APN Roles & Practice in Tennessee
APNs in Tennessee may prescribe medications, including controlled substances, within scope under collaboration requirements.
NPs must hold a Certificate of Fitness before prescribing.
NP prescribing improves access, reduces cost, and improves chronic disease outcomes.
Nurse educators need advanced pharmacology to ensure safe, evidence-based prescribing education.
APN students must complete Advanced Pharmacology, Pathophysiology, and Health Assessment to qualify for prescribing.
Tennessee is a restricted practice state requiring physician collaboration.
Collaboration improves outcomes through support, consultation, and continuity of care.
Regulatory & Legal Foundations
The FDA ensures drug safety, efficacy, and labeling.
The State Board of Nursing regulates nursing licensure and practice.
The FD&C Act (1938) required proof of drug safety before marketing.
The Orphan Drug Act (1983) promotes rare disease drug development.
The Pediatric Research Equity Act (2003) requires pediatric studies.
The Drug Quality and Security Act (2013) improves drug tracking and prevents counterfeit drugs.
PDMP tracks controlled substances; Tennessee uses CSMD.
DEA number allows controlled substance prescribing.
NPI number is used for billing and identification.
Pharmacology Foundations
Drugs are developed through preclinical testing, Phase I (safety), Phase II (efficacy), Phase III (large trials), FDA review, and Phase
IV surveillance.
Expedited pathways include Fast Track, Breakthrough, Accelerated Approval, and Priority Review.
Drug responses include therapeutic, side effect, adverse, toxic, allergic, and idiosyncratic effects.
Dose-response curve shows dose vs effect.
Drug selectivity is receptor targeting specificity.
Ion channel receptors open or close ion channels.
Brand drugs are original products.
Generics are bioequivalent and cheaper.
A formulary is a list of approved drugs.
Tier 1 = generic, Tier 2 = preferred brand, Tier 3 = nonpreferred, Tier 4 = specialty.
Schedule I has no medical use.
Schedule II has high abuse potential and no refills.
Schedule III–V allow up to 5 refills in 6 months (III–IV).
Official labeling = FDA-approved use.
Off-label use = non-FDA-approved indication.
Pharmacokinetics & Pharmacodynamics
Pharmacokinetics is ADME: absorption, distribution, metabolism, excretion.
CYP450 enzymes metabolize drugs and cause major drug interactions.
Inhibitors increase drug levels; inducers decrease them.
Drugs are excreted via kidneys, bile, lungs, sweat, saliva, and breast milk.
Renal excretion depends on age, GFR, kidney disease, hydration, and urine pH.
Pharmacodynamics is drug effect on the body.
Drug choice depends on age, pregnancy, organ function, comorbidities, cost, and adherence.
APNs in Tennessee may prescribe medications, including controlled substances, within scope under collaboration requirements.
NPs must hold a Certificate of Fitness before prescribing.
NP prescribing improves access, reduces cost, and improves chronic disease outcomes.
Nurse educators need advanced pharmacology to ensure safe, evidence-based prescribing education.
APN students must complete Advanced Pharmacology, Pathophysiology, and Health Assessment to qualify for prescribing.
Tennessee is a restricted practice state requiring physician collaboration.
Collaboration improves outcomes through support, consultation, and continuity of care.
Regulatory & Legal Foundations
The FDA ensures drug safety, efficacy, and labeling.
The State Board of Nursing regulates nursing licensure and practice.
The FD&C Act (1938) required proof of drug safety before marketing.
The Orphan Drug Act (1983) promotes rare disease drug development.
The Pediatric Research Equity Act (2003) requires pediatric studies.
The Drug Quality and Security Act (2013) improves drug tracking and prevents counterfeit drugs.
PDMP tracks controlled substances; Tennessee uses CSMD.
DEA number allows controlled substance prescribing.
NPI number is used for billing and identification.
Pharmacology Foundations
Drugs are developed through preclinical testing, Phase I (safety), Phase II (efficacy), Phase III (large trials), FDA review, and Phase
IV surveillance.
Expedited pathways include Fast Track, Breakthrough, Accelerated Approval, and Priority Review.
Drug responses include therapeutic, side effect, adverse, toxic, allergic, and idiosyncratic effects.
Dose-response curve shows dose vs effect.
Drug selectivity is receptor targeting specificity.
Ion channel receptors open or close ion channels.
Brand drugs are original products.
Generics are bioequivalent and cheaper.
A formulary is a list of approved drugs.
Tier 1 = generic, Tier 2 = preferred brand, Tier 3 = nonpreferred, Tier 4 = specialty.
Schedule I has no medical use.
Schedule II has high abuse potential and no refills.
Schedule III–V allow up to 5 refills in 6 months (III–IV).
Official labeling = FDA-approved use.
Off-label use = non-FDA-approved indication.
Pharmacokinetics & Pharmacodynamics
Pharmacokinetics is ADME: absorption, distribution, metabolism, excretion.
CYP450 enzymes metabolize drugs and cause major drug interactions.
Inhibitors increase drug levels; inducers decrease them.
Drugs are excreted via kidneys, bile, lungs, sweat, saliva, and breast milk.
Renal excretion depends on age, GFR, kidney disease, hydration, and urine pH.
Pharmacodynamics is drug effect on the body.
Drug choice depends on age, pregnancy, organ function, comorbidities, cost, and adherence.
