NR 565 Advanced Pharmacology Fundamentals Week 1-4 &
Midterm Exam Study Guide
Schedule 3-5 drugs
Drugs that APRNs can prescribe
Prescriptive authority regulation
Determined by State Boards of Nursing, Medicine, and Pharmacy
Limited prescriptive authority impact
Leads to fewer treatment options for patients, requiring them to find providers with authority
Key responsibilities of prescribing
Understanding prescribed drugs, their effects, contraindications, and ensuring correct dosages
BSCRAP GPS Incudes Rage
Acronym for CYP450 enzyme inducers: Barbiturates, St. John's Wort, Carbamazepine, Rifampin, Alcohol,
Phenytoin, Griseofulvin, Phenobarbital, Sulfonylureas
Bioavailability
Amount of active drug reaching systemic circulation from administration site
Reasons for medication nonadherence
Include forgetfulness, lack of planning, cost, dissatisfaction, and altered dosing
IM administration in neonates and infants
Absorption is slow in neonates due to low muscle blood flow; absorption becomes rapid in early infancy
Oral administration in neonates/infants
Gastric emptying time is prolonged and irregular in early infancy, affecting drug absorption
Dosage determination for pediatric patients
Based on body surface area (BSA) calculation
Guiding principles for prescribers
Steps include defining the problem, setting therapeutic objectives, choosing treatment, verifying its
suitability, starting treatment, giving information, and monitoring treatment
CYP450 inhibitors
Examples include Valproate, Isoniazid, Sulfonamides, Amiodarone, Chloramphenicol, Ketoconazole,
Grapefruit juice, Quinidine
, Pharmacokinetics and pharmacodynamics
Basis for prescribing decisions, considering drug interactions and effects on target receptors
Beer's Criteria
Tool identifying inappropriate medication use in older adults, cautioning against certain drugs and
interactions
Impacts of polypharmacy
Include adverse drug events, increased healthcare interactions, cognitive impairment, reduced
adherence, falls, and mortality
CYP450 inhibitors function
They decrease medication metabolism
CYP450 inhibitors consequences
May cause toxicity if enzymes are inactive or ineffectiveness if enzymes are overactive
Poor metabolism phenotype
Occurs when CYP2D6 alleles have inactivating mutations, leading to enzyme synthesis with impaired or
no activity
US FDA regulation
Ensures safety, efficiency, and security of human and veterinary drugs, biological products, and medical
devices
Pure Opioid Agonists
Include heroin, oxycodone, methadone, and morphine.
Pure Opioid Antagonists
Include naloxone, methylnaltrexone, and naloxegol.
Agonist-Antagonist Opioids
Include pentazocine, buprenorphine, and nalbuphine.
Opioid Risk Tool (ORT)
Predicts overdose risk based on a 5-item measure.
Prescription Drug Monitoring Program
Database tracking patient's controlled substance history.
Naloxone Prescription Criteria
Includes prior overdose, misuse, high doses, and benzodiazepines.
Midterm Exam Study Guide
Schedule 3-5 drugs
Drugs that APRNs can prescribe
Prescriptive authority regulation
Determined by State Boards of Nursing, Medicine, and Pharmacy
Limited prescriptive authority impact
Leads to fewer treatment options for patients, requiring them to find providers with authority
Key responsibilities of prescribing
Understanding prescribed drugs, their effects, contraindications, and ensuring correct dosages
BSCRAP GPS Incudes Rage
Acronym for CYP450 enzyme inducers: Barbiturates, St. John's Wort, Carbamazepine, Rifampin, Alcohol,
Phenytoin, Griseofulvin, Phenobarbital, Sulfonylureas
Bioavailability
Amount of active drug reaching systemic circulation from administration site
Reasons for medication nonadherence
Include forgetfulness, lack of planning, cost, dissatisfaction, and altered dosing
IM administration in neonates and infants
Absorption is slow in neonates due to low muscle blood flow; absorption becomes rapid in early infancy
Oral administration in neonates/infants
Gastric emptying time is prolonged and irregular in early infancy, affecting drug absorption
Dosage determination for pediatric patients
Based on body surface area (BSA) calculation
Guiding principles for prescribers
Steps include defining the problem, setting therapeutic objectives, choosing treatment, verifying its
suitability, starting treatment, giving information, and monitoring treatment
CYP450 inhibitors
Examples include Valproate, Isoniazid, Sulfonamides, Amiodarone, Chloramphenicol, Ketoconazole,
Grapefruit juice, Quinidine
, Pharmacokinetics and pharmacodynamics
Basis for prescribing decisions, considering drug interactions and effects on target receptors
Beer's Criteria
Tool identifying inappropriate medication use in older adults, cautioning against certain drugs and
interactions
Impacts of polypharmacy
Include adverse drug events, increased healthcare interactions, cognitive impairment, reduced
adherence, falls, and mortality
CYP450 inhibitors function
They decrease medication metabolism
CYP450 inhibitors consequences
May cause toxicity if enzymes are inactive or ineffectiveness if enzymes are overactive
Poor metabolism phenotype
Occurs when CYP2D6 alleles have inactivating mutations, leading to enzyme synthesis with impaired or
no activity
US FDA regulation
Ensures safety, efficiency, and security of human and veterinary drugs, biological products, and medical
devices
Pure Opioid Agonists
Include heroin, oxycodone, methadone, and morphine.
Pure Opioid Antagonists
Include naloxone, methylnaltrexone, and naloxegol.
Agonist-Antagonist Opioids
Include pentazocine, buprenorphine, and nalbuphine.
Opioid Risk Tool (ORT)
Predicts overdose risk based on a 5-item measure.
Prescription Drug Monitoring Program
Database tracking patient's controlled substance history.
Naloxone Prescription Criteria
Includes prior overdose, misuse, high doses, and benzodiazepines.
