Midterm Exam) NR 565 Midterm Exam : Study Guide:
Questions & Answers
What are medication examples of Schedule II drugs? - ANSWER:-Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? - ANSWER:-Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? - ANSWER:-Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? - ANSWER:Schedule II through Schedule IV
examples of reasons for medication non-adherence - ANSWER:-too busy
-too expensive
-ran out
-forgetting
-traveling & busy
Distribution in medication in elderly can be affected in what ways? - ANSWER:-decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how? -
ANSWER:medication binds to protein so decreased protein affects how medication is absorbed and
distributed
, In elderly decreased body fat affects medications how? - ANSWER:need fat to transport medications and
some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age due to.... -
ANSWER:decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? -
ANSWER:***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug? - ANSWER:-slow or increase
absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index? - ANSWER:-increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids - ANSWER:respiratory depression
Black box warning for Fentanyl - ANSWER:FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe) - ANSWER:QT interval prolongation
Black box warning for Codeine - ANSWER:-breastfeeding and infant death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone) - ANSWER:-risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic pain) - ANSWER:-
HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... - ANSWER:-Opioids
-Fentanyl
-Methadone
-Codeine
Questions & Answers
What are medication examples of Schedule II drugs? - ANSWER:-Ativan & Valium
-Fentanyl
-Oxycodone
-Methadone
What medications are Schedule III drugs? - ANSWER:-Xanax
-Tramadol
-anabolic steroids
-<90mg of codeine
What medications are Schedule IV drugs? - ANSWER:-Ativan
-Tramadol
-Methadone
-Adderall
Which schedule drugs can APRNs prescribe? - ANSWER:Schedule II through Schedule IV
examples of reasons for medication non-adherence - ANSWER:-too busy
-too expensive
-ran out
-forgetting
-traveling & busy
Distribution in medication in elderly can be affected in what ways? - ANSWER:-decreased lean mass
-decreased albumin
-decreased body fat
-slower gastric acidity
-slower absorption results in delayed response
In the elderly decrease albumin and decreased lean mass affects medications how? -
ANSWER:medication binds to protein so decreased protein affects how medication is absorbed and
distributed
, In elderly decreased body fat affects medications how? - ANSWER:need fat to transport medications and
some drug metabolism is dependent on body weight
When prescribing medication, we must understand that liver function declines with age due to.... -
ANSWER:decreased blood flow to the liver, decreased hepatic enzymes
What is the most important cause of adverse drug reactions? -
ANSWER:***overprescribing/polypharmacy
***decreased renal excretion
-high drug dosages (start low & go slow)
-lack of monitoring medications
What can a poor metabolism phenotype do to a metabolism of a drug? - ANSWER:-slow or increase
absorption
-slow the metabolism
-keep drug in body longer
-increase toxicity
How does poor metabolism affect a high or low therapeutic index? - ANSWER:-increase drug toxicity
(example plavix - clots & increased platelets)
Black box warning for Opioids - ANSWER:respiratory depression
Black box warning for Fentanyl - ANSWER:FATAL respiratory depression
Black box warning for Methadone (NP cannot prescribe) - ANSWER:QT interval prolongation
Black box warning for Codeine - ANSWER:-breastfeeding and infant death can occur
-10% of dose converts to morphine
Black box warning for hydromorphone & oxymorphone (NP cannot prescribe long acting
hydromorphone and oxymorphone) - ANSWER:-risk for high abuse & overdose
-respiratory depression
Black box warning for oxycodone (NP need additional training to prescribe for chronic pain) - ANSWER:-
HIGH potential for abuse
-respiratory depression
Meds that require special training for APNs to prescribe are... - ANSWER:-Opioids
-Fentanyl
-Methadone
-Codeine
