Prescribing principles for APRNs:
FDA system to report drug side effects and safety problems.
MedWatch
What the body does to the drug
Pharmacokinetics
1st line treatment option for allergic rhinitis that helps decrease nasal congestion
Fluticasone propionate nasal (Flonase) (INGCS)
This medication causes adverse effects such as Neuropsychiatric events -Agitation, aggressive behavior, anxiousness, depression, disorientation, dream abnormalities, hallucinations, insomnia, irritability,
Montelukast (Singulair)
Added to the labeling of drugs or drug products by the FDA when serious adverse reactions or special problems can lead to injury or death
Black Box Warnings for medications
Some examples of ________drugs are products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone.
Schedule III
Time for the plasma concentration of drug to be reduced by 50%
Half-life
The class name of Ipratropium bromide is:
Intranasal Anticholinergic
Olopatadine ophthalmic (Pataday) is used to treat
Allergic conjunctivitis
1st line for contact lens wearers who have bacterial conjunctivitis
Fluoroquinolone
A unique ID that allows APRNs to prescribe controlled drugs.
DEA number
An error that was caught before reaching the patient or causing harm. A pharmacist notices a wrong dosage on a prescription and corrects it before the medication reaches the patient.
Near miss
These medications have anticholinergic effects and can cause sedation and other CNS effects.
1st generation antihistamines
Preferred for open-angle glaucoma. Often initial therapy due to efficacy and low adverse effects profile.
Latanoprost (Xalatan); Bimatoprost (Lumigan)- Prostaglandin
Some examples of ________ drugs are Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol.
Schedule IV
Recommended as the best lab for determining renal function
Glomerular filtration rate (GFR)
A regulatory standard that ensures a generic drug product performs the same as its brand-name counterpart.
Bioequivalence
A patient has open angle glaucoma. What are the 3 categories of drugs that were mentioned to have warnings about use?
Glucocorticoids, anticholinergics, sympathomimetics (decongestants)
Central antitussive that acts on the cough centers to depress cough reflex.
Not routinely recommended for acute cough due to the common cold. Mixed in combination with other medications. Has toxic effects for pediatric patients. It is an abused medication by all ages.
Dextromethorphan (Delsym, some Robitussin products)
If a patient is diagnosed with rhinitis medicamentosa, what drug was most likely overused?
Topical decongestant such as oxymetazoline or Afrin
A drug efflux pump that pushes drugs OUT of cells. Inhibiting it leads to increased drug levels, and inducing it leads to decreased drug levels
Drug efflux transporter P-glycoprotein (P-gp)
The study of how a person’s entire genetic makeup affects their response to medications, including effectiveness, metabolism, and risk of adverse effects.
Pharmacogenomics
A patient is bothered by red, itchy, watery eyes consistent with allergic conjunctivitis. The patient has been using over the counter medications for the past 2 months. Which of the following medication would be the most concerning due to the concern for potential for rebound ocular symptoms?
Pheniramine/naphazoline (Naphcon-A)
This medication increases mucus production and thins respiratory secretions to make secretions easier to expel.
Guaifenesin (Mucinex)
A patient diagnosed with Allergic Rhinitis has an elevated blood pressure reading today. Which medication is the most likely cause?
Pseudoephedrine (Sudafed)