lOMoARcPSD|50207110
Pharm Midterm Study Guide
Advanced Pharmacology Fundamentals ( A.T Still University of Health Sciences)
PHARM 101 EXAM 1 COMPLETE
STUDY GUIDE Pharmacology
Fundamentals | NCLEX-Style
Q&A with, Exams of Nursing
Prof Eduardo Molina & Dr Gero
, lOMoARcPSD|50207110
1
Week 1
Drug Schedules
Each drug preparation regulated under the CSA has been assigned to one of five
categories: schedule I, II, III, IV, or V. Drugs in schedule I have a high potential for abuse
and no approved medical use in the United States. In contrast, drugs in schedules II
through V all have approved applications. Assignment to schedules II through V is based
on abuse potential and potential for causing physical or psychological dependence. Of
the drugs that have medical applications, those in schedule II have the highest potential
for abuse and dependence. Drugs in the remaining schedules have decreasing abuse
and dependence liabilities.
-Descriptions of each schedule
Schedule II
All prescriptions for schedule II drugs must be typed or filled out in ink or indelible pencil
and signed by the prescriber. Alternatively, prescribers may submit prescriptions using
an electronic prescribing procedure. Oral prescriptions may be called in but only in
emergencies, and a written prescription must follow within 72 hours. Prescriptions for
schedule II drugs cannot be refilled. However, a DEA rule allows a prescriber to write
multiple prescriptions on the same day—for the same patient and same drug.
Schedules III and IV
Prescriptions for drugs in schedules III and IV may be oral, written, or electronic. If
authorized by the prescriber, these prescriptions may be refilled up to 5 times. Refills
must be made within 6 months of the original order. If additional medication is needed
beyond the amount provided for in the original prescription, a new prescription must be
written.
Schedule V
The same regulations for prescribing drugs in schedules III and IV apply to drugs in
schedule V. In addition, schedule V drugs may be dispensed without a prescription
provided the following conditions are met: (1) the drug is dispensed by a pharmacist; (2)
the amount dispensed is very limited; (3) the recipient is at least 18 years old; (4) the
pharmacist writes and initials a record indicating the date, the name and amount of the
drug, and the name and address of the recipient; and (5) state and local laws do not
prohibit dispensing schedule V drugs without a prescription .
, lOMoARcPSD|50207110
2
•Examples of drugs in each schedule
Schedule I Drugs: Opioids, Acetylmethadol, Heroin, Normethadone, marijuana, any
others
Schedule II Drugs: Opioids, Alfentanil, Codeine, Fentanyl, Hydrocodone,
Methamphetamine, Barbiturates, Cocaine
Schedule III Drugs: Opioids, Buprenorphine, Paregoric, Cannabinoids, Dronabinol (THC),
Stimulants, Testosterone, Ketamine
Schedule IV Drugs: Opioids, Benzodiazepines, Alprazolam, Chlordiazepoxide,
Clonazepam, Lorazepam, Midazolam
Schedule V Drugs: Opioids, Diphenoxylate plus atropine, Pregabalin
•Which ones can and cannot be prescribed by nurse practitioners?
-Prescriptive Authority
Prescriptive authority is the legal right to prescribe drugs. Full prescriptive
authority affords the legal right to prescribe independently and without
limitation. There are two components of prescriptive authority: (1) the right to
prescribe independently and (2) the right to prescribe without limitation. The
provider who prescribes independently is not subject to rules requiring physician
supervision or collaboration.
Full-practice scope
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.
Reduced-practice scope
Nurse practitioners are limited in at least one element of practice. The state requires a formal
collaborative agreement with an outside health discipline for the nurse practitioner to provide patient
care.
Restricted practice scope Nurse practitioners are limited in at least one element of practice by
requiring supervision, delegation, or team management by an outside health discipline for the nurse
practitioner to provide patient care.
, lOMoARcPSD|50207110
3
▪Understand what prescriptive authority is and who mandates it.
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
Prescriptive authority is determined by state law. The regulation of
prescriptive authority is under the jurisdiction of a health professional board. This
may be the State Board of Nursing, the State Board of Medicine, or the State
Board of Pharmacy, as determined by each state.
▪What problems arise when prescriptive authority is limited?
Limited prescriptive authority creates numerous barriers to quality, affordable, and
accessible patient care. For example, restrictions on the distance of the APRN or PA
from the physician providing supervision or collaboration may prevent outreach to areas
of greatest need. A requirement to obtain the physician's cosignature on prescriptions
can increase patient waits. Despite the use of terms such as collaborative arrangement,
these relationships create a situation in which one partner holds the power. In the event
of dissolution of the arrangement, the ultimate loss is commonly assumed by the
advanced practice provider rather than the physician.
