or LSD.
Category V medications have a lower risk of abuse but still a potential for abuse, and a Category V medication may include cough medicines with codeine. So in terms of regulations around these scheduled drugs, these regulations may vary across states, but in general, telephone orders are not acceptable.
So the provider must write and sign the order for these medications. Also, no refills are allowed, and if the patient needs more of one of these medications, they will need to go visit the provider first, who will write a new prescription for that patient.
All right. Let's now talk about drug-risk classification for pregnancy. So we have different kind of categorization here. We have A, B, C, D, and X.
So Category A is the safest during pregnancy, and Category X is the most dangerous during pregnancy. My advice to you is when in doubt, assume all medications are not safe during pregnancy unless otherwise noted by the provider.
The last thing I want to cover in this video is medication reconciliation. This is where you compile a complete and updated list of all of the medications that your patient is taking, including over-the-counter medications and herbal supplements. And we're going to be comparing that list to the provider's orders. And it's really important that we do this to maintain consistency with the medications that the patient is taking and also evaluate for any possible interactions between their prescribed medications, as well as their herbal supplements, and what the doctor has ordered.
So there are some key herbal supplements that are known to cause interactions with prescribed medications. So I've listed some of the common interactions that you may find on card number 3. So this includes ginger, garlic, Ginkgo biloba, St. John's wort, valerian, and saw palmetto. So just refer to that short list to kind of know what interactions to look out for when your patient is taking one of these herbal supplements.
All right. Time for a quiz. So my quizzes are going to be really straightforward. These particular questions I'm going to give you now are true/false. So we're not doing any select-all-that-apply or case studies or anything super involved. So question number one. Category I scheduled medications have the lowest risk for abuse. True or false? The answer is false. Category I scheduled medications have the highest risk for abuse, and Category V has a lower risk for abuse. Okay. Question number two. When performing a medication reconciliation, you need to include herbal supplements that your patient takes. True or false? The answer is true. Many of these herbal supplements have interactions with other prescribed medications, so it's going to be really important for you to get that information. Number three. Prescriptions for scheduled drugs can include a maximum of one refill. True or false? The answer is false. There are no refills allowed for scheduled medications.
All right. Hope you did well with that little quiz. If you missed anything, you might want to go back and watch the video again or review our flashcards. Thank you so much for watching.
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