NR 565 VERIFIED EXAM QUESTIONS AND ANSWERS
CYP450 Inhibitors
Medications that inhibit the metabolic activity of one or more of the CYP450 enzymes.
Higher risk for toxicity; prolongs the pharmacological effect of the "parent drug".
CYP450 Inhibitor Medications
VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
Beers Criteria
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to medication-
disease or medication-syndrome interactions that may exacerbate the disease or
syndrome
-medications to be used cautiously in older adults
-clinically significant drug interactions that should be avoided in older adults
-medications to be avoided or dosage decreased in the presence of impaired kidney
function in older adults
Pharmacokinetic Interactions
when one medication systemically alters the potency of another medication.
Absorption Interaction
result of a change due to one medication's effect on another medication's route of entry
into the body.
Distribution Interaction
caused by the amount of unbound/free medications available at the various target sites.
Metabolism Interaction
,concentration of the medication after biotransformation into active and inactive
metabolites in higher or lower than expected.
Elimination Interaction
the body's ability to eliminate medications in pure form or by altering a metabolite from
the body.
Pharmacodynamic Interactions
does not alter or impact absorption, distribution, metabolism, or elimination because of
the one medication's ability to manipulate the effect of another medication at its site of
action
Practice Authority
refers to the nurse practitioner's ability to practice without physician oversight
prescriptive authority
refers to the nurse practitioner's authority to prescribe medications.
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.
Drugs that cannot be ordered via E-Script
DEA Scheduled Drugs
Drugs that cannot be prescribed or refilled via phone
Schedule II drugs
Acute Pain
, An occurrence of fewer than three months and is often precipitated by trauma and acute
medical conditions or treatment.
Types of Acute Pain
Referred Pain
Acute Somatic Pain
Acute visceral pain
Chronic pain
episode of pain that lasts for 6 months or longer; may be intermittent or continuous
Referred Pain
pain that is felt in a location other than where the pain originates
Acute Somatic Pain
-Arises from connective tissue, muscle, bone and skin.
-Sharp and localized or dull and non-localized
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local anesthetics,
ice, massage
Acute Visceral Pain
Pain in the internal organs and abdomen
Poorly localized (C-fibers)
Radiates
Most responsive to opiates
May also use corticosteroids, NSAIDs
Opioids
any drug, natural or synthetic, that has actions similar to those of morphine
Opioid Receptor Families
Mu (μ)
Kappa (k)
Delta (δ)
At each type of receptor, a drug can act in one of three ways:
(1) pure opioid agonists, (2) agonist-antagonist opioids, (3) pure opioid antagonists.
Mu (u) Receptor
Opioid receptor most responsible for mediating analgesic properties
CYP450 Inhibitors
Medications that inhibit the metabolic activity of one or more of the CYP450 enzymes.
Higher risk for toxicity; prolongs the pharmacological effect of the "parent drug".
CYP450 Inhibitor Medications
VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
Beers Criteria
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to medication-
disease or medication-syndrome interactions that may exacerbate the disease or
syndrome
-medications to be used cautiously in older adults
-clinically significant drug interactions that should be avoided in older adults
-medications to be avoided or dosage decreased in the presence of impaired kidney
function in older adults
Pharmacokinetic Interactions
when one medication systemically alters the potency of another medication.
Absorption Interaction
result of a change due to one medication's effect on another medication's route of entry
into the body.
Distribution Interaction
caused by the amount of unbound/free medications available at the various target sites.
Metabolism Interaction
,concentration of the medication after biotransformation into active and inactive
metabolites in higher or lower than expected.
Elimination Interaction
the body's ability to eliminate medications in pure form or by altering a metabolite from
the body.
Pharmacodynamic Interactions
does not alter or impact absorption, distribution, metabolism, or elimination because of
the one medication's ability to manipulate the effect of another medication at its site of
action
Practice Authority
refers to the nurse practitioner's ability to practice without physician oversight
prescriptive authority
refers to the nurse practitioner's authority to prescribe medications.
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.
Drugs that cannot be ordered via E-Script
DEA Scheduled Drugs
Drugs that cannot be prescribed or refilled via phone
Schedule II drugs
Acute Pain
, An occurrence of fewer than three months and is often precipitated by trauma and acute
medical conditions or treatment.
Types of Acute Pain
Referred Pain
Acute Somatic Pain
Acute visceral pain
Chronic pain
episode of pain that lasts for 6 months or longer; may be intermittent or continuous
Referred Pain
pain that is felt in a location other than where the pain originates
Acute Somatic Pain
-Arises from connective tissue, muscle, bone and skin.
-Sharp and localized or dull and non-localized
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local anesthetics,
ice, massage
Acute Visceral Pain
Pain in the internal organs and abdomen
Poorly localized (C-fibers)
Radiates
Most responsive to opiates
May also use corticosteroids, NSAIDs
Opioids
any drug, natural or synthetic, that has actions similar to those of morphine
Opioid Receptor Families
Mu (μ)
Kappa (k)
Delta (δ)
At each type of receptor, a drug can act in one of three ways:
(1) pure opioid agonists, (2) agonist-antagonist opioids, (3) pure opioid antagonists.
Mu (u) Receptor
Opioid receptor most responsible for mediating analgesic properties
