(NR 508 Week 4 Midterm Outline)
Chapter 1: The Role of the Advanced Practice Nurse as Prescriber
- Roles and responsibilities of APRN prescribers
- Clinical judgement in Prescribing
Chapter 2: Review of Basic Principles of Pharmacology
- Metabolism: Metabolism & Half Life
- Drug Responses
- Receptors: agonists, antagonists
- Pharmacokinetics: Absorption, Distribution, Protein Binding, Metabolism (including first-pass and Phase I and II)
- Cytochrome P450 metabolism
- Excretion: Renal, Biliary, Other (eg for volatile drugs)
Chapter 3: Rational Drug Selection
- Process of rational drug prescribing: 6 Steps proposed by WHO
- Patient education
- Monitor effectiveness
- Drug, Patient, and Provider factors that influence drug selection
- Influences on Rational Prescribing: Pharmaceutical Promotion
Chapter 4: Legal and Professional Issues in Prescribing
- New Drug Approval process including Clinical Phases.
- S. FDA Regulatory Jurisdiction: official labelling vs off-label use of drugs
Chapter 5: Adverse Drug Reactions
- Mechanistic Classification of ADRs including Types of Immune-Mediated ADRs and Types A-F
- Common Causes of ADRs: Risk Factors, including common drugs involved and which cause skin reactions
- Time-Related Classification of ADRs including drugs associated with withdrawal symptoms
- Dose-Related ADRs classification.
Chapter 6: Factors that Foster Positive Outcomes
- Overview of nonadherence
- Keys to effective patient education
- Health and Cultural beliefs
- Health Literacy
- Complexity of Drug Regimen and Polypharmacy
- Simplifying the Regimen
- Communication Difficulties
Chapter 9: Nutrition and Nutraceuticals
- Nutrient-Drug Interactions (eg warfarin and vit K)
- Influence of Diet on Pharmacokinetics of Drugs:
- infants and children
- women of child bearing age
- pregnant women
- vegans
- older adults
- those not exposed to sunlight or with dark skin
- alcoholics
- patients taking isoniazid (INH)
- Nutraceuticals:
- Vitamin that is teratogenic in excessive amounts
- Vitamin that is useful for migraine prophylaxis
Chapter 12: Pharmacoeconomics
- Know what Pharmacoeconomics is
- Impact of Cost: Direct and Indirect
Chapter 13: Over-the-counter Medications
- OTC Medication characteristics and regulation
- OTC Medication Sales
- Hazards of OTC Self-Medication
- Adverse Effects of OTC Self-Medication
- Drug Interactions: antacids, anticholinergics, CNS Depressants, NSAIDS and ASA
- Abuse of OTC Medications: Combat Methamphetamine Epidemic Act
- Patient Education Regarding OTC Medications
Chapter 14 Drugs Affecting the Autonomic Nervous System
- Pharmacodynamics of Alpha2 Agonists
- Pharmacodynamics of Beta Blockers, adverse effects, what happens with abrupt withdrawal of Beta Blockers?
- Pharmacokinetics: Beta blockers
- Phamacotherapeutics: precautions and Contraindications of beta blockers
- Adverse Drug Reactions
- Clinical Uses and Dosing of Beta Blockers pg 194-195 see the table to review!
- Muscarinic Agonists: Pharmacodynamics, MOA, treatment uses,
Chapter 15 Drugs Affecting the Central Nervous System
- Anorexiiants
- Iminostilbenes
- Succinimides:.
- Drugs That Affect GABA
- Tricyclic Antidepressants (TCA
- Monoamine Oxidase Inhibitors(MAOIs):
- SSRI
Chapter 28 Chronic Stable Angina and Low Risk Unstable Angina
Additional Patient Variables: Concomitant Diseases
- MI
- HF
- HTN
- Hypercholesterolemia
- Peripheral vascular disease
- Diabetes Mellitus
- Asthma
- Erectile Dysfunction
Beta Blocker-diabetes Mellitus
Chapter 36: Heart Failure
- Indications for heart failure drugs by stage
- First line drugs of choice for heart failure
- MOA of ACEIs that benefit heart failure
- Indications for use of BBs in patients with heart failure
- Drugs that increase life expectancy in patients with heart failure
- Digoxin indications and adverse reactions
- Drugs contraindicated in heart failure
- Drugs for managing heart failure during pregnancy
- Patient monitoring of HF
- Indications to use anticoagulant therapy
- Patient education
Chapter 40 Hypertension
- Classes of drugs used and their MOAs: Nitrates, BBs, CCBs, ACEIs
- What drugs increase myocardial oxygen supply
- Causes of hypertension
- Which drugs treat hypertension & BPH, MI, Heart Failure African Americans.
Chapter 14: Drugs Affecting the Autonomic Nervous System
- Adrenergic Agonists
- Alpha2 Agonists: Central
- Alpha1 Antagonists
- Combined Alpha- and Beta-Adrenergic Antagonists
- Name of drugs in this category
- Indications for use
- Pharmacodynamics
- Precautions
- ADRs
- Drug interactions of carvedilol
- clinical use: HTN, CHF (what stage of CHF is an indication to use?);
- Withdrawal of alpha-beta blockers
- concomitant diseases
- Monitoring
- Cholinergic Agonists
Chapter 15: Drugs Affecting the Central Nervous System
- Anorexiants
- Anticonvulsants
- Benzodiazepines
- Uses including status epilepticus
Chapter 29: Anxiety and Depression
- Classes of Medications
- ADRs
- Special Populations
- Outcome Evaluation
- Clinical Pearls
Chapter 43: Smoking Cessation
- Rational Drug Selection
- Tobacco-cessation therapies
