Advance Pharmacy NR565 MIDTERM Ques ons With
Actual Answers.
·· Which schedule drugs can APRNs prescribe? - Answer Schedule II-V
· Who determines and regulates prescrip ve authority? - Answer Nurse prac oner scope of
prac ce is determined by state prac ce and licensure laws.
· How does limited prescrip ve authority impact pa ents within the healthcare system? -
Answer limited authority creates problems for the pa ent. The pa ent is not able to get the
care they need
· What are the key responsibili es of prescribing? - Answer 1. Be prudent and deliberate in your
decision-making process
2. Have a documented provider-pa ent rela onship with the person for whom you are
prescribing
3. Do not prescribe medica ons for family or friends or for yourself
4. Document a thorough history and physical examina on in your records
5.Include any discussions you have with the pa ent regarding risk factors, side effects, or
therapy op ons
6. Have a documented plan regarding drug monitoring or tra on, if applicable
· What should be used to make prescribing decisions? - Answer
Pharmakine scs and Pharmodynamics of older adults - Answer drug accumula on secondary to
reduced renal func on
polypharmacy (the use of five or more medica ons daily)
greater severity of illness
,presence of comorbidi es
use of drugs that have a low therapeu c index (e.g., digoxin)
increased individual varia on secondary to altered pharmacokine cs
inadequate supervision of long-term therapy
poor pa ent adherence
· Beer's Criteria - Answer •poten ally Inappropriate Medica on (PIM) use in older adults
•PIM use in older adults due to medica on-disease or medica on-syndrome interac ons that
may exacerbate the disease or syndrome
•medica ons to be used cau ously in older adults
•clinically significant drug interac ons that should be avoided in older adults
•medica ons to be avoided or dosage decreased in the presence of impaired kidney func on in
older adults (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450 - Answer Many medica ons are metabolized through the liver enzyme system called
cytochrome P450 (CYP450). Metaboliza on can be inhibited or induced by drugs and once this
happens drug-drug interac ons can occur.
VISA credit card dept Inhibits Spending on CK and GQ - Answer Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
, Q-uinidine
CYP450 Inhibitors - Answer - Decreases the CYP450 which keeps the medica on in your body
longer which can cause toxicity
CYP450 INDUCERS - Answer Increase CYP450 to work faster causes
Drugs to leave your body faster.
Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs - Answer
Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype? - Answer Metabolizes to
slow or to fast.
How is absorp on of intramuscular medica on different in neonates? - Answer •Slow and
erra c due to low blood flow in muscles first few days of life
•Why is absorp on of medica on in the stomach increased in infancy? - Answer Delayed gastric
emptying (adult values reached by 6-8 months)
Actual Answers.
·· Which schedule drugs can APRNs prescribe? - Answer Schedule II-V
· Who determines and regulates prescrip ve authority? - Answer Nurse prac oner scope of
prac ce is determined by state prac ce and licensure laws.
· How does limited prescrip ve authority impact pa ents within the healthcare system? -
Answer limited authority creates problems for the pa ent. The pa ent is not able to get the
care they need
· What are the key responsibili es of prescribing? - Answer 1. Be prudent and deliberate in your
decision-making process
2. Have a documented provider-pa ent rela onship with the person for whom you are
prescribing
3. Do not prescribe medica ons for family or friends or for yourself
4. Document a thorough history and physical examina on in your records
5.Include any discussions you have with the pa ent regarding risk factors, side effects, or
therapy op ons
6. Have a documented plan regarding drug monitoring or tra on, if applicable
· What should be used to make prescribing decisions? - Answer
Pharmakine scs and Pharmodynamics of older adults - Answer drug accumula on secondary to
reduced renal func on
polypharmacy (the use of five or more medica ons daily)
greater severity of illness
,presence of comorbidi es
use of drugs that have a low therapeu c index (e.g., digoxin)
increased individual varia on secondary to altered pharmacokine cs
inadequate supervision of long-term therapy
poor pa ent adherence
· Beer's Criteria - Answer •poten ally Inappropriate Medica on (PIM) use in older adults
•PIM use in older adults due to medica on-disease or medica on-syndrome interac ons that
may exacerbate the disease or syndrome
•medica ons to be used cau ously in older adults
•clinically significant drug interac ons that should be avoided in older adults
•medica ons to be avoided or dosage decreased in the presence of impaired kidney func on in
older adults (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450 - Answer Many medica ons are metabolized through the liver enzyme system called
cytochrome P450 (CYP450). Metaboliza on can be inhibited or induced by drugs and once this
happens drug-drug interac ons can occur.
VISA credit card dept Inhibits Spending on CK and GQ - Answer Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
, Q-uinidine
CYP450 Inhibitors - Answer - Decreases the CYP450 which keeps the medica on in your body
longer which can cause toxicity
CYP450 INDUCERS - Answer Increase CYP450 to work faster causes
Drugs to leave your body faster.
Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs - Answer
Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype? - Answer Metabolizes to
slow or to fast.
How is absorp on of intramuscular medica on different in neonates? - Answer •Slow and
erra c due to low blood flow in muscles first few days of life
•Why is absorp on of medica on in the stomach increased in infancy? - Answer Delayed gastric
emptying (adult values reached by 6-8 months)
