Names of a drug, what it does in the body, and the five-plus-one rights

Pharmacology is the study of a drug and its action on a living body. It is essential knowledge for a nurse who is to give a drug safely to a patient and to monitor that patient. A chemical name shows the exact chemical structure — the summary gives a truncated example beginning ethyl 4-[…]-piperidinecarboxylate, and the rest of that string is not filled out. A generic name is the official name, entered in a national drug compendium or in the U.S. Pharmacopeia (USP) — loratadine is the example. A trade name is the brand name chosen by the manufacturer — Claritin is the example. A prescription drug needs a doctor’s order and is mainly a drug that is toxic or that carries a risk of misuse. A nonprescription drug is one the FDA has judged safe, and it can be bought without a prescription. A controlled drug is one with a high potential for abuse, strictly managed by the DEA. Development of a drug in the United States goes through a research stage of discovery and tests with animal and human cells, a clinical-trial stage that evaluates safety and effect in human beings, and FDA approval and post-marketing surveillance that monitors safety after a drug is on the market. Those stages are left without a calendar year.

After a dose is given, a drug acts through three stages: a pharmaceutic stage of dissolution, a pharmacokinetic stage of absorption, distribution, metabolism, and excretion, and a pharmacodynamic stage of the biochemical and physiological changes the drug brings about in the body. Age, weight, sex, illness, and the route of administration affect the response, and the functional state of the liver and the kidneys has a large effect on metabolism and excretion. Tolerance is a reduced effect that makes a larger dose necessary for the same effect. An accumulation effect is a raised risk of toxicity as a drug builds up in the body. An idiosyncrasy is an abnormal response from a person’s genetic difference. Drug–drug interactions include additive, synergistic, and antagonistic responses. Drug–food interactions also matter, and can hinder or enhance absorption. In a table of causes and results the summary also places Parkinson’s disease as a progressive neurodegenerative disorder that arises in the central nervous system, mainly affecting motor function, and arising from a loss of dopamine-producing cells in the substantia nigra, and parkinsonism as a similar set of symptoms that can be brought on by other illnesses. A fuller chapter on that illness is not filled out, and

The five-plus-one principles of giving a dose are the right patient — always confirm the person’s identity — the right drug — confirm that the drug prescribed and the drug in hand match — the right dose — prepare and give the prescribed dose exactly — the right route — confirm that the drug is given by the designated route, oral or injection and the like — the right time — confirm that it is given at the set time — and the right documentation — record all information about the dose exactly. In giving a dose, those principles should be kept so that safety and accuracy are assured, and they should be adjusted appropriately in light of each drug’s character and the patient’s condition. A short-term order is a drug given for a short period to ease a temporary symptom. A long-term order is a drug given for a long period to manage a chronic illness. A PRN order, pro re nata, “as needed,” is a drug given according to the patient’s need. A STAT order is a drug that must be given at once. In preparing a dose, confirm the drug against the order and carefully distinguish drugs with similar names; wash the hands cleanly before and after preparing a drug; check the medication administration record (MAR) and the drug label at least three times; and do not split a tablet or open a capsule unless a doctor has ordered it. If a medication error occurs, report it at once to the clinicians involved and take the needed steps. Teach the patient and the family clearly about the drug, and teach a way of preventing an error. A unit-dose system packages the drugs each patient needs in a 24-hour unit. An automated dispensing system uses a barcode to dispense and manage a drug exactly. By route, oral administration minimizes a patient’s physical discomfort and is the most common method; injection gives a drug directly into the blood or a tissue, intradermally, subcutaneously, intramuscularly, or intravenously; and administration through the skin and mucous membranes applies a drug locally or transdermally so that it has a systemic effect.

Worked doses, stimulants, cholinesterase inhibitors, anxiolytics, and antidepressants

A systematic process in giving a drug is essential to assure a patient’s safety and to minimize a medication error. It includes confirming the drug, calculating the dose, confirming the person’s identity, preparing the drug, and monitoring after it is given. Use of a computerized order-entry system and a barcode system matters, and these technical tools help to reduce errors and raise efficiency. Before a dose is given, the label should always be checked thoroughly. The label includes important information such as the drug name, the form, and the strength of the dose. A trade name is usually written in capital letters, and a generic name is written in lowercase in parentheses. Accurate figures are essential in preparing and giving a drug, because each figure shows the dose, the frequency, and the duration exactly. When Augmentin is labeled 125 mg/5 mL and a doctor has ordered 500 mg, the volume needed is (500 mg / 125 mg) × 5 mL = 20 mL of Augmentin. By a ratio method, when Lanoxin is labeled 0.25 mg per tablet and a patient needs 0.50 mg, 0.50 mg / 0.25 mg per tablet = 2 tablets. A liquid drug is provided as a solution in which a solute, the drug, is dissolved in a solvent, most often water, and the label shows the strength in milligrams per milliliter; the calculation divides the total milligrams needed by that strength. When a syringe is already filled at a given concentration, the exact milliliters to inject must be calculated. If diazepam is in a 2 mL syringe labeled 5 mg/mL, 5 mg is given by using only 1 mL of the syringe. A powdered drug for injection is used after a diluent is added to make a solution. This should be done exactly according to the manufacturer’s directions; a wrong dilution can lower the effect. Before reconstitution, the cautions on the label should be confirmed, and only the designated diluent used.

