NR565 / NR 565 Midterm Exam Study Guide (Latest 2025 UPDATED):
Advanced Pharmacology Fundamentals - Chamberlain
APRN prescribing role - (ANSWER)Prescriptive authority for nurse practitioners also regulates
prescribing rights beyond medications and controlled substances. These rights include
therapeutic devices and services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds,
portable oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive authority
encompasses more than writing a prescription correctly. It requires adherence to ethical
guidelines to ensure that patients are safeguarded from harm. Ethical prescribing starts with
being well-informed about medications. Mechanism of action, efficacy, and safety are important
considerations, as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). Most patients receiving a prescription are
taking other medications, whether prescription or over-the-counter. Appropriate selection,
dosing, and duration of pharmaceutical agents are key to maximizing outcomes and minimizing
adverse effects
benefits of full practice authority - (ANSWER)Nurse practitioners have the autonomy to evaluate
patients, diagnose, order and interpret tests, initiate and manage treatments and prescribe
medications, including controlled substances without physician oversight
你是想要一篇“眼睛容易阅读的”
promoting positive outcomes中文文章，还是一篇关于“眼睛”
through prudent prescribing practices - (ANSWER)Administering
medications and prescribing medications are two distinct processes. Prescription writing requires
主题的中文文章？
prudent and deliberate decision-making processes to maintain patient safety and reduce liability,
including:
*documentation of a provider-patient relationship for the recipient of the prescribed medications
*documentation of a thorough history and physical examination for the recipient
*documentation of discussions regarding risk factors, side effects, or therapy options
*documentation of drug monitoring or titration plan, if applicable
,*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a diagnosis
based on clinical reasoning and the selection and monitoring of the most appropriate
pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects, allergies,
hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria - (ANSWER)identifies drugs with a high likelihood of causing adverse effects in
older adults. Accordingly, drugs on this list should generally be avoided in adults older than 65
years except when the benefits are significantly greater than the risks.
Pharmacodynamics - (ANSWER)the study of the biochemical and physiologic effects of drugs
on the body and the molecular mechanisms by which those effects are produced
Pharmacokinetics - (ANSWER)the study of drug movement throughout the body
你是想要一篇“眼睛容易阅读的”
中文文章，还是一篇关于“眼睛”
Pharmacogenomics - (ANSWER)the主题的中文文章？ study of how genes affect a person's response to drugs. The
purpose of this is to combine the sciences of genomics and pharmacology to provide
individualized, targeted, safe drug therapies to patients
CYP450 inducers - (ANSWER)Inducers are xenobiotics (medications and environmental agents)
that elevate CYP450 enzyme activity by increasing enzyme synthesis. This action leads to
additional sites available for biotransformation. The increased number of sites enhances
medication metabolism, decreasing the concentration of the "parent drug" while increasing
metabolite production.
Inducers = Increase medication metabolism
,(Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin, Phenobarbital, Sulfonylureas)
CYP450 inhibitors - (ANSWER)Inhibitors are medications that inhibit the metabolic activity of
one or more of the CYP450 enzymes. Medications that inhibit an enzyme potentially slows that
enzyme's activity or blocks the activity required for the metabolism of other medications, thereby
increasing the levels of medications dependent on that particular enzyme for biotransformation.
Inhibitors = decrease medication metabolism (Valproate, Isoniazid, Sulfonamides, Amiodarone,
Chloramphenicol, Ketoconazole, Grapefruit Juice, Quinidine)
cultural influences in prescribing - (ANSWER)The greatest concern surrounding race-based
therapy has to do with genetic variability. We know there is great diversity within and among
racial groups; therefore, a "one fits all" approach based on race is unwise. Still, we can use
known associations to guide choices. For example, differences in metabolism between people
with East Asian and European heritage are common. The provider can use this knowledge to
guide initial dosing (with adjustment, as indicated based on response) if genetic testing is not
feasible or warranted
Polypharmacy: Definition, challenges, and outcomes - (ANSWER)treatment with multiple drugs
greatly increases the risk for interactions. Some of these interactions are negligible, but some can
have life-threatening consequences. It is of crucial importance to ask the patient about all current
你是想要一篇“眼睛容易阅读的”
drugs, including over-the-counter (OTC) medications and other herbal preparations. Many
patients do not consider OTC中文文章，还是一篇关于“眼睛”
or alternative pharmaceuticals as "medications" and may not
mention them unless you ask主题的中文文章？
specifically.
