ATCvet Code QI01
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The Anatomical Therapeutic Chemical (ATC) Classification System is a
drug classification A drug is any chemical substance other than a nutrient or an essential dietary ingredient, which, when administered to a living organism, produces a biological effect. Consumption of drugs can be via insufflation (medicine), inhalation, drug i ...
system that classifies the
active ingredients An active ingredient is any ingredient that provides biologically active or other direct effect in the diagnosis, cure, mitigation, treatment, or prevention of disease or to affect the structure or any function of the body of humans or animals. ...
of
drug A drug is any chemical substance other than a nutrient or an essential dietary ingredient, which, when administered to a living organism, produces a biological effect. Consumption of drugs can be via insufflation (medicine), inhalation, drug i ...
s according to the
organ Organ and organs may refer to: Biology * Organ (biology), a group of tissues organized to serve a common function * Organ system, a collection of organs that function together to carry out specific functions within the body. Musical instruments ...
or
system A system is a group of interacting or interrelated elements that act according to a set of rules to form a unified whole. A system, surrounded and influenced by its open system (systems theory), environment, is described by its boundaries, str ...
on which they act and their
therapeutic A therapy or medical treatment is the attempted remediation of a health problem, usually following a medical diagnosis. Both words, ''treatment'' and ''therapy'', are often abbreviated tx, Tx, or Tx. As a rule, each therapy has indications an ...
,
pharmacological Pharmacology is the science of drugs and medications, including a substance's origin, composition, pharmacokinetics, pharmacodynamics, therapeutic use, and toxicology. More specifically, it is the study of the interactions that occur between ...
and
chemical A chemical substance is a unique form of matter with constant chemical composition and characteristic properties. Chemical substances may take the form of a single element or chemical compounds. If two or more chemical substances can be combin ...
properties. Its purpose is an aid to monitor drug use and for
research Research is creative and systematic work undertaken to increase the stock of knowledge. It involves the collection, organization, and analysis of evidence to increase understanding of a topic, characterized by a particular attentiveness to ...
to improve quality medication use. It does not imply drug recommendation or
efficacy Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as '' effectiveness'', and it has often been used synonymously, although in pharmacology a distinction is now often made betwee ...
. It is controlled by the
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
Collaborating Centre for Drug Statistics Methodology (WHOCC), and was first published in 1976.


Coding system

This pharmaceutical coding system divides drugs into different groups according to the organ or system on which they act, their
therapeutic A therapy or medical treatment is the attempted remediation of a health problem, usually following a medical diagnosis. Both words, ''treatment'' and ''therapy'', are often abbreviated tx, Tx, or Tx. As a rule, each therapy has indications an ...
intent or nature, and the drug's chemical characteristics. Different brands share the same code if they have the same active substance and indications. Each bottom-level ATC code stands for a pharmaceutically used substance, or a combination of substances, in a single indication (or use). This means that one drug can have more than one code, for example
acetylsalicylic acid Aspirin () is the Generic trademark, genericized trademark for acetylsalicylic acid (ASA), a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain, fever, and inflammation, and as an antithrombotic. Specific inflammatory conditions ...
(aspirin) has as a drug for local
oral The word oral may refer to: Relating to the mouth * Relating to the mouth, the first portion of the alimentary canal that primarily receives food and liquid **Oral administration of medicines ** Oral examination (also known as an oral exam or ora ...
treatment, as a platelet inhibitor, and as an
analgesic An analgesic drug, also called simply an analgesic, antalgic, pain reliever, or painkiller, is any member of the group of drugs used for pain management. Analgesics are conceptually distinct from anesthetics, which temporarily reduce, and in s ...
and
antipyretic An antipyretic (, from ''anti-'' 'against' and ' 'feverish') is a substance that reduces fever. Antipyretics cause the hypothalamus to override a prostaglandin-induced increase in temperature. The body then works to lower the temperature, which r ...
; as well as one code can represent more than one active ingredient, for example is the combination of perindopril with amlodipine, two active ingredients that have their own codes ( and respectively) when prescribed alone. The ATC classification system is a strict hierarchy, meaning that each code necessarily has one and only one parent code, except for the 14 codes at the topmost level which have no parents. The codes are semantic identifiers, meaning they depict information by themselves beyond serving as identifiers (namely, the codes depict themselves the complete lineage of parenthood). As of 7 May 2020, there are 6,331 codes in ATC; the table below gives the count per level.


