Advanced pharm
Which schedule drugs can APRN's prescribe? ANS: schedule 2-4; all except 1
key responsibilities of prescribing ANS: documentation of provider-patient relationship
H&P
documentation of risk factors, SE, etc
Drog monitoring/ titration plan
avoidance of prescribing for self, family, or friends
What makes up rational drug selection? ANS: cost, guidelines, availability, drug interactions, side effects,
allergies, hepatic and renal f(x), need for monitoring, special populations
What belongs on a written prescription? ANS: prescriber name, contact information, patient name,
bday, name of medication, dose, route, frequency, strength, allergies, signature, number of refills,
reason/ indication, number of tablets to dispense, directions for use, NP ID number, DEA #
How is the absorption of drugs affected by advanced age? ANS: increase gastric pH, decreased
absorptive surface area, decreased blood flow, decreased GI motility, delayed gastric emptying
how is the distribution of drugs affected by advanced age? ANS: increased body fat, decreased lean
body mass, decreased total body water, decreased albumin, decreased CO
How is metabolism of drugs affected by age ANS: decreased hepatic blood flow, decreased hepatic
mass, decreased activity of hepatic enzymes
how is the excretion of drugs affected by advanced age? ANS: decreased renal BF, decreased GFR,
decreased tubular secretion, decreased nephrons
, When should nitrates be taken? ANS: no later than 4pm- nitrate free interval for 8 hrs to avoid tolerance
what is Beer's criteria? ANS: developed for safe prescribing for adults. impacts outcomes of poly
pharmacy
Examples of CYP450 inhibitors ANS: valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol,
Ketaconazole, grapefruit, quinidine VISA credit card debts inhibit spendings on designers like CK to look
GQ
How do CYP450 inhibitors affect medications? ANS: prolongs effects= toxicity
Examples of CYP450 inducers ANS: "CRAP GPS"- Carbamazepine, rifampin, alcohol, phenytoin,
Griseofulvin, phenobarbital, sulfonylureas
What do CYP450 inducers do? ANS: increase activity= drug clearance is faster so less therapeutic effect-
dosages of medications may need to be increased
What happens when someone has poor metabolism phenotype ANS: metabolize slow= toxicity
metabolize fast= no therapeutic response
What does the FDA regulate? ANS: safety and effectiveness of the drug's proposed use, appropriateness
of proposed labeling, adequacy of manufacturing methods to assure drug's identify, strength, quality,
and purity
black box warning for codeine ANS: converts to morphine in the liver
how are drugs affected during pregnancy? ANS: increased demand of nutrients, increased GFR= faster
clearance, decreased bowel motility= more absorption, increased liver metabolism
Which schedule drugs can APRN's prescribe? ANS: schedule 2-4; all except 1
key responsibilities of prescribing ANS: documentation of provider-patient relationship
H&P
documentation of risk factors, SE, etc
Drog monitoring/ titration plan
avoidance of prescribing for self, family, or friends
What makes up rational drug selection? ANS: cost, guidelines, availability, drug interactions, side effects,
allergies, hepatic and renal f(x), need for monitoring, special populations
What belongs on a written prescription? ANS: prescriber name, contact information, patient name,
bday, name of medication, dose, route, frequency, strength, allergies, signature, number of refills,
reason/ indication, number of tablets to dispense, directions for use, NP ID number, DEA #
How is the absorption of drugs affected by advanced age? ANS: increase gastric pH, decreased
absorptive surface area, decreased blood flow, decreased GI motility, delayed gastric emptying
how is the distribution of drugs affected by advanced age? ANS: increased body fat, decreased lean
body mass, decreased total body water, decreased albumin, decreased CO
How is metabolism of drugs affected by age ANS: decreased hepatic blood flow, decreased hepatic
mass, decreased activity of hepatic enzymes
how is the excretion of drugs affected by advanced age? ANS: decreased renal BF, decreased GFR,
decreased tubular secretion, decreased nephrons
, When should nitrates be taken? ANS: no later than 4pm- nitrate free interval for 8 hrs to avoid tolerance
what is Beer's criteria? ANS: developed for safe prescribing for adults. impacts outcomes of poly
pharmacy
Examples of CYP450 inhibitors ANS: valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol,
Ketaconazole, grapefruit, quinidine VISA credit card debts inhibit spendings on designers like CK to look
GQ
How do CYP450 inhibitors affect medications? ANS: prolongs effects= toxicity
Examples of CYP450 inducers ANS: "CRAP GPS"- Carbamazepine, rifampin, alcohol, phenytoin,
Griseofulvin, phenobarbital, sulfonylureas
What do CYP450 inducers do? ANS: increase activity= drug clearance is faster so less therapeutic effect-
dosages of medications may need to be increased
What happens when someone has poor metabolism phenotype ANS: metabolize slow= toxicity
metabolize fast= no therapeutic response
What does the FDA regulate? ANS: safety and effectiveness of the drug's proposed use, appropriateness
of proposed labeling, adequacy of manufacturing methods to assure drug's identify, strength, quality,
and purity
black box warning for codeine ANS: converts to morphine in the liver
how are drugs affected during pregnancy? ANS: increased demand of nutrients, increased GFR= faster
clearance, decreased bowel motility= more absorption, increased liver metabolism