Acute Pain Management - (ANSWER)
Chronic Pain Management - (ANSWER)
Opioid Management - (ANSWER)
Regulations of Controlled Substances - (ANSWER)The U.S. Department of Justice Drug
Enforcement Agency (DEA) coordinates with local, state, and federal agents to reduce illicit
drug use. The DEA enacted the Controlled Substances Act (CSA) in 1970 to regulate drugs and
, other substances based on their potential for abuse and dependency. Five schedules of controlled
substances were created that are updated annually. Classes of scheduled substances include
narcotics, depressants, stimulants, hallucinogens, and anabolic steroids. The DEA issues eligible
providers with a registration number to write prescriptions for controlled substances.
Characteristics of a valid DEA number include:
-The first letter identifies the type of provider: A=before 1985; B=after 1985; F=after 2007;
M=nurse practitioner or physician assistant
-The 2nd letter the 1st letter of the provider's last name at the time of initial registration
Example: Tammy Greene applies for and receives a DEA number of MG2705208
M=nurse practitioner and G=Greene
Opioid Epidemic & Responsible Prescribing - (ANSWER)
Opioid Use Disorder - (ANSWER)a pattern of use that leads to significant impairment or
distress. Typically, this disorder is marked by unsuccessful efforts to reduce or control use
resulting in the inability to fulfill work, school, or home responsibilities. Opioid use disorder is
different from drug tolerance and physical dependence, which may also exist. Opioid use creates
high levels of positive reinforcement, increasing the likelihood of continued use. It is often a
chronic lifelong disorder, leading to serious consequences such as disability and death. Although
it is similar to other substance use disorders, it has distinct features that have fueled the current
你是想要一篇“眼睛容易阅读的”
opioid epidemic. Opioids can中文文章，还是一篇关于“眼睛”
lead to physical dependence in only 4-8 weeks. Abruptly stopping
use in chronic users leads to severe symptoms, which motivates continued use to prevent
主题的中文文章？
withdrawal. The 2016 CDC guidelines for prescribing opioids recommends calculating the total
daily dose of opioids to help identify patients who might benefit from the reduction or tapering
of opioids, given the risk of overdose
State Prescription Drug - (ANSWER)Clinicians should review the patient's history of controlled
substance prescriptions using state prescription drug monitoring program (PDMP) data to
determine whether the patient is receiving opioid dosages or dangerous combinations that put
him or her at high risk for overdose. Clinicians should review PDMP data when starting opioid
therapy for chronic pain and periodically during opioid therapy for chronic pain, ranging from
every prescription to every 3 months.
Monitoring Programs - (ANSWER)safeguards to address the opioid public health crisis include
prescription drug monitoring programs (PDMPs). These electronic databases enable providers to
Advanced Pharmacology Fundamentals - Chamberlain
APRN prescribing role - (ANSWER)Prescriptive authority for nurse practitioners also regulates
prescribing rights beyond medications and controlled substances. These rights include
therapeutic devices and services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds,
portable oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive authority
encompasses more than writing a prescription correctly. It requires adherence to ethical
guidelines to ensure that patients are safeguarded from harm. Ethical prescribing starts with
being well-informed about medications. Mechanism of action, efficacy, and safety are important
considerations, as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). Most patients receiving a prescription are
taking other medications, whether prescription or over-the-counter. Appropriate selection,
dosing, and duration of pharmaceutical agents are key to maximizing outcomes and minimizing
adverse effects
benefits of full practice authority - (ANSWER)Nurse practitioners have the autonomy to evaluate
patients, diagnose, order and interpret tests, initiate and manage treatments and prescribe
medications, including controlled substances without physician oversight
你是想要一篇“眼睛容易阅读的”
promoting positive outcomes中文文章，还是一篇关于“眼睛”
through prudent prescribing practices - (ANSWER)Administering
medications and prescribing medications are two distinct processes. Prescription writing requires
主题的中文文章？
prudent and deliberate decision-making processes to maintain patient safety and reduce liability,
including:
*documentation of a provider-patient relationship for the recipient of the prescribed medications
*documentation of a thorough history and physical examination for the recipient
*documentation of discussions regarding risk factors, side effects, or therapy options
*documentation of drug monitoring or titration plan, if applicable
,*documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a diagnosis
based on clinical reasoning and the selection and monitoring of the most appropriate
pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects, allergies,
hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria - (ANSWER)identifies drugs with a high likelihood of causing adverse effects in
older adults. Accordingly, drugs on this list should generally be avoided in adults older than 65
years except when the benefits are significantly greater than the risks.
Pharmacodynamics - (ANSWER)the study of the biochemical and physiologic effects of drugs
on the body and the molecular mechanisms by which those effects are produced
Pharmacokinetics - (ANSWER)the study of drug movement throughout the body
你是想要一篇“眼睛容易阅读的”
中文文章，还是一篇关于“眼睛”
Pharmacogenomics - (ANSWER)the主题的中文文章？ study of how genes affect a person's response to drugs. The
purpose of this is to combine the sciences of genomics and pharmacology to provide
individualized, targeted, safe drug therapies to patients
CYP450 inducers - (ANSWER)Inducers are xenobiotics (medications and environmental agents)
that elevate CYP450 enzyme activity by increasing enzyme synthesis. This action leads to
additional sites available for biotransformation. The increased number of sites enhances
medication metabolism, decreasing the concentration of the "parent drug" while increasing
metabolite production.
