Role of NP - State title protection. Board of nursing regulates practice.
5 states have joint oversight with medical board.
Scope of practice is determined by NP license.
24 states are totally NPs are anonomous
20 states require physician collaboration
3 states have physician supervision
Some states allow NPs to prescribe by protocol.
Role of PA - Title protection in all states.
All have prescription authority
5 states limit PA formulary
15 states permit only schedule III to V drugs
Practice oversight by MD
Control of practice and licensing by medical board.
Factors involved in using good clinical judgement - Is a prescription the right treatment?
Which drugs are effective for the disease?
What are the goals of therapy? Cure or maintain?
Monitor to see if drug meets goals
Check for drug duplications-polypharmacy
OTC vs. Rx
What is the cost of the drug?
Where did you get your information?
Is it EBP?
Pharmacotherapeutics - Intregates pharmacology, pathophysiology, and therapeutics
Pharmacokinectics - How the body processes medications. What the body does with the drug
Pharmacodynamics - What the drug does to the body. The medication action at cellular level
to elict a therapeutic effect.
Two main branches of pharmacology - Pharmacokinetics
Pharmacodynamics
Toxicology - Branch dealing with toxic effects
Therapeutics - The use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy
4 major processes of pharmacokinetics - Drug absorption into the bloodstream
Drug distribution into the tissues to the site of action
Drug metabolism via liver or intestinal enzymes
Drug excretion via the kidneys in urine or intestine in feces
Major processes of pharmacodynamics - Effects on the body
Receptor binding and effect