# 1 Morgan Graybill
- Describe the roles and responsibilities of the APRN when prescribing medication.
- The role of an Advanced Practice Registered Nurse (APRN) when prescribing medication involves numerous responsibilities. As a licensed healthcare provider with prescriptive authority, the APRN must ensure safe and effective use of medications. APRNs must monitor and follow up with patients to see if the medication is working for the patient as well as ensuring proper adherence is happening. The first thing that has to happen before an APRN prescribes a medication is assess and diagnose the patient. This helps the APRN establish a baseline for the patient to figure out what medication would best benefit the patient. Before prescribing therapy, the APRN has a responsibility to gather data by taking a thorough history and performing a physical examination (Arcangelo et al., 2017). A risk-benefit analysis is then analyzed to see if this patient would even need medication. Regardless of a specific prescribing pattern of different providers, all providers must focus on patient-centered care (Zhang & Patel, 2023). Patient education is a huge aspect of healthcare for everyone, not just an APRN. Patient education is a major responsibility that involves interprofessional collaboration within a healthcare system. A responsibility that some providers have to worry about are certain state regulations and statutes. Some providers attend school in a different state than they will be practicing in so they have to take into consideration what will be different from the state they are learning in. Although NPs provide services across the country, their ability to do so is not equal in all areas due to state scope-of-practice laws that limit the services (Milbank Quarterly, 2021).
- Describe the method used to determine what drug therapy to prescribe?
- As stated above, a risk-benefit analysis, evaluating the therapeutic value versus the risk associated with each drug to be prescribed (Arcangelo et al., 2017). Factors that get taken into consideration are the drug action, side effects, interactions, convenience, storage needs, route of administration, efficacy, and cost (Arcangelo et al., 2017). Rational prescribers should attempt to maximize clinical effectiveness, minimize harm, avoid wasting healthcare resources, and respect patient wishes (Maxwell, 2016).
- Discuss responsibilities for patient education and teaching based on the prescribed therapy.
- Patient education is an integral part of an APRNs role and responsibility. Education should include the intended therapeutic effect, potential side effects, and strategies for dealing with possible adverse drug reactions. When I was younger, I had a provider print out easy to understand drug info that I really enjoyed as this was the only prescriber to ever do that for me. I think having that handout readily available can help patients identify what to expect if an adverse reaction is present.
- Discuss Schedule drugs and prescribing restrictions for each scheduled drug.
- The FDA’s Controlled Substances Act of 1970 established the schedule of ranking drugs that have the highest potential for abuse (Arcangelo et al., 2017). Schedule 1 drugs have a high potential for abuse. These drugs are not available for everyday use. Examples are heroin and LSD. Schedule 2 can be prescribed but are not available for refill and must have a new prescription each time. Examples include fentanyl and morphine. Schedule 3 drugs can be refilled up to five times within 6 months. Examples include ketamine and testosterone. Schedule 4 drugs have a low potential for abuse, such as Ativan. Schedule 5 drugs have the least potential for abuse and an example is an antidiarrheal. Providers can only prescribe these medications if they are approved by the Drug Enforcement Agency (DEA). …
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- #2 Hadassa Doucet
- Describe the roles and responsibilities of the APRN when prescribing medication.
The APRN has the responsibility of safeguarding their patients’ health by prescribing therapeutic medication regimens to safely treat their patients. This process involves prescribing safe, appropriate, and effective drug dosing, with the responsibility of following up with the patient to monitor for effectiveness or adverse effects (Arcangelo et al., 2017). There is also the responsibility of providing adequate education to the patient about their condition, including the risks and benefits of treatment, and how the medication will work. This education can promote medication adherence. The APRN must also be knowledgeable in drug safety and product safeguards, such as black box warnings.
2. Describe the method used to determine what drug therapy to prescribe?
The method to determine which drug therapy to prescribe consists of the practitioner determining a need for treatment and evaluating compatibility of the drug for the patient. A thorough history and physical examination should be done to determine diagnoses. Hepatic and renal functioning is important to consider when determining a compatible drug therapy (Arcangelo et al., 2017). Typically, Practitioners will rely on clinical guidelines, research studies, and evidenced based best practice protocols to guide their choices. When choosing a drug to prescribe for treatment the practitioner should select a drug by class of most appropriate medication and evaluate the risks and benefits associated and determine which factor outweighs the other. Other important things to consider are adverse side effects that may occur, medication interactions, convenience, storage needs, route of administration, efficacy, and cost (Arcangelo et al., 2017).
3. Discuss responsibilities for patient education and teaching based on the prescribed therapy.
It is the prescribing practitioners responsibility to educate the patient on the drug therapies being prescribed to them. Patients should be educated on how the medication will benefit them and what risks are associated with the medication. An overview of signs and symptoms of adverse side effects to look out for should also be done with the patient, so that the patient can report these signs to the practitioner in a timely manner if they occurred (Arcangelo et al., 2017). This can be beneficial in that the patient does not just stop the medication without notification to the practitioner. In turn, another alternative medication could be recommended in place of the originally prescribed medication, to find the best therapeutic treatment option.
4. Discuss Schedule drugs and prescribing restrictions for each scheduled drug.
Scheduled drug classes is a classification system established by the FDA in the 1970s to rank the potential of abuse or misuse of a drug. These drugs are called controlled substances and they can be addictive, where the user can grow to be dependent on the drug either physically or mentally. There are five categories in the scheduled drug classes ranging from schedule I to V, with schedule I having the strongest potential for drug abuse and schedule V the least (Arcangelo et al., 2017). Typically schedule I drugs are not used for therapeutic treatments, meaning they are never prescribed by providers and can only be obtained for research purposes only with strict regulations. These include drugs such as LSD and heroin. Schedule II drugs have potential therapeutic effects in medical settings but still a high potential for abuse, these include medications like amphetamines or barbiturates. Schedule II drugs can be prescribed over the phone in emergency settings but a paper script must be provided within the following 72 hours. These medications need a new prescription every time to be filled and are not eligible for refills (Arcangelo et al., 2017). Schedule III drugs can be prescribed with verbal orders given to pharmacies with potential for refills up to five times in six months. Schedule IV drugs are less likely to be habit forming, but do have potential for abuse, this level includes barbital and Xanax. These prescriptions can be written, given verbally over the phone, or faxed to the pharmacist (Dydyk et al., 2023). Lastly Schedule V drugs have the lowest potential for abuse and are widely prescribed by providers in appropriate cases such as cough medications that include codeine. Getting these prescriptions filled are a bit easier as they have the least restrictions. Prescriptions can be written, called in, or faxed to the pharmacy and refilled as needed. Ultimately, APRNs must comply with specific state and federal regulations regarding prescription limits, uphold required licensure, as well as accurate documentation, and patient monitoring to prevent misuse and ensure responsible prescribing practices (Dydyk et al., 2023).
