NR 565 Advanced Pharmacology Fundamentals Week 1-4 &
Midterm Exam Study Guide
What are medication examples of Schedule II drugs?
-Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs?
-Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs?
-Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe?
Schedule II through Schedule IV
examples of reasons for medication non-adherence
-too busy
-too expensive
-ran out
-forgetting
-traveling & busy
Distribution in medication in elderly can be affected in what ways?
-decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how?
medication binds to protein so decreased protein affects how medication is absorbed and distributed
In elderly decreased body fat affects medications how?
, need fat to transport medications and some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age due to....
decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions?
***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug?
-slow or increase absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index?
-increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids
respiratory depression
Black box warning for Fentanyl
FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe)
QT interval prolongation
Black box warning for Codeine
-breastfeeding and infant death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone)
-risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic pain)
-HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are...
Midterm Exam Study Guide
What are medication examples of Schedule II drugs?
-Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs?
-Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs?
-Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe?
Schedule II through Schedule IV
examples of reasons for medication non-adherence
-too busy
-too expensive
-ran out
-forgetting
-traveling & busy
Distribution in medication in elderly can be affected in what ways?
-decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how?
medication binds to protein so decreased protein affects how medication is absorbed and distributed
In elderly decreased body fat affects medications how?
, need fat to transport medications and some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age due to....
decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions?
***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug?
-slow or increase absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index?
-increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids
respiratory depression
Black box warning for Fentanyl
FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe)
QT interval prolongation
Black box warning for Codeine
-breastfeeding and infant death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone)
-risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic pain)
-HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are...
