Schedule Drugs and Prescribing Restrictions

1. Describe the roles and responsibilities of the APRN when prescribing medication.
2. Describe the method used to determine what drug therapy to prescribe?
3. Discuss responsibilities for patient education and teaching based on the prescribed therapy.
4. Discuss Schedule drugs and prescribing restrictions for each scheduled drug.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in the current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
  • Each question must be answered individually as in bullet points. Not in an essay format.
  • Example: Question 1, followed by the answer to question 1; Question 2, followed by the answer to question 2; and so forth.

Question 1: Describe the roles and responsibilities of the APRN when prescribing medication.

1. Assessment and Diagnosis: The APRN conducts a thorough assessment of the patient, including medical history, current medications, and physical examination, to accurately diagnose the condition requiring treatment.
2. Selection of Appropriate Medication: Based on the diagnosis, the APRN selects the most suitable medication, considering factors such as the patient’s age, weight, comorbidities, and potential drug interactions.
3. Developing a Treatment Plan: The APRN formulates a comprehensive treatment plan, including dosage, administration route, and duration of therapy, while monitoring for efficacy and adverse effects.
4. Patient Education: The APRN educates the patient about the prescribed medication, including its purpose, proper usage, potential side effects, and the importance of adherence to the treatment regimen.
5. Monitoring and Follow-Up: The APRN schedules follow-up appointments to monitor the patient’s response to the medication, adjusting the treatment plan as necessary based on clinical outcomes and patient feedback.
6. Collaboration with Other Healthcare Providers: The APRN collaborates with other healthcare professionals, such as pharmacists and physicians, to ensure coordinated care and optimize therapeutic outcomes.
7. Documentation: The APRN meticulously documents all aspects of the prescribing process, including the rationale for the chosen medication, patient instructions, and follow-up plans, in the patient’s medical record.
8. Adherence to Legal and Ethical Standards: The APRN ensures that prescribing practices adhere to state and federal regulations, ethical guidelines, and institutional policies to maintain patient safety and professional integrity.

Question 2: Describe the method used to determine what drug therapy to prescribe?

1. Evidence-Based Practice: The APRN utilizes current clinical guidelines, research studies, and evidence-based practices to inform medication selection.
2. Patient-Specific Factors: The APRN considers individual patient factors such as age, weight, gender, genetic factors, comorbidities, and current medications to tailor drug therapy.
3. Clinical Judgment and Experience: The APRN applies clinical judgment and experience to evaluate the appropriateness of drug therapy for the specific condition, balancing risks and benefits.
4. Pharmacokinetics and Pharmacodynamics: The APRN assesses the pharmacokinetic and pharmacodynamic properties of potential medications, including absorption, distribution, metabolism, and excretion.
5. Contraindications and Interactions: The APRN reviews potential contraindications and drug-drug or drug-food interactions to avoid adverse effects and ensure patient safety.
6. Cost and Accessibility: The APRN considers the cost and accessibility of medications to ensure the prescribed therapy is feasible for the patient.

Question 3: Discuss responsibilities for patient education and teaching based on the prescribed therapy.

1. Medication Purpose and Benefits: The APRN explains the purpose of the medication and the expected benefits to encourage adherence and understanding.
2. Dosage and Administration: The APRN provides clear instructions on the correct dosage, timing, and method of administration, emphasizing the importance of following these guidelines.
3. Potential Side Effects and Adverse Reactions: The APRN informs the patient about possible side effects and adverse reactions, advising on what to do if they occur and when to seek medical attention.
4. Lifestyle and Dietary Considerations: The APRN discusses any necessary lifestyle or dietary modifications that may enhance the effectiveness of the medication or reduce side effects.
5. Adherence and Compliance: The APRN emphasizes the importance of adherence to the medication regimen, addressing potential barriers and providing strategies to improve compliance.
6. Monitoring and Follow-Up: The APRN schedules follow-up appointments and instructs the patient on what symptoms or changes to report, ensuring ongoing monitoring and adjustment of therapy as needed.
7. Use of Educational Materials: The APRN provides written materials, such as pamphlets or brochures, to reinforce verbal instructions and serve as a reference for the patient.

Question 4: Discuss Schedule drugs and prescribing restrictions for each scheduled drug.

1. Schedule I:
   • Definition: Drugs with no currently accepted medical use and a high potential for abuse.
   • Examples: Heroin, LSD, ecstasy.
   • Restrictions: These drugs cannot be prescribed under any circumstances.
2. Schedule II:
   • Definition: Drugs with a high potential for abuse, which may lead to severe psychological or physical dependence.
   • Examples: Morphine, oxycodone, fentanyl, Adderall.
   • Restrictions: Prescriptions must be written and cannot be refilled; strict record-keeping and monitoring are required.
3. Schedule III:
   • Definition: Drugs with a moderate to low potential for physical and psychological dependence.
   • Examples: Ketamine, anabolic steroids, testosterone.
   • Restrictions: Prescriptions can be refilled up to five times within six months; less stringent record-keeping than Schedule II.
4. Schedule IV:
   • Definition: Drugs with a low potential for abuse and low risk of dependence.
   • Examples: Alprazolam (Xanax), diazepam (Valium), lorazepam (Ativan).
   • Restrictions: Prescriptions can be refilled up to five times within six months; moderate record-keeping requirements.
5. Schedule V:
   • Definition: Drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics.
   • Examples: Cough preparations with less than 200 milligrams of codeine per 100 milliliters, pregabalin (Lyrica).
   • Restrictions: Prescriptions can be refilled as authorized by the prescriber; minimal record-keeping requirements.

References:

• Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2017). Pharmacotherapeutics for Advanced Practice Nurse Prescribers. F.A. Davis Company.
• Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s Pharmacotherapeutics for Advanced Practice Providers. Elsevier.