NR-565 Advanced Pharmacology Fundamentals NR565 Midterm Exam Study G uide Which schedule drugs can APRNs prescribe? Correct Answer: Schedule 3 -5 Who determines and regulates prescriptive authority? Correct Answer: The State Board of Nursing, Medicine, and Pharmacy for each individual state. The Federal Government regulates controlled substances, including prescription medications How does limited prescriptive authority impact patients within the healthcare system? Correct Answer: Leaves patients with fewer treatment options. They may have t o seek out a provider who has prescriptive authority. Time consuming, can be expensive for the patient. What are the key responsibilities of prescribing? Correct Answer: Understand the drug you are prescribing, including possible side effects, contraindic ations, and the need for appropriate monitoring. YOU are responsible for the Rx you sign. Ensure drug and dosages are correct. What should be used to make prescribing decisions? Correct Answer: Decisions should be based on pharmacokinetics and pharmacody namic changes that occur in adults and children. Can affect absorption, distribution, metabolism and elimination. Know how they interact with target receptors and produce therapeutic effects. Beer's Criteria Correct Answer: A tool used to identify potentially inappropriate medication (PIM) use in older adults. Includes medications that should be used cautiously in older adults. Includes clinically significant drug interactions that should be avoided in older adults. Identifie s medications that can cause impaired kidney function in older adults. Impacts/outcomes of polypharmacy Correct Answer: Adverse drug events Increased healthcare services interaction Cognitive impairment Reduced adherence Falls Mortality CYP450 inhibito rs examples Correct Answer: Valproate Isoniazid Sulfonamides Amiodarone Chloramphenicol Ketoconazole Grapefruit juice Quinidine What do CYP450 inhibitors do? Correct Answer: Decrease Medication Metabolism What can CYP450 inhibitors cause if not used correctly? Correct Answer: Toxicity if CYP enzymes are not active enough. Ineffectiveness of CYP enzymes are overactive. Examples of CYP450 inducers Correct Answer: BSCRAP GPS Incudes Rage Barbiturates St. Joh n's Wort Carbamazepine Rifampin Alcohol Phenytoin Griseofulvin Phenobarbital Sulfonylureas What happens when someone has a poor metabolism phenotype? Correct Answer: The poor metabolism (PM) phenotype occurs when both alleles of CYP206 carry inactivating mutations and give rise to synthesis of enzyme with impaired activity or no synthesis of enzyme at all.
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