NR565 Advanced Pharmacology Midterm Exam – Drug Therapy and Clinical Application Assessment
Which schedule drugs can APRNs prescribe? - (ANSWER)II-V
Who determines and regulates prescriptive authority? - (ANSWER)State Board of Nursing
How does limited prescriptive authority impact patients within the healthcare system? -
(ANSWER)Longer wait times to sign a prescription
Limit practitioners that are needed in rural areas
Unequal relationships between providers.
Independent practitioners= more patients being seen= lessens the patient/provider load
What are the key responsibilities of prescribing? - (ANSWER)Safe and competent practice
Understanding of the drugs, reactions, and pharmacology
Be aware of the age group you are prescribing to
What should be used to make prescribing decisions? - (ANSWER)Documented provider-patient
relationship
Not prescribing for family or friends
Documenting a thorough H&P, including discussions with the patient, and drug monitoring/titrating.
Cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal function, need for
monitoring, and special populations
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and how that would
translate to baseline information needed to prescribe. - (ANSWER)increase glomerular filtration rate
leads to increase drug excretion
increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
Beer's Criteria- What is it and Why is it important - (ANSWER)Recommendations of medications
inappropriate for elderly (65 and older)
Prevents adverse drug reactions
, NR565 Advanced Pharmacology Midterm Exam – Drug Therapy and Clinical Application Assessment
Impacts/outcomes of polypharmacy - (ANSWER)-increase risk for medication interactions
CYP450 inhibitors
o Examples
o What do they do?
o What do they cause if not used correctly? (aka: What would the patient experience?) -
(ANSWER)inhibit metabolism, increase blood levels of medications
Examples
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit juice,
quinidine
"VISA credit card debt INHIBITS spending on designers like CK to look GQ"
Examples of CYP450 inducers
o Examples
o What do they do?
o What do they cause if not used correctly? (aka: What would the patient experience?) -
(ANSWER)Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood
levels of drug)
Examples
Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital,
sulfonylureas
"Bullshit Crap GPS INDUCES rage"
What happens when someone has a poor metabolism phenotype? - (ANSWER)medications metabolized
slower, medication might not work or put them at risk for side-effects
What does the U.S. Food and Drug Administration regulate when it comes to medications? -
(ANSWER)Whether the drug is safe, effective, and benefits of a drug outweigh the risks
Reasons for medication non-adherence - (ANSWER)patients never filling/refilling prescriptions (resulting
in therapeutic failure)
Which schedule drugs can APRNs prescribe? - (ANSWER)II-V
Who determines and regulates prescriptive authority? - (ANSWER)State Board of Nursing
How does limited prescriptive authority impact patients within the healthcare system? -
(ANSWER)Longer wait times to sign a prescription
Limit practitioners that are needed in rural areas
Unequal relationships between providers.
Independent practitioners= more patients being seen= lessens the patient/provider load
What are the key responsibilities of prescribing? - (ANSWER)Safe and competent practice
Understanding of the drugs, reactions, and pharmacology
Be aware of the age group you are prescribing to
What should be used to make prescribing decisions? - (ANSWER)Documented provider-patient
relationship
Not prescribing for family or friends
Documenting a thorough H&P, including discussions with the patient, and drug monitoring/titrating.
Cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal function, need for
monitoring, and special populations
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and how that would
translate to baseline information needed to prescribe. - (ANSWER)increase glomerular filtration rate
leads to increase drug excretion
increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
Beer's Criteria- What is it and Why is it important - (ANSWER)Recommendations of medications
inappropriate for elderly (65 and older)
Prevents adverse drug reactions
, NR565 Advanced Pharmacology Midterm Exam – Drug Therapy and Clinical Application Assessment
Impacts/outcomes of polypharmacy - (ANSWER)-increase risk for medication interactions
CYP450 inhibitors
o Examples
o What do they do?
o What do they cause if not used correctly? (aka: What would the patient experience?) -
(ANSWER)inhibit metabolism, increase blood levels of medications
Examples
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit juice,
quinidine
"VISA credit card debt INHIBITS spending on designers like CK to look GQ"
Examples of CYP450 inducers
o Examples
o What do they do?
o What do they cause if not used correctly? (aka: What would the patient experience?) -
(ANSWER)Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood
levels of drug)
Examples
Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital,
sulfonylureas
"Bullshit Crap GPS INDUCES rage"
What happens when someone has a poor metabolism phenotype? - (ANSWER)medications metabolized
slower, medication might not work or put them at risk for side-effects
What does the U.S. Food and Drug Administration regulate when it comes to medications? -
(ANSWER)Whether the drug is safe, effective, and benefits of a drug outweigh the risks
Reasons for medication non-adherence - (ANSWER)patients never filling/refilling prescriptions (resulting
in therapeutic failure)
