Midterm Exam Study Guide
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1. 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.
2. Who determines and regulates prescriptive authority?
Answer
AZ - State Board of Nursing
3. How does limited prescriptive authority impact patients within the health-
care system?
Answer
Creates numerous barriers to quality affordable and acessible patient care.
4. What are the key responsibilities of prescribing?
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Answer
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, 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
5. Have a documented plan regarding drug monitoring or titration, if applicable.
5. What should be used to make prescribing decisions?
Answer
Cost, availability, cur- rent practice guidelines, medication interactions with food
side effects need for monitoring how drug is metabolized. special populations. ask
if prescriptions are cost prohibitive.
6. Be familiar with pharmacokinetic and pharmacodynamic changes of older
adults and how that would translate to baseline information needed to pre-
scribe.
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.
7. What is the BEERS criteria?
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Answer
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,lists potentially inappropriate drugs that lead to adverse effects in the elderly
8. 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.
9. Impacts/outcomes of polypharmacy
Answer
- drug interactions with mild side effects to life-threatening consequences
10. CYP450 inhibitors
Answer
inhibit metabolism, increase blood levels of medications
11. CYP450 inhibitors mnemonic ^ drug levels
Answer
CRACK AMIGOS
Cimetidine
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Ritonavir
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, Amiodarone
Ciprofloxacin
Ketoconazole
Acute Alcohol Use
Macrolides
Isoniazid
Grapefruit Juice
Omeprazole
Sulfonamides
12. 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
13. CYP450 inducers
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Answer
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