Midterm Exam:NR 565 MIDTERM: Questions & Answers
(Advanced Pharmacology)
What schedule drugs can APRNs prescribe? - ANSWER:It depends on the governing body in each state. In
AZ there are no restrictions on APRN prescribing by schedule.
Who determines and regulates prescriptive authority? - ANSWER:AZ - State Board of Nursing
How does limited prescriptive authority impact patients within the healthcare system? -
ANSWER:Creates numerous barriers to quality affordable and acessible patient care.
What are the key responsibilities of prescribing? - ANSWER:1. Be prudent and deliberate in your
decision-making process
2. Have a documented provider-patient relationship with the person for whom you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side effects, or therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable.
What should be used to make prescribing decisions? - ANSWER:Cost, availability, current practice
guidelines, medication interactions with food side effects need for monitoring how drug is metabolized.
special populations. ask if prescriptions are cost prohibitive.
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and how that would
translate to baseline information needed to prescribe. - ANSWER:Older adults often metabolize drugs
more slowly. Dosages may need to be adjusted to accommodate age related changes in GI system, liver
function, kidney function, etc.
What is the BEERS criteria? - ANSWER:lists potentially inappropriate drugs that lead to adverse effects in
the elderly
why is the BEERS criteria important? - ANSWER:It provides a list of medications that are potentially
harmful in elderly. List that identifies drugs with a high likelihood of causing adverse effects in older
adults. Beers Criteria are recommendations; ultimately prescribers must determine whether a
medication is appropriate for use or not. These guidelines are not intended to limit the use of
medications or apply to all older adults. Safe and judicious prescribing is crucial in the older adult to
optimize pharmacotherapy.
Impacts/outcomes of polypharmacy - ANSWER:- drug interactions with mild side effects to life-
threatening consequences
CYP450 inhibitors - ANSWER:inhibit metabolism, increase blood levels of medications
CYP450 inhibitors mnemonic ^ drug levels - ANSWER:CRACK AMIGOS
, Cimetidine
Ritonavir
Amiodarone
Ciprofloxacin
Ketoconazole
Acute Alcohol Use
Macrolides
Isoniazid
Grapefruit Juice
Omeprazole
Sulfonamides
CYP450 inducers mnemonic - ANSWER:Bull Shit CRAP GPS induces my rage.
Barbiturates
St. John's wort
Carbamzapine
Rifampin
Alcohol (Chronic use)
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
CYP450 inducers - ANSWER:increase rate of metabolism breaking down more drug. Subsequently
reducing the therapeutic concentration of the drug.
What happens when someone has a poor metabolism phenotype? - ANSWER:medications metabolized
slower, medication might not work or put them at risk for side-effects
What does the US food and drug administration regulate when it comes to medications? -
ANSWER:Whether the drug is safe, effective, and benefits of a drug outweigh the risks
reasons for medication non-adherence - ANSWER:forgetfulness, lack of planning, cost, dissatisfaction,
altered dosing
(Advanced Pharmacology)
What schedule drugs can APRNs prescribe? - ANSWER:It depends on the governing body in each state. In
AZ there are no restrictions on APRN prescribing by schedule.
Who determines and regulates prescriptive authority? - ANSWER:AZ - State Board of Nursing
How does limited prescriptive authority impact patients within the healthcare system? -
ANSWER:Creates numerous barriers to quality affordable and acessible patient care.
What are the key responsibilities of prescribing? - ANSWER:1. Be prudent and deliberate in your
decision-making process
2. Have a documented provider-patient relationship with the person for whom you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
5.Include any discussions you have with the patient regarding risk factors, side effects, or therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable.
What should be used to make prescribing decisions? - ANSWER:Cost, availability, current practice
guidelines, medication interactions with food side effects need for monitoring how drug is metabolized.
special populations. ask if prescriptions are cost prohibitive.
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and how that would
translate to baseline information needed to prescribe. - ANSWER:Older adults often metabolize drugs
more slowly. Dosages may need to be adjusted to accommodate age related changes in GI system, liver
function, kidney function, etc.
What is the BEERS criteria? - ANSWER:lists potentially inappropriate drugs that lead to adverse effects in
the elderly
why is the BEERS criteria important? - ANSWER:It provides a list of medications that are potentially
harmful in elderly. List that identifies drugs with a high likelihood of causing adverse effects in older
adults. Beers Criteria are recommendations; ultimately prescribers must determine whether a
medication is appropriate for use or not. These guidelines are not intended to limit the use of
medications or apply to all older adults. Safe and judicious prescribing is crucial in the older adult to
optimize pharmacotherapy.
Impacts/outcomes of polypharmacy - ANSWER:- drug interactions with mild side effects to life-
threatening consequences
CYP450 inhibitors - ANSWER:inhibit metabolism, increase blood levels of medications
CYP450 inhibitors mnemonic ^ drug levels - ANSWER:CRACK AMIGOS
, Cimetidine
Ritonavir
Amiodarone
Ciprofloxacin
Ketoconazole
Acute Alcohol Use
Macrolides
Isoniazid
Grapefruit Juice
Omeprazole
Sulfonamides
CYP450 inducers mnemonic - ANSWER:Bull Shit CRAP GPS induces my rage.
Barbiturates
St. John's wort
Carbamzapine
Rifampin
Alcohol (Chronic use)
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
CYP450 inducers - ANSWER:increase rate of metabolism breaking down more drug. Subsequently
reducing the therapeutic concentration of the drug.
What happens when someone has a poor metabolism phenotype? - ANSWER:medications metabolized
slower, medication might not work or put them at risk for side-effects
What does the US food and drug administration regulate when it comes to medications? -
ANSWER:Whether the drug is safe, effective, and benefits of a drug outweigh the risks
reasons for medication non-adherence - ANSWER:forgetfulness, lack of planning, cost, dissatisfaction,
altered dosing
