Medications

Intro

Submissions by manufacturers, database maintained by the FDA
https://www.fda.gov/drugs/drug-approvals-and-databases/national-drug-code-directory
does not mean drug is FDA approved
excludes blood products, drugs only available as part of combination
updated daily
Coding System
- 10-11 digit code
- first 4-6 digits are manufacturer code
- next 3-4 digits are for name, strength, dose, form (non-standardized)
- next 1-2 digits are package codes (# of pills per package)

For most research use cases, the specific manufacturer of a chemical compound is irrelevant
Need to map all of these different codes to some intrinsic clinical meaning
commercial and public databases available

Maintained by NLM, Part of UMLS
https://www.nlm.nih.gov/research/umls/rxnorm/index.html
Normalized naming system for generic and branded drugs
Mapping between drug terminologies and pharmacy knowledge base systems
Excludes Non-therapeutic radiopharmaceuticals, bulk powders, contrast media, food, dietary supplements, and medical devices

Anatomic Therapeutic Chemical Classification
Controlled by WHO
Classifies drugs based on therapeutic of pharmaceutical class / subclass
5 levels
- First Level: Anatomic main group
- Second Level: Pharmacologic OR Therapeutic Group
- Third Level: Pharmacologic OR Therapeutic SubGroup
- Fourth Level: Additional Pharmacologic OR Therapeutic Group
- Fifth Level: Chemical Substance
Issues: many drugs have mixed mechanisms of actions, or multiple indications, but only classified into a single ATC group
Some drugs assigned under MoA rather than indication
ex: Beta Blockers: propranolol