•Know the responsibilities of prescribing
need route on every prescription. for future reference, if giving a 90 day rx then refills needed = 3
The best way to keep your patients (and yourself) safe is to be prudent and
deliberate in your decision-making process. Have a documented provider–patient
relationship with the person for whom you are prescribing. Do not prescribe
medications for family or friends or for yourself. Document a thorough history and
Pharm Midterm Study Guide
Advanced Pharmacology Fundamentals ( A.T Still University of Health Sciences)
PHARM 101 EXAM 1 COMPLETE
STUDY GUIDE Pharmacology
Fundamentals | NCLEX-Style
Q&A with, Exams of Nursing
Prof Eduardo Molina & Dr Gero
, lOMoARcPSD|50207110
1
Week 1
Drug Schedules
Each drug preparation regulated under the CSA has been assigned to one of five
categories: schedule I, II, III, IV, or V. Drugs in schedule I have a high potential for abuse
and no approved medical use in the United States. In contrast, drugs in schedules II
through V all have approved applications. Assignment to schedules II through V is based
on abuse potential and potential for causing physical or psychological dependence. Of
the drugs that have medical applications, those in schedule II have the highest potential
for abuse and dependence. Drugs in the remaining schedules have decreasing abuse
and dependence liabilities.
-Descriptions of each schedule
Schedule II
All prescriptions for schedule II drugs must be typed or filled out in ink or indelible pencil
and signed by the prescriber. Alternatively, prescribers may submit prescriptions using
an electronic prescribing procedure. Oral prescriptions may be called in but only in
emergencies, and a written prescription must follow within 72 hours. Prescriptions for
schedule II drugs cannot be refilled. However, a DEA rule allows a prescriber to write
multiple prescriptions on the same day—for the same patient and same drug.
Schedules III and IV
Prescriptions for drugs in schedules III and IV may be oral, written, or electronic. If
authorized by the prescriber, these prescriptions may be refilled up to 5 times. Refills
must be made within 6 months of the original order. If additional medication is needed
beyond the amount provided for in the original prescription, a new prescription must be
written.
Schedule V
The same regulations for prescribing drugs in schedules III and IV apply to drugs in
schedule V. In addition, schedule V drugs may be dispensed without a prescription
provided the following conditions are met: (1) the drug is dispensed by a pharmacist; (2)
the amount dispensed is very limited; (3) the recipient is at least 18 years old; (4) the
pharmacist writes and initials a record indicating the date, the name and amount of the
drug, and the name and address of the recipient; and (5) state and local laws do not
prohibit dispensing schedule V drugs without a prescription .
, lOMoARcPSD|50207110
2
•Examples of drugs in each schedule
Schedule I Drugs: Opioids, Acetylmethadol, Heroin, Normethadone, marijuana, any
others
Schedule II Drugs: Opioids, Alfentanil, Codeine, Fentanyl, Hydrocodone,
Methamphetamine, Barbiturates, Cocaine
Schedule III Drugs: Opioids, Buprenorphine, Paregoric, Cannabinoids, Dronabinol (THC),
Stimulants, Testosterone, Ketamine
Schedule IV Drugs: Opioids, Benzodiazepines, Alprazolam, Chlordiazepoxide,
Clonazepam, Lorazepam, Midazolam
Schedule V Drugs: Opioids, Diphenoxylate plus atropine, Pregabalin
•Which ones can and cannot be prescribed by nurse practitioners?
-Prescriptive Authority
Prescriptive authority is the legal right to prescribe drugs. Full prescriptive
authority affords the legal right to prescribe independently and without
limitation. There are two components of prescriptive authority: (1) the right to
prescribe independently and (2) the right to prescribe without limitation. The
provider who prescribes independently is not subject to rules requiring physician
supervision or collaboration.
Full-practice scope
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.
Reduced-practice scope
Nurse practitioners are limited in at least one element of practice. The state requires a formal
collaborative agreement with an outside health discipline for the nurse practitioner to provide patient
care.
Restricted practice scope Nurse practitioners are limited in at least one element of practice by
requiring supervision, delegation, or team management by an outside health discipline for the nurse
practitioner to provide patient care.
, lOMoARcPSD|50207110
3
▪Understand what prescriptive authority is and who mandates it.
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
Prescriptive authority is determined by state law. The regulation of
prescriptive authority is under the jurisdiction of a health professional board. This
may be the State Board of Nursing, the State Board of Medicine, or the State
Board of Pharmacy, as determined by each state.
▪What problems arise when prescriptive authority is limited?
Limited prescriptive authority creates numerous barriers to quality, affordable, and
accessible patient care. For example, restrictions on the distance of the APRN or PA
from the physician providing supervision or collaboration may prevent outreach to areas
of greatest need. A requirement to obtain the physician's cosignature on prescriptions
can increase patient waits. Despite the use of terms such as collaborative arrangement,
these relationships create a situation in which one partner holds the power. In the event
of dissolution of the arrangement, the ultimate loss is commonly assumed by the
advanced practice provider rather than the physician.
•Know the responsibilities of prescribing
need route on every prescription. for future reference, if giving a 90 day rx then refills needed = 3
The best way to keep your patients (and yourself) safe is to be prudent and
deliberate in your decision-making process. Have a documented provider–patient
relationship with the person for whom you are prescribing. Do not prescribe
medications for family or friends or for yourself. Document a thorough history and
