NR 565 PHARM MIDTERM ALL EXAM QUESTIONS AND ANSWERS, RATED| LATEST UPDATES 2024/25 APPROVED| A+

NR 565 PHARM MIDTERM ALL EXAM QUESTIONS AND ANSWERS, RATED A+ Which scheduled drugs can APRNs prescribe? - -II-V Who determines and regulates prescriptive authority? - -Boards of nursing, pharmacy, medicine How does limited prescriptive authority impact patients within the healthcare system? - -Decreased access to care, longer wait times for APRN/MD signatures, decreased treatment time of the patient Key responsibility of prescribing? - -Documentation of discussion between prescriber and patient, did not prescribe to friends and family, obtain thorough H&P, document discussions regarding medication's, side effects, respecters, monitoring and titrating What should be used to make prescribing decisions? - -Cost, availability, hepatic/renal monitoring, allergies, side effects, interactions, guidelines, special populations Pharmacokinetic/pharmacodynamic changes in older adults. - -Things move slower in older adults. Absorption of medication's in the G.I. tract decrease function of the liver decrease function of the kidneys. Decrease lean muscle mass increase adipose tissue. Beers Criteria for Potentially Inappropriate Medication Use in Older Adults - -Potentially inappropriate medication used in adults due to medication disease or medication syndrome interactions that may exacerbate the disease or syndrome. Clinically significant drug interactions that should be avoided in older adults there's decrease may need to be incorporated it due to decreased kidney function Impacts - outcomes of polypharmacy - -Simplifying drug regimen, providing clear and concise verbal and written instructions, using an appropriate dosage form, clearly labeling and dispensing easy to open containers, developing daily reminders, monitoring frequently, affordability of drugs, support system. CYP 450 inhibitors - -Inhibits the metabolism activity of one or more of the CYP 450 enzymes VISA CKGQ valproate , Isoniazid, sulfonamides, amiodarone, Chloramphincol, ketoconazole, grapefruit, quinidine. Can cause higher levels of toxicity in some meds CYP 450 inducers - -Induces are xenobiotics that elevate CYP 450 enzyme activity by increasing enzyme synthesis examples crap GPS is BS. Carbamazepine, rifampin, alcohol, PhenoBarb, Griselfulvin, phenytoin, barbiturate, St. John's wort, may need to start higher doses of some of these medication's to take affect may take longer. What happens when someone has a poor metabolism phenotype? - -Alters the effect of the medication to produce the desired outcome can either be slow or fast What does the US Food and drug in ministration regulate when it comes to medication? - -Adverse drug reactions Reasons for medication nonadherence - -Cost difficult regimen I'll-effects unwanted side effects frequent monitoring polypharmacy and little to no education. Black box warning's - -Heavily black labeled inside the box for dire and or fatal warnings against issues that can occur with medication's Why are black box warning issued? - -To warn of serious side effects an adverse reactions that can occur with medication Neonate an infant drug absorption - -Adult rate for absorption at two years old for oral distribution adult rate is 10 to 12 months protein binding, hepatic metabolism