NR565 Midterm Study
ACEI - ANS-
Management of Acute Pain - ANS- Agonist is an ANS-type medication that binds to and
activates a receptor. Can be full, partial or inverse. A full agonist has high efficacy because it
elicits a full response from a small number of receptors. Full agonists are more effective than
partial agonists. Even though it occupies the entire receptor population, it cannot produce the
maximal response at any concentration because it produces sub-maximal activation. An inverse
agonist produces an effect opposite to that of an agonist, yet it binds to the same receptor
binding-site as an agonist
Alendronate - ANS-
ANS- Allopurinol Antagonist - ANS-A drug that attenuates the effect of an agonist. can be
competitive or non-competitive, with either reversibility or irreversibility possible. A competitive
antagonist binds to the same site as the agonist but does not activate it, thus blocks the
agonist's action. A non-competitive antagonist binds to an allosteric (non-agonist) site on the
receptor to prevent activation of the receptor. A reversible antagonist binds non-covalently to
the receptor, therefore can be "washed out". An irreversible antagonist binds covalently to the
receptor and cannot be displaced by either competing ligands or washing.
ANS, or anticoagulants, antiplatelet agents - ANS-
APRN prescribing role - ANS-Prescriptive authority for nurse practitioners also regulates
prescribing rights beyond medications and controlled substances. These rights include
therapeutic devices and services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds,
portable oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive authority
encompasses more than writing a prescription correctly. It requires adherence to ethical
guidelines to ensure that patients are safeguarded from harm. Ethical prescribing starts with
being well-informed about medications. Mechanism of action, efficacy, and safety are important
considerations, as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). The majority of people who get
prescriptions also take other prescription or over-the-counter medications. To get the best
results and minimize side effects, pharmaceutical agents must be chosen, administered, and
used appropriately. ARB - ANS-
OUD Assessment and Treatment - ANS- Drugs with a high likelihood of adverse effects in older
adults are identified using Beer's Criteria, which is used by ANS. Accordingly, drugs on this list
should generally be avoided in adults older than 65 years except when the benefits are
significantly greater than the risks.
benefits of 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
, Beta-blockers - ANS-β blockers (e.g., propranolol, metoprolol) are first-line drugs for angina of
effort, but are not effective against vasospastic angina
β blockers should not be used by patients with sick sinus syndrome, heart failure, or
second-degree or third-degree AV block.
β blockers reduce anginal pain primarily by decreasing cardiac oxygen demand, principally
through blockade of β1 receptors in the heart, which decreases heart rate and contractility.
β blockers should be used with caution by patients with asthma. A 1-selective agent (like
metoprolol) should be used if an asthmatic must use a blocker. blockers can cover up signs of
hypoglycemia, so they should be used with caution in diabetic patients. When starting or
restarting sotalol, patients should be in a facility that can provide continuous electrocardiogram
monitoring and cardiopulmonary resuscitation for a minimum of 3 days to minimize problems
associated with induced arrhythmia.
Creatinine clearance should be established before initiating this drug.
Betapace cannot be substituted for Betapace AF when treating atrial fibrillation.
Therapeutic Goal: Principal indications are hypertension, angina pectoris, heart failure, and
cardiac dysrhythmias. Indications for individual agents are shown in Table 16.5.
Baseline Information: Heart rate, blood pressure (supine, sitting, and standing, depending on
the patient's status), electrocardiogram (ECG), and general cardiovascular status (if the patient's
age and status warrant it). Monitoring: Heart rate, blood pressure, evaluation for adverse effects
(with symptom-focused assessment if indicated). Advise patients to record the incidence,
circumstances, and severity of any symptoms that may indicate inadequate control of symptoms
for which the drug is given (e.g., angina) or a new onset of adverse effects.
Identifying High-Risk Pat
Calcium Channel Blockers - ANS-The CCBs used most frequently are verapamil, diltiazem, and
nifedipine (a dihydropyridine-type calcium channel blocker). Accordingly, our discussion
focuses on these three drugs. All three can block calcium channels in VSM, primarily in
arterioles.
Diltiazem and verapamil Therapeutic Goal: Verapamil and diltiazem are indicated for
hypertension, angina, and cardiac dysrhythmias.
Baseline Data: Determine blood pressure and pulse rate and obtain laboratory evaluations of
liver and kidney function.
Monitoring: No routine blood monitoring required.
Identifying High-Risk Patients: These drugs are contraindicated in patients with hypotension,
sick sinus syndrome, and second- or third-degree atrioventricular block.
Evaluating Therapeutic Effects: Keep an eye on your blood pressure on a regular basis. For
angina, the patient should keep ongoing records of time and intensity of anginal attacks.
Minimizing Adverse Effects: Initiate therapy with low doses, adjust doses carefully, monitor
weight loss daily, and use an intermittent dosing schedule.
