2.1. Explain the classifications of medicine

This guide will help you answer 2.1. Explain the classifications of medicine.

Medicines are substances used to prevent, treat, or manage diseases and medical conditions. In the UK, medicines are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) to ensure their safety, quality, and effectiveness. Medicines are classified into several categories based on factors such as their legal availability, use, and the way they act in the body. Understanding these classifications is important for health and social care workers to ensure proper handling, administration, and patient understanding of their treatments.

Legal Classifications of Medicine

The legal classification of medicines determines how they can be supplied, prescribed, or administered. There are three main legal categories in the UK.

Prescription-Only Medicines (POM)

Prescription-only medicines can only be supplied with a prescription written by an authorised healthcare professional. These professionals include doctors, dentists, and certain nurses or pharmacists with prescribing qualifications. POMs are used to treat conditions that require diagnosis or monitoring by a healthcare professional.

Examples:

• Antibiotics, like amoxicillin, for bacterial infections
• Insulin, for managing diabetes
• Antidepressants, like sertraline, for mental health conditions

Reasons for restriction:

1. The medicine could be harmful if misused.
2. Expert advice is required before use.
3. The condition it treats needs ongoing monitoring.

Pharmacy Medicines (P)

Pharmacy medicines can be purchased without a prescription but only from a pharmacy and under the supervision of a pharmacist. These medicines treat less complex conditions that do not always need a doctor’s intervention but still require professional advice.

Examples:

• Pain relievers like ibuprofen in certain pack sizes
• Cough syrups containing codeine
• Antihistamines like chlorphenamine for allergies

Pharmacist’s role:
Pharmacists ensure the medicine is appropriate, check for contraindications (conditions where the medicine may cause harm), and provide guidance on how to use it safely.

General Sales List Medicines (GSL)

GSL medicines can be purchased over the counter in many shops, supermarkets, or online. They are considered safe for use without professional supervision, provided users follow the instructions on the packaging.

Examples:

• Paracetamol in small pack sizes
• Antacids for indigestion
• Simple cough syrups

Key features:

1. They have a wide safety margin.
2. They are for conditions people can self-diagnose and manage.

Therapeutic Classifications of Medicine

Medicines are also classified by how they work or the type of condition they treat. This form of classification is known as ‘therapeutic classification’. Below are some of the common therapeutic categories:

Analgesics

Analgesics are pain-relieving medicines. They work by interfering with the transmission of pain signals in the body.

Examples:

• Paracetamol for mild pain
• Ibuprofen (also an anti-inflammatory)
• Morphine for severe pain

Antibiotics

Antibiotics are used to treat bacterial infections. They work by killing bacteria or stopping them from multiplying.

Examples:

• Amoxicillin, for chest infections
• Ciprofloxacin, for urinary tract infections

Important point: Antibiotics do not work against viruses, such as those causing colds or flu. Overuse can cause antibiotic resistance, making infections harder to treat.

Antidepressants

These medicines treat depression and other mental health conditions by altering chemical imbalances in the brain.

Examples:

• Sertraline, which affects serotonin levels (a mood-related chemical)
• Amitriptyline, for treating depression as well as nerve pain

Antihistamines

Antihistamines treat allergic reactions by blocking histamine, a chemical released by the body in response to an allergen.

Examples:

• Loratadine, for hay fever
• Diphenhydramine, for itching and rashes

Antihypertensive Medicines

These medicines control high blood pressure (hypertension). They lower blood pressure to reduce the risk of strokes or heart attacks.

Examples:

• Ramipril, an ACE inhibitor that relaxes blood vessels
• Amlodipine, a calcium channel blocker

Anticoagulants and Antiplatelets

These medicines reduce the risk of blood clot formation. They are used to prevent conditions like strokes and deep vein thrombosis (DVT).

Examples:

• Warfarin, an anticoagulant
• Aspirin, an antiplatelet medicine

Pharmacological Classifications of Medicine

Pharmacological classification refers to how a medicine works in the body or its mechanism of action.

Beta-Blockers

Beta-blockers reduce the effect of adrenaline on the heart. This slows the heart rate and lowers blood pressure. They are used for conditions like hypertension and anxiety.

Examples:

• Propranolol
• Atenolol

Diuretics

Diuretics, often called ‘water tablets’, increase the amount of water and salt expelled from the body through urine. They are prescribed for conditions like heart failure or kidney disease.

Examples:

• Furosemide
• Bendroflumethiazide

Proton Pump Inhibitors (PPIs)

PPIs reduce stomach acid production. They treat acid reflux, ulcers, and other gastrointestinal conditions.

Examples:

• Omeprazole
• Lansoprazole

Bronchodilators

Bronchodilators relax the muscles around the airways, making it easier to breathe. They are commonly used to treat asthma and chronic obstructive pulmonary disease (COPD).

Examples:

• Salbutamol, a short-acting bronchodilator
• Tiotropium, a long-acting bronchodilator

Over-the-Counter and Herbal Medicines

Over-the-Counter (OTC) Medicines

OTC medicines are non-prescription medicines available in pharmacies and general shops. They are used for minor health problems.

Examples:

• Cold and flu remedies, like Lemsip
• Laxatives for constipation

Although OTC medicines are accessible, misuse or exceeding the recommended dosage can still cause harm.

Herbal Medicines

Herbal medicines are made from plants or plant extracts. They are popular for alternative or natural treatments. However, they are not classified as medicines if not licensed, and some can interfere with prescribed drugs.

Examples:

• St John’s Wort, used for mild depression
• Echinacea, claimed to boost the immune system

Special Categories of Medicines

Some medicines have specific classifications due to their purpose or potential harm.

Controlled Drugs (CDs)

Controlled Drugs are tightly regulated because of their potential for misuse and harm. Healthcare workers must follow strict legal requirements when storing, prescribing, and administering them.

Examples:

• Morphine, used for pain relief
• Diazepam, used for anxiety

Black Triangle Medicines

Black triangle medicines are new or have unique features (e.g., a new combination of active ingredients). They require additional monitoring to collect data about their safety.

Identifiable by: A black triangle symbol (▼) on their packaging.

Final Thoughts

Medicines are classified in different ways to help manage their risks, monitor their effects, and improve their use. Legal classifications determine how they are accessed, while therapeutic and pharmacological classifications relate to their purpose and mechanism of action. Understanding these distinctions helps health and social care workers provide better support for individuals receiving medication. For this reason, it is important to consistently follow guidelines and work alongside healthcare professionals to support safe and effective medication use.