NR565 Midterm Exam Study Guide
Which schedule drugs can APRNs prescribe?
Correct Answer:
Schedule 3-5
Who determines and regulates prescriptive authority?
Correct Answer:
The State Board of Nursing, Medicine, and Pharmacy for each individual
state.
The Federal Government regulates controlled substances, including
prescription medications
How does limited prescriptive authority impact patients within the healthcare
system?
Correct Answer:
Leaves patients with fewer treatment options. They may have to seek out a
provider who has prescriptive authority. Time consuming, can be expensive
for the patient.
,What are the key responsibilities of prescribing?
Correct Answer:
Understand the drug you are prescribing, including possible side effects,
contraindications, and the need for appropriate monitoring.
YOU are responsible for the Rx you sign.
Ensure drug and dosages are correct.
What should be used to make prescribing decisions?
Correct Answer:
Decisions should be based on pharmacokinetics and pharmacodynamic
changes that occur in adults and children. Can affect absorption, distribution,
metabolism and elimination.
Know how they interact with target receptors and produce therapeutic
effects.
Beer's Criteria
Correct Answer:
A tool used to identify potentially inappropriate medication (PIM) use in older
adults.
Includes medications that should be used cautiously in older adults.
Includes clinically significant drug interactions that should be avoided in
older adults.
Identifies medications that can cause impaired kidney function in older
adults.
,Impacts/outcomes of polypharmacy
Correct Answer:
Adverse drug events
Increased healthcare services interaction
Cognitive impairment
Reduced adherence
Falls
Mortality
CYP450 inhibitors examples
Correct Answer:
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit juice
Quinidine
What do CYP450 inhibitors do?
Correct Answer:
Decrease Medication Metabolism
, What can CYP450 inhibitors cause if not used correctly?
Correct Answer:
Toxicity if CYP enzymes are not active enough.
Ineffectiveness of CYP enzymes are overactive.
Examples of CYP450 inducers
Correct Answer:
BSCRAP GPS Incudes Rage
Barbiturates
St. John's Wort
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
What happens when someone has a poor metabolism phenotype?
Correct Answer:
The poor metabolism (PM) phenotype occurs when both alleles of CYP206
carry inactivating mutations and give rise to synthesis of enzyme with
impaired activity or no synthesis of enzyme at all.