DETAILED QUESTIONS AND VERIFIED
ANSWERS FULL SOLUTION GRADED A+
⩥Who determines and regulates prescriptive authority? Answer: The
state's health professional board
⩥How does limited prescriptive authority impact patients within the
healthcare system? Answer: Creates numerous barriers to quality,
affordable, and accessible patient care
May prevent outreach to areas of greatest need
Physician approval of prescriptions can increase patient waits
⩥What are the key responsibilities of prescribing? Answer: A sound
understanding of drugs and the conditions that they are used to manage
Be deliberate in decision-making process
Do not prescribe for family or friends
Document thorough history and physical for the records, including
education provided on drug
Have a documented plan for monitoring and titration
⩥What should be used in making prescribing decisions? Answer: Cost,
follow current guidelines, availability, interactions, side effects,
,allergies, hepatic/renal function, need for monitoring, special
populations
⩥PK and PD changes in older adults and how that affects how you
prescribe? Answer: Very high risk of adverse drug reactions and drug-
drug interactions
D/t altered PK, multiple and severe illnesses, polypharmacy, poor
adherence
⩥Beer's Criteria Answer: List of potentially inappropriate medications to
use in the older populations
Updated annually
Prescribers ultimately decide whether to prescribe or not
⩥Impacts/outcomes of polypharmacy? Answer: Increased ADRs and
drug-drug interactions
⩥What are CYP450? Answer: Enzymes responsible for drug metabolism
(biotransformation)-oxidization, reduction, hydrolyzed to promote renal
dug excretion
Hepatic enzyme system, composed of 12 enzyme families
⩥What do CYP450 enzymes do? Answer: Promote drug excretion by
making them more "excretable"--hydrophilic/water soluble and charged
(ion)
, Inactivate drugs, increase therapeutic action through metabolism,
activate a prodrug, decrease drug toxicity
⩥CYP450 inhibitor examples? Answer: VISA credit card debt inhibits
spending on designers like CK to look GQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconzaole
Grapefruit juice
Quinidine
⩥What do CYP450 inhibitors do? Answer: Decrease the rate of
metabolism
Act on liver through process of inhibition
Slows rate of metabolism, increases active drug accumulation which can
lead to adverse reactions and drug toxicity
⩥What do CYP450 inhibitors do if not used correctly? Answer: Can
lead to adverse effects and drug toxicity