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R 565 :Advanced Pharmacology:NR 565 Package Deal: NR 565 Final Exam: NR 565 Midterm Exam:NR 565 Pharmacology Final Exam

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R 565 :Advanced Pharmacology:NR 565 Package Deal: NR 565 Final Exam: NR 565 Midterm Exam:NR 565 Pharmacology Final Exam

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R 565 :Advanced Pharmacology:NR 565 Package Deal: NR 565
Final Exam: NR 565 Midterm Exam:NR 565 Pharmacology Final
Exam

Which schedule drugs can APRNs prescribe? - ANSWER:II-V

Who determines and regulates prescriptive authority? - ANSWER:State Board of Nursing

How does limited prescriptive authority impact patients within the healthcare system? - ANSWER:Longer
wait times to sign a prescription

Limit practitioners that are needed in rural areas

Unequal relationships between providers.

Independent practitioners= more patients being seen= lessens the patient/provider load

What are the key responsibilities of prescribing? - ANSWER:Safe and competent practice

Understanding of the drugs, reactions, and pharmacology

Be aware of the age group you are prescribing to

What should be used to make prescribing decisions? - ANSWER:Documented provider-patient
relationship

Not prescribing for family or friends

Documenting a thorough H&P, including discussions with the patient, and drug monitoring/titrating.

Cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal function, need for
monitoring, and special populations

Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and how that would
translate to baseline information needed to prescribe. - ANSWER:increase glomerular filtration rate leads
to increase drug excretion

increase hepatic metabolism

decrease tone and motility of bowel

increase drug absorption

Beer's Criteria- What is it and Why is it important - ANSWER:Recommendations of medications
inappropriate for elderly (65 and older)

Prevents adverse drug reactions

Impacts/outcomes of polypharmacy - ANSWER:-increase risk for medication interactions

, CYP450 inhibitors

o Examples

o What do they do?

o What do they cause if not used correctly? (aka: What would the patient experience?) - ANSWER:inhibit
metabolism, increase blood levels of medications

Examples

Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit juice,
quinidine

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Examples of CYP450 inducers

o Examples

o What do they do?

o What do they cause if not used correctly? (aka: What would the patient experience?) - ANSWER:Speed
up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood levels of drug)

Examples

Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital,
sulfonylureas

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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 U.S. 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:patients never filling/refilling prescriptions (resulting
in therapeutic failure)

multiple chronic disorders

multiple prescription medications

multiple doses per day for each medication

drug packaging that is difficult to open

multiple prescribers

changes in the regimen (adding meds, changes in dose or timing)

cognitive or physical impairment (reduction in memory, hearing, visual, color, or manual dexterity)
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