Central-nervous-system stimulants, as the summary enumerates them, are of three kinds. Amphetamine-type drugs are used mainly to treat attention-deficit hyperactivity disorder (ADHD). Wake-promoting drugs are used to treat narcolepsy and sleep attacks, and as an adjunct in obstructive sleep apnea; the examples are caffeine, modafinil, and armodafinil. Anorexiants are used to suppress appetite for a loss of weight; the example is lorcaserin. Clinical uses include ADHD, narcolepsy, obstructive sleep apnea, exogenous obesity, and fatigue with caffeine. The action is stimulation of the CNS, an increase in dopamine transmission, and sympathetic stimulation, which raise blood pressure, wakefulness, and pulse. Adverse effects include headache, dizziness, anxiety, disorientation, urinary retention, and tachycardia. Contraindications include a previous hypersensitivity, a seizure disorder, COPD, heart disease, hypertension, hyperthyroidism, glaucoma, and use in pregnancy. A combination with an antidepressant should be avoided, and a combination with another CNS stimulant can increase the effect. Before a dose, review the person’s present health, a history of drug use, and contraindications. During a dose, monitor the response, check blood pressure and pulse, and respond at once if an adverse effect appears. Specific nursing diagnoses include managing hyperactivity, reducing anxiety, normalizing a sleep pattern, and monitoring the cardiovascular system. Cholinesterase inhibitors — the heading in the source is written as a different word, and is treated here as cholinesterase without a typo note — are placed next to Alzheimer disease, the most common form of dementia, in which cognitive function declines with age. Main symptoms include a loss of memory, a decline in attention and in the ability to communicate in language, and a decline in the ability to solve problems. A distinctive pathological change is the appearance of amyloid plaques and neurofibrillary tangles in the cortex of the brain, bringing neurodegeneration. Cholinesterase inhibitors are used mainly in the early and middle stages of Alzheimer disease, to strengthen neurotransmission and with an aim of improving memory. They inhibit the breakdown of acetylcholine in the central nervous system, raise its concentration, slow the destruction of nerves, and improve memory and the ability to think. Adverse effects include loss of appetite, nausea, vomiting, diarrhea, dizziness, and headache. They should be avoided in a person with a hypersensitivity, in pregnancy and during nursing, and in a person with kidney disease, bladder obstruction, or a seizure disorder. The effect can be reduced with an anticholinergic, and the risk of gastrointestinal bleeding can rise when they are combined with an NSAID. Before a dose, assess overall health, a history of drug use, allergies, and existing health problems. During a dose, monitor adverse effects, the progress of the therapeutic effect, and changes in cognitive state and functional ability. Nursing diagnoses include managing a decline in cognitive function, managing a change of behavior, support in activities of daily life, and education and support for family members.

For anxiolytics, benzodiazepine-type drugs activate a GABA receptor, depress the central nervous system, and show a sedative effect. Non-benzodiazepine-type drugs act on a serotonin receptor or affect a particular part of the brain, and have less dependence. Clinical uses include an acute anxiety symptom, alcohol withdrawal, sedation before anesthesia, and a convulsion or a seizure. Adverse effects include drowsiness, grogginess, dizziness, headache, somnolence, disorientation, anger, nausea, constipation, and dry mouth. Contraindications and cautions include a hypersensitivity, psychosis, narrow-angle glaucoma, and use in pregnancy and during delivery. Long-term use of a benzodiazepine-type drug raises the risk of dementia. Interactions with alcohol, an analgesic, a tricyclic antidepressant, an antipsychotic, digoxin, and the like can raise the risk of central-nervous-system depression or toxicity. Before a dose, assess mental state, the level of anxiety, the history, anxious behavior such as a difficulty of concentration, restlessness, and frowning, and a physical assessment of blood pressure, pulse, respiration, and weight. During a dose, monitor the level of anxiety after the drug, blood pressure, the ability to act, functional ability, and adverse effects. Specific nursing diagnoses include a risk of injury, impaired comfort, and ineffective individual coping, connected with dizziness, hypotension, and a gastrointestinal problem. A hypnotic mainly induces drowsiness and is given at night or at bedtime, with the aim of promoting sleep. A sedative reduces tension and induces a sedative effect; it is used in the daytime, and can make a person drowsy, but does not bring on sleep. Clinical uses include insomnia, a convulsion or a seizure, sedation before an operation, and light sedation. Barbiturates depress the central nervous system, with an effect from sedation to a coma; benzodiazepine-type and non-benzodiazepine-type drugs mainly strengthen neural inhibition through a GABA receptor. Adverse effects include dizziness, drowsiness, headache, and nausea. They should be avoided in a person with a hypersensitivity, in a person in a coma, and in a person with a severe respiratory disorder. Interactions with an antidepressant, an opioid analgesic, an antihistamine, a phenothiazine-type drug, cimetidine, alcohol, and the like can increase central-nervous-system depression. Before a dose, measure and record vital signs such as blood pressure, pulse, and respiratory rate. During a dose, monitor the response, and confirm whether the drug has helped with sleep and whether the person is in pain or other discomfort. Specific nursing diagnoses include a risk of injury connected with drowsiness or a memory impairment, an ineffective breathing pattern connected with respiratory depression, and ineffective individual coping connected with overuse of a drug.