ANS- Chronic Pain Management Colchincine - ANS-
cultural influences in prescribing - ANS-The greatest concern surrounding race-based therapy
has to do with genetic variability. We know there is great diversity within and among racial
groups; therefore, a "one fits all" approach based on race is unwise. Still, we can use known
associations to guide choices. For example, differences in metabolism between people with
East Asian and European heritage are common. The provider can use this knowledge to guide
ACEI - ANS-
Management of Acute Pain - ANS- Agonist is an ANS-type medication that binds to and
activates a receptor. Can be full, partial or inverse. A full agonist has high efficacy because it
elicits a full response from a small number of receptors. Full agonists are more effective than
partial agonists. Even though it occupies the entire receptor population, it cannot produce the
maximal response at any concentration because it produces sub-maximal activation. An inverse
agonist produces an effect opposite to that of an agonist, yet it binds to the same receptor
binding-site as an agonist
Alendronate - ANS-
ANS- Allopurinol Antagonist - ANS-A drug that attenuates the effect of an agonist. can be
competitive or non-competitive, with either reversibility or irreversibility possible. A competitive
antagonist binds to the same site as the agonist but does not activate it, thus blocks the
agonist's action. A non-competitive antagonist binds to an allosteric (non-agonist) site on the
receptor to prevent activation of the receptor. A reversible antagonist binds non-covalently to
the receptor, therefore can be "washed out". An irreversible antagonist binds covalently to the
receptor and cannot be displaced by either competing ligands or washing.
ANS, or anticoagulants, antiplatelet agents - ANS-
APRN prescribing role - ANS-Prescriptive authority for nurse practitioners also regulates
prescribing rights beyond medications and controlled substances. These rights include
therapeutic devices and services and are outlined in state practice laws and regulations and
include Durable Medical Equipment (DME) such as wheelchairs, power scooters, hospital beds,
portable oxygen equipment, handicap placards, etc. and medical services such as Physical
Therapy (PT), Occupational Therapy (OT), home health services, etc. Prescriptive authority
encompasses more than writing a prescription correctly. It requires adherence to ethical
guidelines to ensure that patients are safeguarded from harm. Ethical prescribing starts with
being well-informed about medications. Mechanism of action, efficacy, and safety are important
considerations, as are a patient's distinct needs and circumstances, including the number of
medications prescribed (Mitchell & Oliphant, 2016). The majority of people who get
prescriptions also take other prescription or over-the-counter medications. To get the best
results and minimize side effects, pharmaceutical agents must be chosen, administered, and
used appropriately. ARB - ANS-
OUD Assessment and Treatment - ANS- Drugs with a high likelihood of adverse effects in older
adults are identified using Beer's Criteria, which is used by ANS. Accordingly, drugs on this list
should generally be avoided in adults older than 65 years except when the benefits are
significantly greater than the risks.
benefits of 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
, Beta-blockers - ANS-β blockers (e.g., propranolol, metoprolol) are first-line drugs for angina of
effort, but are not effective against vasospastic angina
β blockers should not be used by patients with sick sinus syndrome, heart failure, or
second-degree or third-degree AV block.
β blockers reduce anginal pain primarily by decreasing cardiac oxygen demand, principally
through blockade of β1 receptors in the heart, which decreases heart rate and contractility.
β blockers should be used with caution by patients with asthma. A 1-selective agent (like
metoprolol) should be used if an asthmatic must use a blocker. blockers can cover up signs of
hypoglycemia, so they should be used with caution in diabetic patients. When starting or
restarting sotalol, patients should be in a facility that can provide continuous electrocardiogram
monitoring and cardiopulmonary resuscitation for a minimum of 3 days to minimize problems
associated with induced arrhythmia.
Creatinine clearance should be established before initiating this drug.
Betapace cannot be substituted for Betapace AF when treating atrial fibrillation.
Therapeutic Goal: Principal indications are hypertension, angina pectoris, heart failure, and
cardiac dysrhythmias. Indications for individual agents are shown in Table 16.5.
Baseline Information: Heart rate, blood pressure (supine, sitting, and standing, depending on
the patient's status), electrocardiogram (ECG), and general cardiovascular status (if the patient's
age and status warrant it). Monitoring: Heart rate, blood pressure, evaluation for adverse effects
(with symptom-focused assessment if indicated). Advise patients to record the incidence,
circumstances, and severity of any symptoms that may indicate inadequate control of symptoms
for which the drug is given (e.g., angina) or a new onset of adverse effects.
Identifying High-Risk Pat
Calcium Channel Blockers - ANS-The CCBs used most frequently are verapamil, diltiazem, and
nifedipine (a dihydropyridine-type calcium channel blocker). Accordingly, our discussion
focuses on these three drugs. All three can block calcium channels in VSM, primarily in
arterioles.
Diltiazem and verapamil Therapeutic Goal: Verapamil and diltiazem are indicated for
hypertension, angina, and cardiac dysrhythmias.
Baseline Data: Determine blood pressure and pulse rate and obtain laboratory evaluations of
liver and kidney function.
Monitoring: No routine blood monitoring required.
Identifying High-Risk Patients: These drugs are contraindicated in patients with hypotension,
sick sinus syndrome, and second- or third-degree atrioventricular block.
Evaluating Therapeutic Effects: Keep an eye on your blood pressure on a regular basis. For
angina, the patient should keep ongoing records of time and intensity of anginal attacks.
Minimizing Adverse Effects: Initiate therapy with low doses, adjust doses carefully, monitor
weight loss daily, and use an intermittent dosing schedule.
ANS- Chronic Pain Management Colchincine - ANS-
cultural influences in prescribing - ANS-The greatest concern surrounding race-based therapy
has to do with genetic variability. We know there is great diversity within and among racial
groups; therefore, a "one fits all" approach based on race is unwise. Still, we can use known
associations to guide choices. For example, differences in metabolism between people with
East Asian and European heritage are common. The provider can use this knowledge to guide
