Advance Pharmacy NR565 MIDTERM
- ANS-
· Beer's Criteria - ANS-•potentially Inappropriate Medication (PIM) use in older adults
• Using PIMs in older adults because of interactions between medications and diseases or
syndromes that could make the diseases or syndromes worse • medications that should be
used with caution in older people •clinically important drug interactions that older adults should
avoid • medications that older adults with impaired kidney function should avoid or reduce in
dosage (American Geriatric Society Beers Criteria Update Expert Panel, 2019) How do patients
in the healthcare system react to limited prescriptive authority? ANS: Limited authority causes
problems for the patient. The patient is not able to get the care they need
ANS-1: What are the primary responsibilities of prescribing? Be careful and thoughtful when
making decisions. 2. Have a documented provider-patient relationship with the person for
whom you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. In your records, make a thorough history and physical examination. 5. Include any
conversations you have with the patient about potential side effects, risk factors, or treatment
options. 6. Have a written strategy for drug monitoring or titration, if necessary. · What happens
when someone has a poor metabolism phenotype? - ANS-Metabolizes to slow or to fast.
· What should be used to make prescribing decisions? - ANS-
ANS-Nurse practitioner scope of practice is determined by state practice and licensure laws.
Who determines and regulates prescriptive authority? ANS-Schedule II-V: which schedule drugs
can be prescribed by APRNs •During what trimester is a pregnant woman most at risk for
adverse drug reactions with potential long-term consequences? - ANS-1 trimester
• Obtaining a thorough drug history that includes over-the-counter medications is one way that
healthcare providers can reduce the likelihood that an elderly patient will experience an adverse
drug reaction. •considering pharmacokinetic and pharmacodynamic changes due to age
•monitoring the patient's clinical response and plasma drug levels
•using the simplest regimen possible
•monitoring for drug-drug interactions and iatrogenic illness
•periodically reviewing the need for continued drug therapy
•encouraging the patient to dispose of old medications
• Taking measures to encourage compliance and stay away from drugs on the Beers list •What
are some medications that we know to be teratogenic? - ANS-•Antiepileptic drugs,
antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large doses, some
anticoagulants, and hormonal medications such as diethylstilbestrol (DES).
•What are some of the Physiologic changes that occur in the body when a woman is pregnant
that can change the pharmacodynamic and pharmacokinetic properties of many drugs? - ANS--
Increased GFR= Increased drug excretion
- Increased drug metabolism in the liver. - A decreased bowel tone and mobility - Increased
drug absorption.
, •What are the nine factors that impact the outcome of medication according to Rosenthal &
Burcham? - ANS-•Gender and race
•Genetics and pharmacogenomics
•Variability in absorption
•placebo effect
•Tolerance
•patho
•age
•bodyweight
•What is 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.
•What is reduced practice authority? - ANS-Nurse practitioners are limited in at least one
element of practice. The state requires a formal collaborative agreement with an outside health
discipline for the nurse practitioner to provide patient care.
•What determines a nurse practitioner's scope of practice? ANS-Nurse practitioner scope of
practice is established by state practice and licensure laws. •What is the difference between NP
practice authority and prescriptive authority? - ANS-Practice authority refers to the nurse
practitioner's ability to practice without physician oversight, whereas prescriptive authority refers
to the nurse practitioner's authority to prescribe medications independently and without
limitations.
•What should be included in medication administration patient education? - ANS-1. dosage size
and timing
2. route and technique of administration
3. duration of treatment
4.drug storage
5.nature and time course of desired responses
6. nature and time course of adverse responses
•Who regulates prescription authority? - ANS-The regulation of prescriptive authority is under
the jurisdiction of a health professional board. Depending on what each state decides, this
could be the State Board of Nursing, the State Board of Medicine, or the State Board of
Pharmacy. Prescriptive authority is not under the control of the federal government, even though
drug regulation is under its control. •Why is absorption of medication in the stomach increased
in infancy? - ANS-Delayed gastric emptying (adult values reached by 6-8 months)
3 drugs to treat Heart Failure - ANS-Diuretics
Anti-beta blockers ACE/ARBS
RAAS
ACE inhibitors can be benificial in which population? - ANS-At risk for end stage renal disease
Diabetic
Adverse effects of Aldactone or Spirolactone, an aldosterone antagonist - ANS-Hyper K
Adverse AFFECTS of Digoxine - ANS-Toxicity which leads to AV block
Eyes can become blurry and they will see a yellow tinge and HALO
- ANS-
· Beer's Criteria - ANS-•potentially Inappropriate Medication (PIM) use in older adults
• Using PIMs in older adults because of interactions between medications and diseases or
syndromes that could make the diseases or syndromes worse • medications that should be
used with caution in older people •clinically important drug interactions that older adults should
avoid • medications that older adults with impaired kidney function should avoid or reduce in
dosage (American Geriatric Society Beers Criteria Update Expert Panel, 2019) How do patients
in the healthcare system react to limited prescriptive authority? ANS: Limited authority causes
problems for the patient. The patient is not able to get the care they need
ANS-1: What are the primary responsibilities of prescribing? Be careful and thoughtful when
making decisions. 2. Have a documented provider-patient relationship with the person for
whom you are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. In your records, make a thorough history and physical examination. 5. Include any
conversations you have with the patient about potential side effects, risk factors, or treatment
options. 6. Have a written strategy for drug monitoring or titration, if necessary. · What happens
when someone has a poor metabolism phenotype? - ANS-Metabolizes to slow or to fast.