Depression is an emotional state that generally includes sadness, unhappiness, or a low mood, and can affect daily activity. Major depressive disorder (MDD) is a clinically diagnosed depression, and can include a persistent depressed mood, a loss of interest or pleasure, a lack of energy, a sleep disturbance, a feeling of worthlessness or guilt, a decline in concentration, a change of appetite, and thoughts of suicide. Among antidepressant names SSRIs, for example fluoxetine (Prozac) and sertraline (Zoloft); SNRIs/DNRIs, for example venlafaxine (Effexor XR) and bupropion (Wellbutrin); TCAs, for example amitriptyline and doxepin; and MAOIs, for example phenelzine and tranylcypromine. Clinical uses include a depressive episode, an anxiety disorder, bulimia nervosa, and some management of pain. The action is to block the reuptake of a neurotransmitter, stimulate the central nervous system, and ease a depressed mood. Adverse effects include drowsiness, dizziness, headache, a gastrointestinal reaction, and a sexual-function disturbance. Use is limited in a person with a hypersensitivity, where a combination with a particular drug is forbidden, and in a pregnant woman. A combination with another central-nervous-system depressant, a particular antihypertensive, or an MAOI can be dangerous. Before a dose, assess the present condition, a history of drug use, possible interactions, and the severity of the symptoms. During a dose, monitor the effect and an adverse reaction, and continually assess the person’s response. The same Korean report, at fuller length, is on CampusDown.