History

The ATC system is based on the earlier Anatomical Classification System, which is intended as a tool for the pharmaceutical industry to classify pharmaceutical products (as opposed to their active ingredients). This system, confusingly also called ATC, was initiated in 1971 by the
European Pharmaceutical Market Research Association European Pharmaceutical Market Research Association (EPHMRA) is a European pharmaceutical market research association established in 1961. EPHMRA aimed to provide the best methods of market research and share it with the global community. It also ...
(EphMRA) and is being maintained by the EphMRA and Intellus. Its codes are organised into four levels. The WHO's system, having five levels, is an extension and modification of the EphMRA's. It was first published in 1976.


Classification

In this system, drugs are classified into groups at five different levels:


First level

The first level of the code indicates the anatomical main group and consists of one letter. There are 14 main groups: ''Example'': C
Cardiovascular system In vertebrates, the circulatory system is a system of organs that includes the heart, blood vessels, and blood which is circulated throughout the body. It includes the cardiovascular system, or vascular system, that consists of the heart a ...


Second level

The second level of the code indicates the therapeutic subgroup and consists of two digits. ''Example'': C03
Diuretic A diuretic () is any substance that promotes diuresis, the increased production of urine. This includes forced diuresis. A diuretic tablet is sometimes colloquially called a water tablet. There are several categories of diuretics. All diuretics ...
s


Third level

The third level of the code indicates the therapeutic/pharmacological subgroup and consists of one letter. ''Example'': C03C High-ceiling diuretics


Fourth level

The fourth level of the code indicates the chemical/therapeutic/pharmacological subgroup and consists of one letter. ''Example'': C03CA
Sulfonamide In organic chemistry, the sulfonamide functional group (also spelled sulphonamide) is an organosulfur group with the Chemical structure, structure . It consists of a sulfonyl group () connected to an amine group (). Relatively speaking this gro ...
s


Fifth level

The fifth level of the code indicates the chemical substance and consists of two digits. ''Example'': C03CA01
furosemide Furosemide, sold under the brand name Lasix among others, is a loop diuretic medication used to treat edema due to heart failure, liver scarring, or kidney disease. Furosemide may also be used for the treatment of high blood pressure. It can ...


Other ATC classification systems


ATCvet

The ''Anatomical Therapeutic Chemical Classification System for veterinary medicinal products'' (ATCvet) is used to classify
veterinary Veterinary medicine is the branch of medicine that deals with the prevention, management, diagnosis, and treatment of disease, disorder, and injury in non-human animals. The scope of veterinary medicine is wide, covering all animal species, both ...
drugs. ATCvet codes can be created by placing the letter Q in front of the ATC code of most human medications. For example, furosemide for veterinary use has the code QC03CA01. Some codes are used exclusively for veterinary drugs, such as '' QI Immunologicals'', '' QJ51 Antibacterials for intramammary use'' or ''QN05AX90 amperozide''.


Herbal ATC (HATC)

The Herbal ATC system (HATC) is an ATC classification of herbal substances; it differs from the regular ATC system by using 4 digits instead of 2 at the 5th level group. The herbal classification is not adopted by WHO. The
Uppsala Monitoring Centre Uppsala Monitoring Centre (UMC) is a non-profit foundation working for the safer use of medicines and vaccines. Located in Uppsala, Sweden, UMC is the designated World Health Organization Collaborating Centre for International Drug Monitoring. UM ...
is responsible for the Herbal ATC classification, and it is part of the WHODrug Global portfolio available by
subscription The subscription business model is a business model in which a customer must pay a recurring price at regular intervals for access to a product or service. The model was pioneered by publishers of books and periodicals in the 17th century. It ...
.


