1
,2
, Follow up and monitoring to see how well treatment with the drug is meeting the goal
Include questions when to consult with or refer to a specialist
Are there unnecessary duplication with other drugs that the patient is already taking
Review patient medication history at each encounter to detect duplications or
medications that maybe discontinued
Use of an integrated EHR can assist the provider in discovering the duplication of
therapy and collaborating wi5 other providers to develop a simplified regimen.
Would an OTC drug be just as useful as a prescription drug?
Increasing numbers of drugs are being moved from prescription to OTC, May lead to
reduction in cost or increase patients cost due to insurance no longer paying for the
medication.
Patient may not consider OTC as drugs because they are not prescribed therefore a
careful history of medications would specifically ask about OTC medications.
What about the cost?
Can the patient afford the drug?
Will the cost of medication affect adherence to the treatment regimen
Consideration of cost is a major factor in choosing between the newer drugs and ones
that has been around long enough to be available in generic form
Where is the information to answer this questions?
Sources of drug information includes the wide array of professional literature that ranges
from journals to literatures from specialty and professional organizations and drug
databases such as lexicomp and Epocrates
Reliable drug information - Current, unbiased information, relevant to specific patient
for whom the drug will be prescribed, reliable and valid research, national and
international guidelines were used
Collaboration with other providers
Physicians- expertise related to pharmacology is based on understanding biochemistry
and prescribing for a given pathophysiology- emphasis is on the disease and the drug
with less emphasis on the impact on the patient.
, Pharmacist- extensive knowledge about pathophysiology and best drug to prescribe.
Can assist APRNs and physicians by offering expertise on the clinical management of
the patients including available dosage forms, potential adverse reactions and drug
interactions.
other APRNs- one to one basis dealing with individual patient issues. Share knowledge
base and collaborate to improve the care of the patient. Collaboration on issues related
to SOP and prescriptive privilege at the state and national level is critical to obtaining
and maintaining the autonomy of practice needed to provide optimal patient care.
PA-practice is similar to that of a physician so both APRN and PA can benefit from
interaction with each other
Nurses not in advance practice roles such as certified Diabetic Educator- carry out
APRNs order. APRNs must know the Nurse practice act in the state where they practice
because nurses preparation and responsibility are defined by the Nurse practice act in
each state.
Autonomy and Prescriptive authority
Most states are broadening and expanding the legal reimbursement and prescriptive authority to
practice for all APRNs. Momentum to full autonomy is gaining with 26 states allowing
independent practice for NPs and 21 states allowing independent full prescribing as of January
2015. APRNs in other states have also gained recognition, although the SOP and prescriptive
authority is often restricted.
Not all states have legislation that permits APRNs to prescribed independently of any required
physician involvement. Turf battles continue between APRNs and physicians at national and
many states levels over physician's supervision requirements and co signature on prescriptions
Chapter 2: Review of Basic Principles of Pharmacology
How Drugs are Developed
Drugs are developed by pharmaceutical companies to help patients and to make money
The early part of the drug development process is called the preclinical stage
Pharmaceutical companies will identify a drug target, starting sometimes with ingredients
isolated from a plant (or organism in the case of antibiotics) with desirable medicinal
,2
, Follow up and monitoring to see how well treatment with the drug is meeting the goal
Include questions when to consult with or refer to a specialist
Are there unnecessary duplication with other drugs that the patient is already taking
Review patient medication history at each encounter to detect duplications or
medications that maybe discontinued
Use of an integrated EHR can assist the provider in discovering the duplication of
therapy and collaborating wi5 other providers to develop a simplified regimen.
Would an OTC drug be just as useful as a prescription drug?
Increasing numbers of drugs are being moved from prescription to OTC, May lead to
reduction in cost or increase patients cost due to insurance no longer paying for the
medication.
Patient may not consider OTC as drugs because they are not prescribed therefore a
careful history of medications would specifically ask about OTC medications.
What about the cost?
Can the patient afford the drug?
Will the cost of medication affect adherence to the treatment regimen
Consideration of cost is a major factor in choosing between the newer drugs and ones
that has been around long enough to be available in generic form
Where is the information to answer this questions?
Sources of drug information includes the wide array of professional literature that ranges
from journals to literatures from specialty and professional organizations and drug
databases such as lexicomp and Epocrates
Reliable drug information - Current, unbiased information, relevant to specific patient
for whom the drug will be prescribed, reliable and valid research, national and
international guidelines were used
Collaboration with other providers
Physicians- expertise related to pharmacology is based on understanding biochemistry
and prescribing for a given pathophysiology- emphasis is on the disease and the drug
with less emphasis on the impact on the patient.
, Pharmacist- extensive knowledge about pathophysiology and best drug to prescribe.
Can assist APRNs and physicians by offering expertise on the clinical management of
the patients including available dosage forms, potential adverse reactions and drug
interactions.
other APRNs- one to one basis dealing with individual patient issues. Share knowledge
base and collaborate to improve the care of the patient. Collaboration on issues related
to SOP and prescriptive privilege at the state and national level is critical to obtaining
and maintaining the autonomy of practice needed to provide optimal patient care.
PA-practice is similar to that of a physician so both APRN and PA can benefit from
interaction with each other
Nurses not in advance practice roles such as certified Diabetic Educator- carry out
APRNs order. APRNs must know the Nurse practice act in the state where they practice
because nurses preparation and responsibility are defined by the Nurse practice act in
each state.
Autonomy and Prescriptive authority
Most states are broadening and expanding the legal reimbursement and prescriptive authority to
practice for all APRNs. Momentum to full autonomy is gaining with 26 states allowing
independent practice for NPs and 21 states allowing independent full prescribing as of January
2015. APRNs in other states have also gained recognition, although the SOP and prescriptive
authority is often restricted.
Not all states have legislation that permits APRNs to prescribed independently of any required
physician involvement. Turf battles continue between APRNs and physicians at national and
many states levels over physician's supervision requirements and co signature on prescriptions
Chapter 2: Review of Basic Principles of Pharmacology
How Drugs are Developed
Drugs are developed by pharmaceutical companies to help patients and to make money
The early part of the drug development process is called the preclinical stage
Pharmaceutical companies will identify a drug target, starting sometimes with ingredients
isolated from a plant (or organism in the case of antibiotics) with desirable medicinal
