NR 565 - advanced pharmacology midterm - Chamberlain
1. During what trimester is a pregnant woman most at risk for adverse drug
reactions with potential long term consequences?: 1st trimester (fetus most
at risk d/t rapid growth)
2. What is BEERS criteria?: Recommendations of medications inappropriate for
elderly (65 and older), prescriber ultimately decides
3. What is the CYP450 (cytochrome P450): liver enzyme system where
medications are metabolized, can either be inducers or inhibitors and create
drug-drug interactions
4. CYP450 inducers: Speed up metabolism of drugs (drug is cleared faster), drug
has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
5. CYP450 inducers pneumonic: "Bullshit Crap GPS INDUCES rage"
6. CYP450 inducer drug names: Barbituates, St John wort, Carbamazepine,
rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas
7. CYP450 inhibitors: inhibit metabolism, increase blood levels of medications
8. CYP450 pneumonic: "VISA credit card debt INHIBITS spending on designers
like CK to look GQ"
9. CYP450 inhibitors drug names: Valproate, isoniazid, sulfonamides,
amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine
10. Physiological changes during pregnancy that impact pharmacodynamics
and pharmacokinetic properties of drugs?: increase glomerular filtration
rate leads to increase durg excretion increase hepatic metabolism decrease
tone and motility of bowel increase drug absorption
11. Examples of medications that can be teratogenic: Antiepileptic drugs,
antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as
diethylstilbestrol (DES).
12. How is absorption of intramuscular medications different in neonates?:
slow and erratic due to low blood flow in muscles first few days of life
13. Why is absorption of medication in the stomach increased in infancy?:
delayed gastric emptying
14. Some medications that should be avoided in the pediatric patient?:
glucocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulfonamides, levofloxacin (antibiotics) aspirin (Severe
intoxication from acute overdose)
15. what should be included in medication administration patient
education?:
dosage size and timing
,route and technique of administration
duration of treatment
drug storage nature and time course of
desired responses nature and time course of
adverse responses finish taking antibiotic
16. What are some things that put the elderly patient at higher risk for
adverse drug reactions?: reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy poor patient adherence
17. How can healthcare providers decrease likelihood of an elderly patient
experiencing an adverse drug reaction?:
obtaining a thorough drug history that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible monitoring for drug-drug
interactions and iatrogenic illness periodically reviewing the
need for continued drug therapy encouraging the patient to
dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
18. How can we promote medication adherence with elderly patients?:
simplifying drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-open containers
developing daily reminders monitoring frequently
affordability of drugs support systems
19. Why do nitrates need to be taken no later than 4 PM?: Need nitrate free
interval so tolerance doesn't develop
20. Nine factors that impact outcome of medication?:
Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
, NR 565 - advanced pharmacology midterm - Chamberlain
patho age
bodyweight
21. Do you need informed consent for genetic testing?: yes
22. What is the purpose of the Genetic Information Non-Discriminatory Act?:
Protects patients from discrimination by employers and insurance providers
based on genetic information
23. Difference between practice authority and prescriptive authority?:
Practice authority refers to the nurse practitioner's ability to practice without
physician oversight, whereas prescriptive authority refers to the nurse
practitioner's authority to prescribe medications independently and without
limitations.
24. Who regulates prescriptive authority?: 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.
25. What is scope of practice determined by?: is determined by state practice
and licensure laws.
26. What is full practice authority?: 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.
27. What is reduced practice authority?: 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. ex/ physician involvement for 5 yrs than independent
28. What is restricted practice authority?: 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.- typically doctor on site
29. What are components of Rx?: Prescriber Contact info
Prescriber name
NPI
DEA
Patient name
DOB
Date
Allergies
Medication name
1. During what trimester is a pregnant woman most at risk for adverse drug
reactions with potential long term consequences?: 1st trimester (fetus most
at risk d/t rapid growth)
2. What is BEERS criteria?: Recommendations of medications inappropriate for
elderly (65 and older), prescriber ultimately decides
3. What is the CYP450 (cytochrome P450): liver enzyme system where
medications are metabolized, can either be inducers or inhibitors and create
drug-drug interactions
4. CYP450 inducers: Speed up metabolism of drugs (drug is cleared faster), drug
has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
5. CYP450 inducers pneumonic: "Bullshit Crap GPS INDUCES rage"
6. CYP450 inducer drug names: Barbituates, St John wort, Carbamazepine,
rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas
7. CYP450 inhibitors: inhibit metabolism, increase blood levels of medications
8. CYP450 pneumonic: "VISA credit card debt INHIBITS spending on designers
like CK to look GQ"
9. CYP450 inhibitors drug names: Valproate, isoniazid, sulfonamides,
amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine
10. Physiological changes during pregnancy that impact pharmacodynamics
and pharmacokinetic properties of drugs?: increase glomerular filtration
rate leads to increase durg excretion increase hepatic metabolism decrease
tone and motility of bowel increase drug absorption
11. Examples of medications that can be teratogenic: Antiepileptic drugs,
antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as
diethylstilbestrol (DES).
12. How is absorption of intramuscular medications different in neonates?:
slow and erratic due to low blood flow in muscles first few days of life
13. Why is absorption of medication in the stomach increased in infancy?:
delayed gastric emptying
14. Some medications that should be avoided in the pediatric patient?:
glucocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulfonamides, levofloxacin (antibiotics) aspirin (Severe
intoxication from acute overdose)
15. what should be included in medication administration patient
education?:
dosage size and timing
,route and technique of administration
duration of treatment
drug storage nature and time course of
desired responses nature and time course of
adverse responses finish taking antibiotic
16. What are some things that put the elderly patient at higher risk for
adverse drug reactions?: reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy poor patient adherence
17. How can healthcare providers decrease likelihood of an elderly patient
experiencing an adverse drug reaction?:
obtaining a thorough drug history that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible monitoring for drug-drug
interactions and iatrogenic illness periodically reviewing the
need for continued drug therapy encouraging the patient to
dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
18. How can we promote medication adherence with elderly patients?:
simplifying drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-open containers
developing daily reminders monitoring frequently
affordability of drugs support systems
19. Why do nitrates need to be taken no later than 4 PM?: Need nitrate free
interval so tolerance doesn't develop
20. Nine factors that impact outcome of medication?:
Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
, NR 565 - advanced pharmacology midterm - Chamberlain
patho age
bodyweight
21. Do you need informed consent for genetic testing?: yes
22. What is the purpose of the Genetic Information Non-Discriminatory Act?:
Protects patients from discrimination by employers and insurance providers
based on genetic information
23. Difference between practice authority and prescriptive authority?:
Practice authority refers to the nurse practitioner's ability to practice without
physician oversight, whereas prescriptive authority refers to the nurse
practitioner's authority to prescribe medications independently and without
limitations.
24. Who regulates prescriptive authority?: 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.
25. What is scope of practice determined by?: is determined by state practice
and licensure laws.
26. What is full practice authority?: 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.
27. What is reduced practice authority?: 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. ex/ physician involvement for 5 yrs than independent
28. What is restricted practice authority?: 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.- typically doctor on site
29. What are components of Rx?: Prescriber Contact info
Prescriber name
NPI
DEA
Patient name
DOB
Date
Allergies
Medication name