Sources

1. Pharmacology is the study of a drug and its action on a living body, and is essential knowledge for a nurse who is to give a drug safely to a patient and to monitor that patient. A chemical name shows the exact chemical structure (example: ethyl 4-[…]-piperidinecarboxylate; the rest of that string is not filled out). A generic name is the official name, entered in a national drug compendium or in the U.S. Pharmacopeia, USP (example: loratadine). A trade name is the brand name chosen by the manufacturer (example: Claritin). A prescription drug needs a doctor’s order and is mainly a drug that is toxic or that carries a risk of misuse. A nonprescription drug is one the FDA has judged safe, and can be bought without a prescription. A controlled drug is one with a high potential for abuse, strictly managed by the DEA. Development of a drug in the United States goes through a research stage of discovery and tests with animal and human cells, a clinical-trial stage that evaluates safety and effect in human beings, and FDA approval and post-marketing surveillance. After a dose is given, a drug acts through a pharmaceutic stage of dissolution, a pharmacokinetic stage of absorption, distribution, metabolism, and excretion, and a pharmacodynamic stage of the biochemical and physiological changes the drug brings about in the body. Age, weight, sex, illness, and the route of administration affect the response; the functional state of the liver and the kidneys has a large effect on metabolism and excretion. Tolerance: a reduced effect makes a larger dose necessary for the same effect. Accumulation effect: a raised risk of toxicity as a drug builds up in the body. Idiosyncrasy: an abnormal response from a person’s genetic difference. Drug–drug interactions include additive, synergistic, and antagonistic responses. Drug–food interactions can hinder or enhance absorption. The five-plus-one principles: right patient, right drug, right dose, right route, right time, right documentation. Short-term, long-term, PRN (pro re nata, as needed), and STAT (at once) orders. Confirm the drug against the order; distinguish similar names; wash the hands; check the MAR and the label at least three times; do not split a tablet or open a capsule unless a doctor has ordered it. If a medication error occurs, report it at once and take the needed steps; teach the patient and the family. A unit-dose system packages what each patient needs in a 24-hour unit. An automated dispensing system uses a barcode. Oral administration is the most common method and minimizes physical discomfort; injection is intradermal, subcutaneous, intramuscular, or intravenous; administration through the skin and mucous membranes may be local or transdermal with a systemic effect. A systematic process includes confirming the drug, calculating the dose, confirming identity, preparing the drug, and monitoring afterward; a computerized order-entry system and a barcode system help to reduce errors. A trade name is usually in capital letters, a generic name in lowercase in parentheses. If Augmentin is 125 mg/5 mL and 500 mg is ordered, (500 / 125) × 5 mL = 20 mL. If Lanoxin is 0.25 mg per tablet and 0.50 mg is needed, 2 tablets. If diazepam is 5 mg/mL in a 2 mL syringe and 5 mg is to be given, use 1 mL. A liquid label shows milligrams per milliliter. A powdered drug for injection is reconstituted with the designated diluent according to the manufacturer’s directions. Central-nervous-system stimulants: amphetamine-type drugs mainly for ADHD; wake-promoting drugs for narcolepsy and sleep attacks and as an adjunct in obstructive sleep apnea (caffeine, modafinil, armodafinil); anorexiants to suppress appetite (lorcaserin). Uses also include exogenous obesity and fatigue with caffeine. Action: CNS stimulation, increased dopamine transmission, sympathetic stimulation, raising blood pressure, wakefulness, and pulse. Adverse effects: headache, dizziness, anxiety, disorientation, urinary retention, tachycardia. Contraindications: previous hypersensitivity, a seizure disorder, COPD, heart disease, hypertension, hyperthyroidism, glaucoma, use in pregnancy. Avoid a combination with an antidepressant; a combination with another CNS stimulant can increase the effect. Nursing before, during, and specific diagnoses. Cholinesterase inhibitors (the source heading is treated as cholinesterase without a typo note) and Alzheimer disease, the most common form of dementia: loss of memory, a decline in attention and language, a decline in problem-solving; amyloid plaques and neurofibrillary tangles in the cortex. Used mainly in early and middle stages, to inhibit the breakdown of acetylcholine, raise its concentration, slow the destruction of nerves, and improve memory and thinking. Adverse effects: loss of appetite, nausea, vomiting, diarrhea, dizziness, headache. Avoid in hypersensitivity, pregnancy and nursing, kidney disease, bladder obstruction, a seizure disorder. An anticholinergic can reduce the effect; an NSAID can raise the risk of gastrointestinal bleeding. Anxiolytics: benzodiazepines activate a GABA receptor and depress the CNS; non-benzodiazepines act on a serotonin receptor or a particular part of the brain and have less dependence. Uses: an acute anxiety symptom, alcohol withdrawal, sedation before anesthesia, a convulsion or a seizure. Adverse effects: drowsiness, grogginess, dizziness, headache, somnolence, disorientation, anger, nausea, constipation, dry mouth. Contraindications: hypersensitivity, psychosis, narrow-angle glaucoma, pregnancy and delivery. Long-term benzodiazepine use raises the risk of dementia. Interactions with alcohol, an analgesic, a tricyclic antidepressant, an antipsychotic, digoxin, and the like. A hypnotic induces drowsiness and is given at night or at bedtime; a sedative reduces tension in the daytime and can make a person drowsy but does not bring on sleep. Uses: insomnia, a convulsion or a seizure, sedation before an operation, light sedation. Barbiturates: CNS depression from sedation to a coma; benzodiazepines and non-benzodiazepines strengthen neural inhibition through a GABA receptor. Interactions with an antidepressant, an opioid analgesic, an antihistamine, a phenothiazine, cimetidine, alcohol. Depression and major depressive disorder (MDD) including thoughts of suicide among possible symptoms. SSRIs: fluoxetine (Prozac), sertraline (Zoloft). SNRIs/DNRIs: venlafaxine (Effexor XR), bupropion (Wellbutrin). TCAs: amitriptyline, doxepin. MAOIs: phenelzine, tranylcypromine. Uses: a depressive episode, an anxiety disorder, bulimia nervosa, some management of pain. Action: block reuptake of a neurotransmitter. Adverse effects: drowsiness, dizziness, headache, a gastrointestinal reaction, a sexual-function disturbance. A combination with another CNS depressant, a particular antihypertensive, or an MAOI can be dangerous. Parkinson’s disease is placed briefly as a progressive neurodegenerative disorder of the CNS, mainly affecting motor function, from a loss of dopamine-producing cells in the substantia nigra; parkinsonism can be brought on by other illnesses. A fuller chapter is not filled out.

Last updated: 14 November 2026