Bioavailability can be different between the generic and trade versions of a drug. When is it not appropriate for a generic drug to be substituted for a trade version?
1. The trade version costs the same as the generic.
2. The time for onset of action is different between the generic and trade versions.
3. The inert ingredients are different in the generic and trade versions.
4. The drug is a critical care drug, or one with a narrow safety margin.
Correct Answer: 4
Rationale 1: While the cost of the trade version is usually greater than that of the generic version of the same drug, cost does not affect bioavailability.
Rationale 2: The time of onset of action is not always an issue in using the generic over the trade version.
Rationale 3: The difference in inert ingredients is not always an issue in substitution of a generic over the trade version.
Rationale 4: The nurse should not substitute a generic drug for a trade version if the drug is a critical care drug or has a narrow safety margin.
Global Rationale: The nurse should not substitute a generic drug for a trade version if the drug is a critical care drug or has a narrow safety margin. While the cost of the trade version is usually greater than that of the generic version of the same drug, cost does not affect bioavailability. The time of onset of action is not always an issue in using the generic over the trade version. The difference in inert ingredients is not always an issue in substitution of a generic over the trade version.
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