NR565/ NR 565 Midterm Exam Review:
Advanced Pharmacology Care of the Fundamentals
Questions and Answers
1. ·· Which schedule drugs can APRNs prescribe?
Answer> Schedule II-V
2. · Who determines and regulates prescriptive authority?
Answer> Nurse practitioner scope of practice is determined by state practice and
licensure laws.
3. · How does limited prescriptive authority impact patients within the health-
care system?
Answer> limited authority creates problems for the patient. The patient is not able to
get the care they need
4. · What are the key responsibilities of prescribing?
Answer> 1. Be prudent and deliber- ate in your decision-making process
2. Have a documented provider-patient relationship with the person for whom you
are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
,5. Include any discussions you have with the patient regarding risk factors, side
effects, or therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable
5. · What should be used to make prescribing decisions?
Answer>
6. Pharmakinetiscs and Pharmodynamics of older adults
Answer> drug accumulation secondary to 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
7.
Answer>
8. · Beer's Criteria
Answer> •potentially Inappropriate Medication (PIM) use in older adults
• PIM use in older adults due to medication-disease or medication-syndrome inter-
,actions 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 (American Geriatric Society Beers Criteria Update Expert
Panel, 2019)
9. CYP450
Answer> Many medications are metabolized through the liver enzyme system
called cytochrome P450 (CYP450). Metabolization can be inhibited or induced by
drugs and once this happens drug-drug interactions can occur.
10. VISA credit card dept Inhibits Spending on CK and GQ
Answer> Valproate I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
Q-uinidine
, 11. CYP450 Inhibitors
Answer> - Decreases the CYP450 which keeps the medication in your body
longer which can cause toxicity
12. CYP450 INDUCERS
Answer> Increase CYP450 to work faster causes Drugs to leave
your body faster.
13. Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse
Greasy Carbs
Answer> Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Advanced Pharmacology Care of the Fundamentals
Questions and Answers
1. ·· Which schedule drugs can APRNs prescribe?
Answer> Schedule II-V
2. · Who determines and regulates prescriptive authority?
Answer> Nurse practitioner scope of practice is determined by state practice and
licensure laws.
3. · How does limited prescriptive authority impact patients within the health-
care system?
Answer> limited authority creates problems for the patient. The patient is not able to
get the care they need
4. · What are the key responsibilities of prescribing?
Answer> 1. Be prudent and deliber- ate in your decision-making process
2. Have a documented provider-patient relationship with the person for whom you
are prescribing
3. Do not prescribe medications for family or friends or for yourself
4. Document a thorough history and physical examination in your records
,5. Include any discussions you have with the patient regarding risk factors, side
effects, or therapy options
6. Have a documented plan regarding drug monitoring or titration, if applicable
5. · What should be used to make prescribing decisions?
Answer>
6. Pharmakinetiscs and Pharmodynamics of older adults
Answer> drug accumulation secondary to 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
7.
Answer>
8. · Beer's Criteria
Answer> •potentially Inappropriate Medication (PIM) use in older adults
• PIM use in older adults due to medication-disease or medication-syndrome inter-
,actions 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 (American Geriatric Society Beers Criteria Update Expert
Panel, 2019)
9. CYP450
Answer> Many medications are metabolized through the liver enzyme system
called cytochrome P450 (CYP450). Metabolization can be inhibited or induced by
drugs and once this happens drug-drug interactions can occur.
10. VISA credit card dept Inhibits Spending on CK and GQ
Answer> Valproate I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
Q-uinidine
, 11. CYP450 Inhibitors
Answer> - Decreases the CYP450 which keeps the medication in your body
longer which can cause toxicity
12. CYP450 INDUCERS
Answer> Increase CYP450 to work faster causes Drugs to leave
your body faster.
13. Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse
Greasy Carbs
Answer> Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
