Advance Pharmacy NR565
MIDTERM questions and answers
2024\2025 A+ grade
·· Which schedule drugs can APRNs prescribe?
- correct answer Schedule II-V
· Who determines and regulates prescriptive authority?
- correct answer Nurse practitioner scope of practice is determined by state practice and licensure laws.
· How does limited prescriptive authority impact patients within the healthcare system?
- correct answer limited authority creates problems for the patient. The patient is not able to get the
care they need
· What are the key responsibilities of prescribing?
- correct answer 1. Be prudent and deliberate 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
· What should be used to make prescribing decisions?
- correct answer
Pharmakinetiscs and Pharmodynamics of older adults
- correct 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
· Beer's Criteria
- correct answer •potentially Inappropriate Medication (PIM) use in older adults
•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 (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450
- correct 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.
VISA credit card dept Inhibits Spending on CK and GQ
- correct answer Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
, Q-uinidine
CYP450 Inhibitors
- correct answer - Decreases the CYP450 which keeps the medication in your body longer which can
cause toxicity
CYP450 INDUCERS
- correct answer Increase CYP450 to work faster causes
Drugs to leave your body faster.
Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs
- correct answer Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype?
- correct answer Metabolizes to slow or to fast.
How is absorption of intramuscular medication different in neonates?
- correct answer •Slow and erratic due to low blood flow in muscles first few days of life
•Why is absorption of medication in the stomach increased in infancy?
- correct answer Delayed gastric emptying (adult values reached by 6-8 months)
What are some medications that should be avoided in the pediatric patient?
- correct answer glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus
with sulfonamides
MIDTERM questions and answers
2024\2025 A+ grade
·· Which schedule drugs can APRNs prescribe?
- correct answer Schedule II-V
· Who determines and regulates prescriptive authority?
- correct answer Nurse practitioner scope of practice is determined by state practice and licensure laws.
· How does limited prescriptive authority impact patients within the healthcare system?
- correct answer limited authority creates problems for the patient. The patient is not able to get the
care they need
· What are the key responsibilities of prescribing?
- correct answer 1. Be prudent and deliberate 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
· What should be used to make prescribing decisions?
- correct answer
Pharmakinetiscs and Pharmodynamics of older adults
- correct 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
· Beer's Criteria
- correct answer •potentially Inappropriate Medication (PIM) use in older adults
•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 (American Geriatric Society Beers Criteria Update Expert Panel, 2019)
CYP450
- correct 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.
VISA credit card dept Inhibits Spending on CK and GQ
- correct answer Valproate
I-soniazid
S-ulfamids
A-miodarone
C-hloramphenical
Ketoconazole
G-rapefruit Juice
, Q-uinidine
CYP450 Inhibitors
- correct answer - Decreases the CYP450 which keeps the medication in your body longer which can
cause toxicity
CYP450 INDUCERS
- correct answer Increase CYP450 to work faster causes
Drugs to leave your body faster.
Inducers for PY450 Chronic Alcholics Steal Phen Phen and Never Refuse Greasy Carbs
- correct answer Chronic Alcoholics
St. Johns Wort
Phenytoin
Phenobarbital
Nevirapine
Refiampin
Griseofalvin
Carbamazepine
· What happens when someone has a poor metabolism phenotype?
- correct answer Metabolizes to slow or to fast.
How is absorption of intramuscular medication different in neonates?
- correct answer •Slow and erratic due to low blood flow in muscles first few days of life
•Why is absorption of medication in the stomach increased in infancy?
- correct answer Delayed gastric emptying (adult values reached by 6-8 months)
What are some medications that should be avoided in the pediatric patient?
- correct answer glucocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus
with sulfonamides
