NR 565: Advanced Pharmacology midterm study guide
i i i i i i
Week i1
• - iDrug iSchedules i Descriptions iof ieach ischedule
• Examples iof idrugs iin ieach ischedule
Schedule iI iControlled iSubstances
Substances iin ithis ischedule ihave ino icurrently iaccepted imedical iuse iin ithe iUnited
iStates, ia ilack iof iaccepted isafety ifor iuse iunder imedical isupervision, iand ia ihigh
ipotential ifor iabuse.
Some iexamples iof isubstances ilisted iin iSchedule iI iare: iheroin, ilysergic iacid
idiethylamide i(LSD), imarijuana i(cannabis), ipeyote, imethaqualone, iand i3,4-
imethylenedioxymethamphetamine i("Ecstasy").
Schedule iII/IIN iControlled iSubstances i(2/2N)
Substances iin ithis ischedule ihave ia ihigh ipotential ifor iabuse iwhich imay ilead ito
isevere ipsychological ior iphysical idependence.
Examples iof iSchedule iII inarcotics iinclude: ihydromorphone i(Dilaudid®),
imethadone i(Dolophine®), imeperidine i(Demerol®), ioxycodone i(OxyContin®,
iPercocet®), iand ifentanyl i(Sublimaze®, iDuragesic®). iOther iSchedule iII inarcotics
iinclude: imorphine, iopium, icodeine, iand ihydrocodone.
Examples iof iSchedule iIIN istimulants iinclude: iamphetamine i(Dexedrine®,
iAdderall®), imethamphetamine i(Desoxyn®), iand imethylphenidate i(Ritalin®).
Other iSchedule iII isubstances iinclude: iamobarbital, iglutethimide, iand
ipentobarbital.
Schedule iIII/IIIN iControlled iSubstances i(3/3N)
Substances iin ithis ischedule ihave ia ipotential ifor iabuse iless ithan isubstances iin
iSchedules iI ior iII iand iabuse imay ilead ito imoderate ior ilow iphysical idependence ior
ihigh ipsychological idependence.
Examples iof iSchedule iIII inarcotics iinclude: iproducts icontaining inot imore ithan i90
imilligrams iof icodeine iper idosage iunit i(Tylenol iwith iCodeine®), iand
ibuprenorphine i(Suboxone®).
Examples iof iSchedule iIIIN inon-narcotics iinclude: ibenzphetamine i(Didrex®),
iphendimetrazine, iketamine, iand ianabolic isteroids isuch ias iDepo®-Testosterone.
Schedule iIV iControlled iSubstances
, Substances iin ithis ischedule ihave ia ilow ipotential ifor iabuse irelative ito isubstances
iin iSchedule iIII.
Examples iof iSchedule iIV isubstances iinclude: ialprazolam i(Xanax®), icarisoprodol
i(Soma®), iclonazepam i(Klonopin®), iclorazepate i(Tranxene®), idiazepam
i(Valium®), ilorazepam i(Ativan®), imidazolam i(Versed®), itemazepam i(Restoril®),
iand itriazolam i(Halcion®).
Schedule iV iControlled iSubstances
Substances iin ithis ischedule ihave ia ilow ipotential ifor iabuse irelative ito isubstances
ilisted iin iSchedule iIV iand iconsist iprimarily iof ipreparations icontaining ilimited
iquantities iof icertain inarcotics.
Examples iof iSchedule iV isubstances iinclude: icough ipreparations icontaining inot
imore ithan i200 imilligrams iof icodeine iper i100 imilliliters ior iper i100 igrams
i(Robitussin iAC®, iPhenergan iwith iCodeine®), iand iezogabine.
• Which iones ican iand ican inot ibe iprescribed iby inurse ipractitioners
➢ They ican iprescribe iall ibut ischedule i1 ibecause ithey iare inot ilegal. iVaries iby istate
• Prescriptive iAuthority
• Understand iwhat iprescriptive iauthority iis iand iwho imandates iit.
