NURS 5334 ADVANCED PHARMACOLOGY MODULE 1 |
QUESTIONS AND ANSWERS | 2024|25 VERSION
What is prescriptive authority? - Legal right to prescribe drugs
Varies for nonphysician providers
Limitations tied to oversight by MD or DO
Arguments for full prescriptive authority - - APRNs are educated to practice and
prescribe independently without supervision
- National examinations validate ability to provide safe competent care
- Licensure ensures compliance with standards to promote public health and safety -
Limited prescriptive authority creates numerous barriers to quality, affordable, &
accessible patient care
Drug selection factors - cost, guidelines, availability, interactions, side effects, allergies,
liver & renal function, need for monitoring, special populations
Elements needed to complete a prescription - - Prescriber name, license number, and
contact information
- Prescriber DEA number, if applicable
- Patient name and date of birth
- Patient allergies
- Name of medication
- Indication of medication
- Medication strength (e.g., 25 mg, 500 mg/mL)
- Dose of medication and frequency (e.g., 12.5 mg once daily)
- Number of tablets/capsules to dispense
- Number of refills
Pharmokinetics - the study of drugs within the body, absorption , distribution,
metabolism, excretion
3 ways drugs cross cell membrane - 1. channels & pores
2. transport systems (p glycoprotein)
3. direct penetration of membrane ( most common -> drugs too large to pass through
pores & channels)
absorption - the movement of a drug from its site of administration into the blood
rate of absorption determines how soon effects will begin
, amount of absorption determine intensity of effects
factors affecting absorption - rate of dissolution, surface area, blood flow, lipid solubility,
pH partitioning
P-glycoprotein - Transmembrane protein that transports a wide variety of drugs out of
cells
How does the liver aid in pharmacokinetics? - transports drugs into bile for elimination
How do the kidneys aid in pharmacokinetics? - pumps drugs into urine for excretion
How does the placenta aid in pharmacokinetics? - transports drugs back into the
maternal blood
How does the brain aid in pharmacokinetics? - pumps drugs into blood to limit drugs'
access to the brain
passive diffusion - molecules move from one side of a barrier to another without
expending energy; moving from an area of higher concentration to lower concentration
"like dissolves like" rule - Cell membranes are composed primarily of lipids; therefore,
to directly penetrate membranes, a drug must be lipid soluble (lipophilic)
polar molecules - Molecules that have an unequal distribution of charges
No net charge
ions - molecules that have a net electrical charge
quaternary ammonium compounds - molecules that contain at least 1 atom of nitrogen
and carry a positive charge at all times
pH dependent ionization - Acid is a proton donor - tends to ionize in basic (alkaline)
media
Base is a proton acceptor - tends to ionize in acidic media
ion trapping (pH partitioning) - acidic drugs accumulate on the alkaline side
basic drugs accumulate on the acidic side
blood flow to tissues - Drugs are carried by the blood to tissues and organs of the body
Blood flow determines the rate of delivery
QUESTIONS AND ANSWERS | 2024|25 VERSION
What is prescriptive authority? - Legal right to prescribe drugs
Varies for nonphysician providers
Limitations tied to oversight by MD or DO
Arguments for full prescriptive authority - - APRNs are educated to practice and
prescribe independently without supervision
- National examinations validate ability to provide safe competent care
- Licensure ensures compliance with standards to promote public health and safety -
Limited prescriptive authority creates numerous barriers to quality, affordable, &
accessible patient care
Drug selection factors - cost, guidelines, availability, interactions, side effects, allergies,
liver & renal function, need for monitoring, special populations
Elements needed to complete a prescription - - Prescriber name, license number, and
contact information
- Prescriber DEA number, if applicable
- Patient name and date of birth
- Patient allergies
- Name of medication
- Indication of medication
- Medication strength (e.g., 25 mg, 500 mg/mL)
- Dose of medication and frequency (e.g., 12.5 mg once daily)
- Number of tablets/capsules to dispense
- Number of refills
Pharmokinetics - the study of drugs within the body, absorption , distribution,
metabolism, excretion
3 ways drugs cross cell membrane - 1. channels & pores
2. transport systems (p glycoprotein)
3. direct penetration of membrane ( most common -> drugs too large to pass through
pores & channels)
absorption - the movement of a drug from its site of administration into the blood
rate of absorption determines how soon effects will begin
, amount of absorption determine intensity of effects
factors affecting absorption - rate of dissolution, surface area, blood flow, lipid solubility,
pH partitioning
P-glycoprotein - Transmembrane protein that transports a wide variety of drugs out of
cells
How does the liver aid in pharmacokinetics? - transports drugs into bile for elimination
How do the kidneys aid in pharmacokinetics? - pumps drugs into urine for excretion
How does the placenta aid in pharmacokinetics? - transports drugs back into the
maternal blood
How does the brain aid in pharmacokinetics? - pumps drugs into blood to limit drugs'
access to the brain
passive diffusion - molecules move from one side of a barrier to another without
expending energy; moving from an area of higher concentration to lower concentration
"like dissolves like" rule - Cell membranes are composed primarily of lipids; therefore,
to directly penetrate membranes, a drug must be lipid soluble (lipophilic)
polar molecules - Molecules that have an unequal distribution of charges
No net charge
ions - molecules that have a net electrical charge
quaternary ammonium compounds - molecules that contain at least 1 atom of nitrogen
and carry a positive charge at all times
pH dependent ionization - Acid is a proton donor - tends to ionize in basic (alkaline)
media
Base is a proton acceptor - tends to ionize in acidic media
ion trapping (pH partitioning) - acidic drugs accumulate on the alkaline side
basic drugs accumulate on the acidic side
blood flow to tissues - Drugs are carried by the blood to tissues and organs of the body
Blood flow determines the rate of delivery
