NR565 Midterm Study
APRN prescribing role - answers Prescriptive authority for nurse practitioners also regulates prescribing rights beyond medications and controlled substances. These rights include therapeutic devices and services and are outlined in state practice laws and ...
APRN prescribing role - answers Prescriptive authority for nurse practitioners also
regulates prescribing rights beyond medications and controlled substances. These
rights include therapeutic devices and services and are outlined in state practice laws
and regulations and include Durable Medical Equipment (DME) such as wheelchairs,
power scooters, hospital beds, portable oxygen equipment, handicap placards, etc. and
medical services such as Physical Therapy (PT), Occupational Therapy (OT), home
health services, etc. Prescriptive authority encompasses more than writing a
prescription correctly. It requires adherence to ethical guidelines to ensure that patients
are safeguarded from harm. Ethical prescribing starts with being well-informed about
medications. Mechanism of action, efficacy, and safety are important considerations, as
are a patient's distinct needs and circumstances, including the number of medications
prescribed (Mitchell & Oliphant, 2016). Most patients receiving a prescription are taking
other medications, whether prescription or over-the-counter. Appropriate selection,
dosing, and duration of pharmaceutical agents are key to maximizing outcomes and
minimizing adverse effects
benefits of full practice authority - answers Nurse practitioners have the autonomy to
evaluate patients, diagnose, order and interpret tests, initiate and manage treatments
and prescribe medications, including controlled substances without physician oversight
promoting positive outcomes through prudent prescribing practices - answers
Administering medications and prescribing medications are two distinct processes.
Prescription writing requires prudent and deliberate decision-making processes to
maintain patient safety and reduce liability, including:
*documentation of a provider-patient relationship for the recipient of the prescribed
medications
*documentation of a thorough history and physical examination for the recipient
*documentation of discussions regarding risk factors, side effects, or therapy options
*documentation of drug monitoring or titration plan, if applicable
, *documentation of consultations, if any
avoidance of prescribing medications for self, family, or friends
Rational drug selection requires a logical approach that includes the formulation of a
diagnosis based on clinical reasoning and the selection and monitoring of the most
appropriate pharmacological treatment
Considerations include: Cost, guidelines, availability, interactions, side effects, allergies,
hepatic/renal functions, need for monitoring, & special populations
Beer's Criteria - answers identifies drugs with a high likelihood of causing adverse
effects in older adults. Accordingly, drugs on this list should generally be avoided in
adults older than 65 years except when the benefits are significantly greater than the
risks.
Pharmacodynamics - answers the study of the biochemical and physiologic effects of
drugs on the body and the molecular mechanisms by which those effects are produced
Pharmacokinetics - answers the study of drug movement throughout the body
Pharmacogenomics - answers the study of how genes affect a person's response to
drugs. The purpose of this is to combine the sciences of genomics and pharmacology to
provide individualized, targeted, safe drug therapies to patients
CYP450 inducers - answers Inducers are xenobiotics (medications and environmental
agents) that elevate CYP450 enzyme activity by increasing enzyme synthesis. This
action leads to additional sites available for biotransformation. The increased number of
sites enhances medication metabolism, decreasing the concentration of the "parent
drug" while increasing metabolite production.
CYP450 inhibitors - answers Inhibitors are medications that inhibit the metabolic activity
of one or more of the CYP450 enzymes. Medications that inhibit an enzyme potentially
slows that enzyme's activity or blocks the activity required for the metabolism of other
medications, thereby increasing the levels of medications dependent on that particular
enzyme for biotransformation. Inhibitors = decrease medication metabolism (Valproate,
Isoniazid, Sulfonamides, Amiodarone, Chloramphenicol, Ketoconazole, Grapefruit
Juice, Quinidine)
cultural influences in prescribing - answers The greatest concern surrounding race-
based therapy has to do with genetic variability. We know there is great diversity within
and among racial groups; therefore, a "one fits all" approach based on race is unwise.
Still, we can use known associations to guide choices. For example, differences in
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