· What should be used to make prescribing decisions? - ANS-
ANS-Nurse practitioner scope of practice is determined by state practice and licensure laws.
Who determines and regulates prescriptive authority? ANS-Schedule II-V: which schedule drugs
can be prescribed by APRNs •During what trimester is a pregnant woman most at risk for
adverse drug reactions with potential long-term consequences? - ANS-1 trimester
• Obtaining a thorough drug history that includes over-the-counter medications is one way that
healthcare providers can reduce the likelihood that an elderly patient will experience an adverse
drug reaction. •considering pharmacokinetic and pharmacodynamic changes due to age
•monitoring the patient's clinical response and plasma drug levels
•using the simplest regimen possible
•monitoring for drug-drug interactions and iatrogenic illness
•periodically reviewing the need for continued drug therapy
•encouraging the patient to dispose of old medications
• Taking measures to encourage compliance and stay away from drugs on the Beers list •What
are some medications that we know to be teratogenic? - ANS-•Antiepileptic drugs,
antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large doses, some
anticoagulants, and hormonal medications such as diethylstilbestrol (DES).
•What are some of the Physiologic changes that occur in the body when a woman is pregnant
that can change the pharmacodynamic and pharmacokinetic properties of many drugs? - ANS--
Increased GFR= Increased drug excretion
- Increased drug metabolism in the liver. - A decreased bowel tone and mobility - Increased
drug absorption.
, •What are the nine factors that impact the outcome of medication according to Rosenthal &
Burcham? - ANS-•Gender and race
•Genetics and pharmacogenomics
•Variability in absorption
•placebo effect
•Tolerance
•patho
•age
•bodyweight
•What is 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.
•What is reduced practice authority? - ANS-Nurse practitioners are limited in at least one
element of practice. The state requires a formal collaborative agreement with an outside health
discipline for the nurse practitioner to provide patient care.
•What determines a nurse practitioner's scope of practice? ANS-Nurse practitioner scope of
practice is established by state practice and licensure laws. •What is the difference between NP
practice authority and prescriptive authority? - ANS-Practice authority refers to the nurse
practitioner's ability to practice without physician oversight, whereas prescriptive authority refers
to the nurse practitioner's authority to prescribe medications independently and without
limitations.
•What should be included in medication administration patient education? - ANS-1. dosage size
and timing
2. route and technique of administration
3. duration of treatment
4.drug storage
5.nature and time course of desired responses
6. nature and time course of adverse responses
•Who regulates prescription authority? - ANS-The regulation of prescriptive authority is under
the jurisdiction of a health professional board. Depending on what each state decides, this
could be the State Board of Nursing, the State Board of Medicine, or the State Board of
Pharmacy. Prescriptive authority is not under the control of the federal government, even though
drug regulation is under its control. •Why is absorption of medication in the stomach increased
in infancy? - ANS-Delayed gastric emptying (adult values reached by 6-8 months)
3 drugs to treat Heart Failure - ANS-Diuretics
Anti-beta blockers ACE/ARBS
RAAS
ACE inhibitors can be benificial in which population? - ANS-At risk for end stage renal disease
Diabetic
Adverse effects of Aldactone or Spirolactone, an aldosterone antagonist - ANS-Hyper K
Adverse AFFECTS of Digoxine - ANS-Toxicity which leads to AV block
Eyes can become blurry and they will see a yellow tinge and HALO