➢ State imandates iit iunder ithe ijurisdiction iof ithe ihealth iprofessional iboard. i(state
iboard iof inursing, iboard iof imedicine ior iboard iof ipharmacy). iFederal igovernment
icontrols idrug iregulations ibut ihas ino icontrol iover iprescriptive iauthority.
iPrescriptive iauthority iis ithe ilegal iright ito iprescribe idrugs. iFull iauthority iis ibeing
iable ito iprescribe iindependently iwithout ilimitations. iMDs iand iDOs ihave ino ilimits.
iLimitations iare itied ito ioversight iof ithe idoctor ior iDO. iBeing iable ito iprescribe
iindependently imeans iis inot isubject ito irules irequiring iphysician isupervision ior
icollaboration. iFlorida iIII-V icollaborative.
• What iproblems iarise iwhen iit iis ilimited?
➢ Barriers iinclude iquality, iaffordable, iand iaccessible ipatient icare. iCan iincrease
ipatient iwaits
• Know ithe iresponsibilities iof iprescribing
➢ Must iconsider icost, iavailability, iinteractions iwith ieither ifood ior iother
imedications, iside ieffects, iallergies, ihow ithe idrug iis imetabolized i(hepatic ior irenal),
ineed ifor imonitoring i(labs, ieffectiveness, iect) ispecial ipopulations i(pregnancy,
inursing imothers, ior iolder iadults)
• Know ipatient ireasons ifor imedication inon-adherence
➢ Missed ia idose, iforgot ito itake ia idose, idid inot irefill imedication iin itime, itook ilower
ithan iprescribed idose, idid inot irefill imedication, istopped itaking imedication.
➢ Reason iwhy iincludes iforgot ia idose, iran iout, iwas iaway ifrom ihome, itrying ito isave
imoney, idid inot ilike ithe iside ieffects, iwas itoo ibusy, ithe imedication ididn’t iwork,
ididn’t ibelieve imedication iwas inecessary, ididn’t ilike itaking ithe imedication. iFailure
ito icomprehend iinstructions ifor ireasons isuch ias ivisual, iintellectual ior iauditory
iimpairment, iuse iof icomplex iregimens i(taking iseveral idrugs imultiple itimes ia iday)
i i i i i i
Week i1
• - iDrug iSchedules i Descriptions iof ieach ischedule
• Examples iof idrugs iin ieach ischedule
Schedule iI iControlled iSubstances
Substances iin ithis ischedule ihave ino icurrently iaccepted imedical iuse iin ithe iUnited
iStates, ia ilack iof iaccepted isafety ifor iuse iunder imedical isupervision, iand ia ihigh
ipotential ifor iabuse.
Some iexamples iof isubstances ilisted iin iSchedule iI iare: iheroin, ilysergic iacid
idiethylamide i(LSD), imarijuana i(cannabis), ipeyote, imethaqualone, iand i3,4-
imethylenedioxymethamphetamine i("Ecstasy").
Schedule iII/IIN iControlled iSubstances i(2/2N)
Substances iin ithis ischedule ihave ia ihigh ipotential ifor iabuse iwhich imay ilead ito
isevere ipsychological ior iphysical idependence.
Examples iof iSchedule iII inarcotics iinclude: ihydromorphone i(Dilaudid®),
imethadone i(Dolophine®), imeperidine i(Demerol®), ioxycodone i(OxyContin®,
iPercocet®), iand ifentanyl i(Sublimaze®, iDuragesic®). iOther iSchedule iII inarcotics
iinclude: imorphine, iopium, icodeine, iand ihydrocodone.
Examples iof iSchedule iIIN istimulants iinclude: iamphetamine i(Dexedrine®,
iAdderall®), imethamphetamine i(Desoxyn®), iand imethylphenidate i(Ritalin®).
Other iSchedule iII isubstances iinclude: iamobarbital, iglutethimide, iand
ipentobarbital.
Schedule iIII/IIIN iControlled iSubstances i(3/3N)
Substances iin ithis ischedule ihave ia ipotential ifor iabuse iless ithan isubstances iin
iSchedules iI ior iII iand iabuse imay ilead ito imoderate ior ilow iphysical idependence ior
ihigh ipsychological idependence.
