NR565- Advance Pharmacology
1. Which schedule drugs can APRNs prescribe?: II-V
2. Who determines and regulates prescriptive authority?: State Board of
Nursing
3. How does limited prescriptive authority impact patients within the
healthcare system?: 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
4. What are the key responsibilities of prescribing?: Safe and competent
practice
Understanding of the drugs, reactions, and pharmacology
Be aware of the age group you are prescribing to
5. What should be used to make prescribing decisions?: 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
6. Be familiar with pharmacokinetic and pharmacodynamic changes of older
adults and how that would translate to baseline information needed to
prescribe.: increase glomerular filtration rate leads to increase drug excretion
increase hepatic metabolism decrease tone and motility of bowel increase drug
absorption
7. Beer's Criteria- What is it and Why is it important: Recommendations of
medications inappropriate for elderly (65 and older)
Prevents adverse drug reactions
8. Impacts/outcomes of polypharmacy: -increase risk for medication
interactions 9. CYP450 inhibitors o Examples o What do they do? o What
do they cause if not used correctly? (aka: What would the patient
experience?): inhibit metabolism, increase blood levels of medications
Examples
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole,
grapefruit juice, quinidine
"VISA credit card debt INHIBITS spending on designers like CK to look GQ"
, NR565- Advance Pharmacology
10. 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?): 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
"Bullshit Crap GPS INDUCES rage"
11. What happens when someone has a poor metabolism phenotype?: med-
ications metabolized slower, medication might not work or put them at risk for side-
effects
12. What does the U.S. Food and Drug Administration regulate when it
comes to medications?: Whether the drug is safe, effective, and benefits of a
drug outweigh the risks
13. Reasons for medication non-adherence: 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) living alone
recent discharge from the hospital
low literacy
inability to pay for meds
personal conviction that a drug is unnecessary or the dosage is too high
presence of side effects 14. Black Box Warnings o What are they?
o Why are they issued?: Is the strongest safety warning a drug can carry and still
remain on the market. Usually presented on the label with a heavy black border.
Issued by the FDA due to having serious or life-threatening risks
1. Which schedule drugs can APRNs prescribe?: II-V
2. Who determines and regulates prescriptive authority?: State Board of
Nursing
3. How does limited prescriptive authority impact patients within the
healthcare system?: 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
4. What are the key responsibilities of prescribing?: Safe and competent
practice
Understanding of the drugs, reactions, and pharmacology
Be aware of the age group you are prescribing to
5. What should be used to make prescribing decisions?: 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
6. Be familiar with pharmacokinetic and pharmacodynamic changes of older
adults and how that would translate to baseline information needed to
prescribe.: increase glomerular filtration rate leads to increase drug excretion
increase hepatic metabolism decrease tone and motility of bowel increase drug
absorption
7. Beer's Criteria- What is it and Why is it important: Recommendations of
medications inappropriate for elderly (65 and older)
Prevents adverse drug reactions
8. Impacts/outcomes of polypharmacy: -increase risk for medication
interactions 9. CYP450 inhibitors o Examples o What do they do? o What
do they cause if not used correctly? (aka: What would the patient
experience?): inhibit metabolism, increase blood levels of medications
Examples
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole,
grapefruit juice, quinidine
"VISA credit card debt INHIBITS spending on designers like CK to look GQ"
, NR565- Advance Pharmacology
10. 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?): 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
"Bullshit Crap GPS INDUCES rage"
11. What happens when someone has a poor metabolism phenotype?: med-
ications metabolized slower, medication might not work or put them at risk for side-
effects
12. What does the U.S. Food and Drug Administration regulate when it
comes to medications?: Whether the drug is safe, effective, and benefits of a
drug outweigh the risks
13. Reasons for medication non-adherence: 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) living alone
recent discharge from the hospital
low literacy
inability to pay for meds
personal conviction that a drug is unnecessary or the dosage is too high
presence of side effects 14. Black Box Warnings o What are they?
o Why are they issued?: Is the strongest safety warning a drug can carry and still
remain on the market. Usually presented on the label with a heavy black border.
Issued by the FDA due to having serious or life-threatening risks