Defined daily dose

The ATC system also includes defined daily doses (DDDs) for many drugs. This is a measurement of drug consumption based on the usual daily dose for a given drug. According to the definition, " e DDD is the assumed average maintenance dose per day for a drug used for its main indication in adults."


Adaptations and updates

National issues of the ATC classification, such as the
German German(s) may refer to: * Germany, the country of the Germans and German things **Germania (Roman era) * Germans, citizens of Germany, people of German ancestry, or native speakers of the German language ** For citizenship in Germany, see also Ge ...
''Anatomisch-therapeutisch-chemische Klassifikation mit Tagesdosen'', may include additional codes and DDDs not present in the WHO version. ATC follows guidelines in creating new codes for newly approved drugs. An application is submitted to WHO for ATC classification and DDD assignment. A preliminary or temporary code is assigned and published on the website and in the ''WHO Drug Information'' for comment or objection. New ATC/DDD codes are discussed at the semi-annual Working Group meeting. If accepted it becomes a final decision and published semi-annually on the website and ''WHO Drug Information'' and implemented in the annual print/on-line ACT/DDD Index on January 1. Changes to existing ATC/DDD follow a similar process to become temporary codes and if accepted become a final decision as ATC/DDD alterations. ATC and DDD alterations are only valid and implemented in the coming annual updates; the original codes must continue until the end of the year. An updated version of the complete on-line/print ATC index with DDDs is published annually on January 1.


See also

*
Classification of Pharmaco-Therapeutic Referrals The ''Classification of Pharmaco-Therapeutic Referrals'' (''CPR'') is a taxonomy that defines and groups situations requiring a referral between pharmacists and physicians regarding patients’ pharmacotherapy. It has been published in 2008. It ...
(CPR) *
ICD-10 ICD-10 is the 10th revision of the International Classification of Diseases (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, abnormal findings, complaints, social cir ...
International Classification of Diseases *
International Classification of Primary Care The International Classification of Primary Care (ICPC) is a classification method for primary care encounters. The ICPC-3 strives to be a person centered classification for Primary Care, building on the foundations of the ICPC-2. It includes ref ...
(ICPC-2) /
ICPC-2 PLUS ICPC-2 PLUS is an extended terminology classified to ICPC-2 International Classification of Primary Care, which aids data entry, retrieval and analysis. ICPC-2 PLUS takes into account the frequency distribution of problems seen in primary health car ...
*
Medical classification A medical classification is used to transform descriptions of medical diagnoses or procedures into standardized statistical code in a process known as clinical coding. Diagnosis classifications list diagnosis codes, which are used to track dise ...
*
Pharmaceutical care Pharmaceutical care is a pharmacy practice model developed in the 1990s that describes patient-centered medication management services performed by pharmacists. Medication Management Service There are many definitions for "medication management ser ...
*
Pharmacotherapy Pharmacotherapy, also known as pharmacological therapy or drug therapy, is defined as medical treatment that utilizes one or more pharmaceutical drugs to improve ongoing symptoms (symptomatic relief), treat the underlying condition, or act as a p ...
*
RxNorm RxNorm is US-specific terminology in medicine that contains all medications available on the US market. It can also be used in personal health records applications. RxNorm is part of Unified Medical Language System (UMLS) terminology and is maint ...


References


External links

* * Quarterly journal providing an overview of topics relating to medicines development and regulation. * from
EphMRA Anatomical Classification (ATC and NFC)

atcd
R script to scrape the ATC data from the WHOCC website; contains link to download entire ATC tree. {{portal bar , Medicine Drugs Pharmacological classification systems World Health Organization