Examples iof iSchedule iIII inarcotics iinclude: iproducts icontaining inot imore ithan i90
imilligrams iof icodeine iper idosage iunit i(Tylenol iwith iCodeine®), iand
ibuprenorphine i(Suboxone®).
Examples iof iSchedule iIIIN inon-narcotics iinclude: ibenzphetamine i(Didrex®),
iphendimetrazine, iketamine, iand ianabolic isteroids isuch ias iDepo®-Testosterone.
Schedule iIV iControlled iSubstances
, Substances iin ithis ischedule ihave ia ilow ipotential ifor iabuse irelative ito isubstances
iin iSchedule iIII.
Examples iof iSchedule iIV isubstances iinclude: ialprazolam i(Xanax®), icarisoprodol
i(Soma®), iclonazepam i(Klonopin®), iclorazepate i(Tranxene®), idiazepam
i(Valium®), ilorazepam i(Ativan®), imidazolam i(Versed®), itemazepam i(Restoril®),
iand itriazolam i(Halcion®).
Schedule iV iControlled iSubstances
Substances iin ithis ischedule ihave ia ilow ipotential ifor iabuse irelative ito isubstances
ilisted iin iSchedule iIV iand iconsist iprimarily iof ipreparations icontaining ilimited
iquantities iof icertain inarcotics.
Examples iof iSchedule iV isubstances iinclude: icough ipreparations icontaining inot
imore ithan i200 imilligrams iof icodeine iper i100 imilliliters ior iper i100 igrams
i(Robitussin iAC®, iPhenergan iwith iCodeine®), iand iezogabine.
• Which iones ican iand ican inot ibe iprescribed iby inurse ipractitioners
➢ They ican iprescribe iall ibut ischedule i1 ibecause ithey iare inot ilegal. iVaries iby istate
• Prescriptive iAuthority
• Understand iwhat iprescriptive iauthority iis iand iwho imandates iit.
➢ State imandates iit iunder ithe ijurisdiction iof ithe ihealth iprofessional iboard. i(state
iboard iof inursing, iboard iof imedicine ior iboard iof ipharmacy). iFederal igovernment
icontrols idrug iregulations ibut ihas ino icontrol iover iprescriptive iauthority.
iPrescriptive iauthority iis ithe ilegal iright ito iprescribe idrugs. iFull iauthority iis ibeing
iable ito iprescribe iindependently iwithout ilimitations. iMDs iand iDOs ihave ino ilimits.
iLimitations iare itied ito ioversight iof ithe idoctor ior iDO. iBeing iable ito iprescribe
iindependently imeans iis inot isubject ito irules irequiring iphysician isupervision ior
icollaboration. iFlorida iIII-V icollaborative.
• What iproblems iarise iwhen iit iis ilimited?
➢ Barriers iinclude iquality, iaffordable, iand iaccessible ipatient icare. iCan iincrease
ipatient iwaits
• Know ithe iresponsibilities iof iprescribing
➢ Must iconsider icost, iavailability, iinteractions iwith ieither ifood ior iother
imedications, iside ieffects, iallergies, ihow ithe idrug iis imetabolized i(hepatic ior irenal),
ineed ifor imonitoring i(labs, ieffectiveness, iect) ispecial ipopulations i(pregnancy,
inursing imothers, ior iolder iadults)
• Know ipatient ireasons ifor imedication inon-adherence
➢ Missed ia idose, iforgot ito itake ia idose, idid inot irefill imedication iin itime, itook ilower
ithan iprescribed idose, idid inot irefill imedication, istopped itaking imedication.
➢ Reason iwhy iincludes iforgot ia idose, iran iout, iwas iaway ifrom ihome, itrying ito isave
imoney, idid inot ilike ithe iside ieffects, iwas itoo ibusy, ithe imedication ididn’t iwork,
ididn’t ibelieve imedication iwas inecessary, ididn’t ilike itaking ithe imedication. iFailure
ito icomprehend iinstructions ifor ireasons isuch ias ivisual, iintellectual ior iauditory
iimpairment, iuse iof icomplex iregimens i(taking iseveral idrugs imultiple itimes ia iday)
