NR 565 MIDTERM EXAM STUDY GUIDE
(LATEST 2026 UPDATED): ADVANCED
PHARMACOLOGY FUNDAMENTALS –
CHAMBERLAIN
1. promoting positive outcomes through prudent prescribing practices - -
ANS☑️☑️--Administering medications and prescribing medications
are two distinct processes. Prescription writing requires 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
2. Beer's Criteria - -ANS☑️☑️--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.
3. Pharmacodynamics - -ANS☑️☑️--the study of the biochemical and
physiologic effects of drugs on the body and the molecular
mechanisms by which those effects are produced
4. Pharmacokinetics - -ANS☑️☑️--the study of drug movement
throughout the body
5. Pharmacogenomics - -ANS☑️☑️--the 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
6. CYP450 inducers - -ANS☑️☑️--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.
7. APRN prescribing role - -ANS☑️☑️--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
8. benefits of full practice authority - -ANS☑️☑️--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
, 9. Inducers = Increase medication metabolism
10. (Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin,
Phenobarbital, Sulfonylureas)
11. CYP450 inhibitors - -ANS☑️☑️--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)
12. cultural influences in prescribing - -ANS☑️☑️--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
13. Polypharmacy: Definition, challenges, and outcomes - -
ANS☑️☑️--treatment with multiple drugs
(LATEST 2026 UPDATED): ADVANCED
PHARMACOLOGY FUNDAMENTALS –
CHAMBERLAIN
1. promoting positive outcomes through prudent prescribing practices - -
ANS☑️☑️--Administering medications and prescribing medications
are two distinct processes. Prescription writing requires 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
2. Beer's Criteria - -ANS☑️☑️--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.
3. Pharmacodynamics - -ANS☑️☑️--the study of the biochemical and
physiologic effects of drugs on the body and the molecular
mechanisms by which those effects are produced
4. Pharmacokinetics - -ANS☑️☑️--the study of drug movement
throughout the body
5. Pharmacogenomics - -ANS☑️☑️--the 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
6. CYP450 inducers - -ANS☑️☑️--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.
7. APRN prescribing role - -ANS☑️☑️--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
8. benefits of full practice authority - -ANS☑️☑️--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
, 9. Inducers = Increase medication metabolism
10. (Carbamazepine, Rifampin, Alcohol, Phenytoin, Griseofulvin,
Phenobarbital, Sulfonylureas)
11. CYP450 inhibitors - -ANS☑️☑️--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)
12. cultural influences in prescribing - -ANS☑️☑️--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
13. Polypharmacy: Definition, challenges, and outcomes - -
ANS☑️☑️--treatment with multiple drugs