Inducers = Increase medication metabolism
,(Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin, Phenobarbital, Sulfonylureas)
CYP450 inhibitors - (ANSWER)Inhibitors are medications that inhibit the metabolic activity of
one or more of the CYP450 enzymes. Medications that inhibit an enzyme potentially slows that
enzyme's activity or blocks the activity required for the metabolism of other medications, thereby
increasing the levels of medications dependent on that particular enzyme for biotransformation.
Inhibitors = decrease medication metabolism (Valproate, Isoniazid, Sulfonamides, Amiodarone,
Chloramphenicol, Ketoconazole, Grapefruit Juice, Quinidine)
cultural influences in prescribing - (ANSWER)The greatest concern surrounding race-based
therapy has to do with genetic variability. We know there is great diversity within and among
racial groups; therefore, a "one fits all" approach based on race is unwise. Still, we can use
known associations to guide choices. For example, differences in metabolism between people
with East Asian and European heritage are common. The provider can use this knowledge to
guide initial dosing (with adjustment, as indicated based on response) if genetic testing is not
feasible or warranted
Polypharmacy: Definition, challenges, and outcomes - (ANSWER)treatment with multiple drugs
greatly increases the risk for interactions. Some of these interactions are negligible, but some can
have life-threatening consequences. It is of crucial importance to ask the patient about all current
你是想要一篇“眼睛容易阅读的”
drugs, including over-the-counter (OTC) medications and other herbal preparations. Many
patients do not consider OTC中文文章，还是一篇关于“眼睛”
or alternative pharmaceuticals as "medications" and may not
mention them unless you ask主题的中文文章？
specifically.
Acute Pain Management - (ANSWER)
Chronic Pain Management - (ANSWER)
Opioid Management - (ANSWER)
Regulations of Controlled Substances - (ANSWER)The U.S. Department of Justice Drug
Enforcement Agency (DEA) coordinates with local, state, and federal agents to reduce illicit
drug use. The DEA enacted the Controlled Substances Act (CSA) in 1970 to regulate drugs and
, other substances based on their potential for abuse and dependency. Five schedules of controlled
substances were created that are updated annually. Classes of scheduled substances include
narcotics, depressants, stimulants, hallucinogens, and anabolic steroids. The DEA issues eligible
providers with a registration number to write prescriptions for controlled substances.
Characteristics of a valid DEA number include:
-The first letter identifies the type of provider: A=before 1985; B=after 1985; F=after 2007;
M=nurse practitioner or physician assistant
-The 2nd letter the 1st letter of the provider's last name at the time of initial registration
Example: Tammy Greene applies for and receives a DEA number of MG2705208
M=nurse practitioner and G=Greene
Opioid Epidemic & Responsible Prescribing - (ANSWER)
Opioid Use Disorder - (ANSWER)a pattern of use that leads to significant impairment or
distress. Typically, this disorder is marked by unsuccessful efforts to reduce or control use
resulting in the inability to fulfill work, school, or home responsibilities. Opioid use disorder is
different from drug tolerance and physical dependence, which may also exist. Opioid use creates
high levels of positive reinforcement, increasing the likelihood of continued use. It is often a
chronic lifelong disorder, leading to serious consequences such as disability and death. Although
it is similar to other substance use disorders, it has distinct features that have fueled the current
你是想要一篇“眼睛容易阅读的”
opioid epidemic. Opioids can中文文章，还是一篇关于“眼睛”
lead to physical dependence in only 4-8 weeks. Abruptly stopping
use in chronic users leads to severe symptoms, which motivates continued use to prevent
主题的中文文章？
withdrawal. The 2016 CDC guidelines for prescribing opioids recommends calculating the total
daily dose of opioids to help identify patients who might benefit from the reduction or tapering
of opioids, given the risk of overdose
State Prescription Drug - (ANSWER)Clinicians should review the patient's history of controlled
substance prescriptions using state prescription drug monitoring program (PDMP) data to
determine whether the patient is receiving opioid dosages or dangerous combinations that put
him or her at high risk for overdose. Clinicians should review PDMP data when starting opioid
therapy for chronic pain and periodically during opioid therapy for chronic pain, ranging from
every prescription to every 3 months.
Monitoring Programs - (ANSWER)safeguards to address the opioid public health crisis include
prescription drug monitoring programs (PDMPs). These electronic databases enable providers to
