1
- Advance Pharmacy NR565 MIDTERM
· Beer's Criteria - ANSWER •potentially Inappropriate Medication (PIM) use in older
m
adults
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•PIM use in older adults due to medication-disease or medication-syndrome interactions
ail
that may exacerbate the disease or syndrome
•medications to be used cautiously in older adults
gm
•clinically significant drug interactions that should be avoided in older adults
r@
•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,
he
2019)
hig
ing
· How does limited prescriptive authority impact patients within the healthcare system? -
ANSWER limited authority creates problems for the patient. The patient is not able to
fly
get the care they need
· What are the key responsibilities of prescribing? - ANSWER 1. Be prudent and
deliberate in your decision-making process
, 2
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
m
therapy options
.co
6. Have a documented plan regarding drug monitoring or titration, if applicable
ail
gm
· What happens when someone has a poor metabolism phenotype? -
Metabolizes to slow or to fast.
ANSWER
r@
he
· What should be used to make prescribing decisions? - ANSWER
hig
· Who determines and regulates prescriptive authority? - ANSWER Nurse practitioner
ing
scope of practice is determined by state practice and licensure laws.
fly
·· Which schedule drugs can APRNs prescribe? - ANSWER Schedule II-V
, 3
•During what trimester is a pregnant woman most at risk for adverse drug reactions with
potential long-term consequences? - ANSWER 1 trimester
•How can we as healthcare providers decrease the likelihood of a elderly patient
experiencing an adverse drug reaction? - ANSWER •- obtaining a thorough drug
m
history that includes over-the-counter medications
.co
•considering pharmacokinetic and pharmacodynamic changes due to age
ail
•monitoring the patient's clinical response and plasma drug levels
gm
•using the simplest regimen possible
•monitoring for drug-drug interactions and iatrogenic illness
r@
•periodically reviewing the need for continued drug therapy
he
•encouraging the patient to dispose of old medications
hig
•taking steps to promote adherence and to avoid drugs on the Beers list
ing
•What are some medications that we know to be teratogenic? - ANSWER •Antiepileptic
fly
drugs, antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES).
, 4
•What are some of the Physiologic changes that occur in the body when a woman is
pregnant that can change the pharmacodynamic and pharmacokinetic properties of
many drugs? - ANSWER - Increased GFR= Increased drug excretion
- Increased hepatic metabolism for some drugs.
- Decreased tone and mobility of bowel
m
- Increased drug absorption.
.co
ail
•What are the nine factors that impact the outcome of medication according to
gm
Rosenthal & Burcham? - ANSWER •Gender and race
•Genetics and pharmacogenomics
r@
•Variability in absorption
he
•placebo effect
hig
•Tolerance
•patho
ing
•age
fly
•bodyweight
- Advance Pharmacy NR565 MIDTERM
· Beer's Criteria - ANSWER •potentially Inappropriate Medication (PIM) use in older
m
adults
.co
•PIM use in older adults due to medication-disease or medication-syndrome interactions
ail
that may exacerbate the disease or syndrome
•medications to be used cautiously in older adults
gm
•clinically significant drug interactions that should be avoided in older adults
r@
•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,
he
2019)
hig
ing
· How does limited prescriptive authority impact patients within the healthcare system? -
ANSWER limited authority creates problems for the patient. The patient is not able to
fly
get the care they need
· What are the key responsibilities of prescribing? - ANSWER 1. Be prudent and
deliberate in your decision-making process
, 2
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
m
therapy options
.co
6. Have a documented plan regarding drug monitoring or titration, if applicable
ail
gm
· What happens when someone has a poor metabolism phenotype? -
Metabolizes to slow or to fast.
ANSWER
r@
he
· What should be used to make prescribing decisions? - ANSWER
hig
· Who determines and regulates prescriptive authority? - ANSWER Nurse practitioner
ing
scope of practice is determined by state practice and licensure laws.
fly
·· Which schedule drugs can APRNs prescribe? - ANSWER Schedule II-V
, 3
•During what trimester is a pregnant woman most at risk for adverse drug reactions with
potential long-term consequences? - ANSWER 1 trimester
•How can we as healthcare providers decrease the likelihood of a elderly patient
experiencing an adverse drug reaction? - ANSWER •- obtaining a thorough drug
m
history that includes over-the-counter medications
.co
•considering pharmacokinetic and pharmacodynamic changes due to age
ail
•monitoring the patient's clinical response and plasma drug levels
gm
•using the simplest regimen possible
•monitoring for drug-drug interactions and iatrogenic illness
r@
•periodically reviewing the need for continued drug therapy
he
•encouraging the patient to dispose of old medications
hig
•taking steps to promote adherence and to avoid drugs on the Beers list
ing
•What are some medications that we know to be teratogenic? - ANSWER •Antiepileptic
fly
drugs, antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES).
, 4
•What are some of the Physiologic changes that occur in the body when a woman is
pregnant that can change the pharmacodynamic and pharmacokinetic properties of
many drugs? - ANSWER - Increased GFR= Increased drug excretion
- Increased hepatic metabolism for some drugs.
- Decreased tone and mobility of bowel
m
- Increased drug absorption.
.co
ail
•What are the nine factors that impact the outcome of medication according to
gm
Rosenthal & Burcham? - ANSWER •Gender and race
•Genetics and pharmacogenomics
r@
•Variability in absorption
he
•placebo effect
hig
•Tolerance
•patho
ing
•age
fly
•bodyweight
