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  3. NR 508 Week 4 Midterm Filled Outline + Chart (2 Versions)

NR 508 Week 4 Midterm Filled Outline + Chart (2 Versions)

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
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