What is prescriptive authority? -Answer Legal right to prescribe drugs
Varies for nonphysician providers
Limitations tied to oversight by MD or DO
Arguments for full prescriptive authority -Answer- APRNs are educated to practice and
prescribe independently without supervision
- National examinations validate ability to provide safe competent care
Licensure assures standards to promote the public health and safety Limited
prescriptive authority creates many barriers to quality, affordable, & accessible patient
care
Drug selection factors- cost, guidelines, availability, interactions, side effects, allergies,
liver & renal function, need for monitoring, special populations
Elements necessary to fill a prescription- Prescriber name, license number, and contact
information
Prescriber DEA number, if appropriate
- Patient name and date of birth
- Patient allergies
- Name of medication
- Indication of medication
- Medication strength, for example 25 mg, 500 mg/mL
- Dose of medication and frequency, for example, 12.5 mg once daily
- Number of tablets/capsules to dispense
- Number of refills
,Pharmokinetics - Answer the study of drugs within the body, absorption, distribution,
metabolism, excretion
P-glycoprotein - Answer transmembrane protein that pumps a wide variety of drugs out
of cells
How does the liver help with pharmacokinetics? - Answer moves drugs into bile for
removal
How do the kidneys help with pharmacokinetics? - Answer pumps drugs into urine for
excretion
How does the placenta help with pharmacokinetics? - Answer pumps drugs back into
maternal blood
, How does the brain assist in pharmacokinetics? -Answer pumps drugs into blood to limit
drugs' access into the brain
passive diffusion- Answer molecules move from one side of a barrier to another without
expelling energy; moving from an area of higher concentration to lower concentration
"like dissolves like" rule - Answer Cell membranes are composed primarily of lipids;
therefore, to directly penetrate membranes, a drug must be lipid soluble (lipophilic)
polar molecules - Answer Molecules that have an unequal distribution of charges
No net charge
ions - Answer molecules that have a net electrical charge
quaternary ammonium compounds - Answer molecules that contain at least 1 atom of
nitrogen and carry a positive charge at all times
pH dependent ionization - Answer Acid is a proton donor - tends to ionize in basic
(alkaline) media
Base is a proton acceptor - tends to ionize in acidic media
ion trapping (pH partitioning) - Answer acidic drugs accumulate on the alkaline side
basic drugs accumulate on the acidic side
blood flow to tissues - Answer Drugs are carried by the blood to tissues and organs of
the body
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