ANSWER
Course Objectives (COs) for Nursing Practice Pharmacology
CO 1: Determine Which Agents in the Main Drug Classes Are Most Frequently Prescribed
To provide safe and efficient patient care, nurses must be knowledgeable with the most often given medications across a range of therapeutic classes. For instance:
Antihypertensives: To treat hypertension, doctors commonly give drugs such metoprolol (beta-blockers), amlodipine (calcium channel blockers), and lisinopril (ACE inhibitors).
Antibiotics: Common treatments for bacterial infections include amoxicillin, cephalexin, and azithromycin.
Analgesics: Opioids like morphine or oxycodone and non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen are frequently recommended to treat pain.
Antidiabetic agents: Patients with type 2 diabetes are frequently prescribed medications such as glimepiride, insulin, and metformin to regulate their blood sugar levels.
Nurse practitioners can evaluate therapy results and educate patients by being knowledgeable about these popular drugs.
CO 2: Choose the Best Evidence-Based Therapeutic Intervention for Each Patient Making Use of Substances from the Principal Drug Classes
In order to choose the best prescription for each patient, nurse practitioners (NPs) must base their treatment decisions on evidence-based standards. A few things to think about are:
Patient Diagnosis: If lifestyle modifications have not resulted in acceptable blood glucose control, an NP may prescribe metformin as the first medication for a diabetic patient.
Patient Preferences: Oral drugs may be preferred by certain individuals over insulin injections. In certain situations, SGLT2 inhibitors or GLP-1 receptor agonists might be taken into consideration.
Guidelines for Clinical Practice: Following recognized clinical guidelines, such as those issued by the American Diabetes Association or the American College of Cardiology, helps guarantee that the best medication therapy is selected for the patient’s clinical situation.
CO 3: Utilize Pharmacokinetic, Pharmacodynamic, and Pharmacogenomics Knowledge to Write Patient Treatment Prescriptions
When prescribing tailored treatment, pharmacokinetics (the way the drug affects the body), pharmacodynamics (the way the drug affects the body), and pharmacogenomics (the genetic factors impacting drug response) are essential:
Pharmacokinetics: For instance, because of changes in metabolism, a patient with liver impairment may need to have the dosage of statins (e.g., atorvastatin) adjusted.
Pharmacodynamics: By inhibiting beta-adrenergic receptors, medications such as beta-blockers (such as metoprolol) lower blood pressure and heart rate.
Pharmacogenomics: Drugs like clopidogrel may not work as well in persons with specific genetic variants (such as the CYP2C19 polymorphism), requiring alternate antiplatelet therapy.
NPs can optimize medication therapy for individual patients by incorporating pharmacokinetics, pharmacodynamics, and pharmacogenomics into clinical practice.
CO 4: Differentiate between Environmental Factors Internal and External to Drug Action, Reaction, Efficacy, and Interaction
Drug safety and efficacy can be impacted by a number of internal and external factors:
Internal Factors: Drug absorption, metabolism, and excretion might be impacted by age, gender, liver and kidney function, and concomitant diseases. For example, elderly patients may require dosage modifications due to slower medication metabolism.
External Factors: Drug effectiveness may be impacted by environmental factors, including exposure to pollutants, lifestyle decisions (such as smoking or drinking alcohol), and prescription adherence. For instance, smoking can cause CYP1A2 liver enzymes, which can alter how some medications, like theophylline, are metabolized.
The NP can make safer and more efficient treatment decisions by having a better understanding of how these factors affect medication therapy.
CO 5: Determine Client Indicators of Adverse Reactions, Therapeutic, Ineffective, and Side Effects to Drug Therapy
In pharmacologic treatment, it is essential to monitor for side effects, unfavorable consequences, and therapeutic effectiveness:
A decrease in blood pressure, which signifies that the medication is having the desired effect, would be a therapeutic response for a patient using ACE inhibitors (such as lisinopril) for hypertension.
Ineffective Reaction: The NP may consider drug resistance, the necessity for a dosage change, or the use of an alternative class of antihypertensive medication if a patient’s blood pressure doesn’t go down when using lisinopril.
Adverse Reactions: NSAIDs and other medications may result in bleeding in the gastrointestinal tract. It would be crucial to keep an eye out for symptoms like tarry, black feces in order to identify an unfavorable reaction.
Side Effects: ACE inhibitors frequently cause headaches or dizziness, which may need to be managed with patient education or dosage changes.
NPs may provide the best possible patient safety and care by tracking and identifying these responses, which allows them to modify the treatment plan as needed.
In conclusion
In addition to having pharmacology expertise, a nurse practitioner must be able to apply that information in practical clinical settings. NPs can make well-informed, evidence-based decisions for patient care by knowing the most often prescribed agents in various medication classes, taking into account pharmacokinetics, pharmacodynamics, and pharmacogenomics, and identifying the variables that affect drug activity. Additionally, identifying adverse responses, side effects, and indications of therapeutic response helps guarantee that the recommended treatments are safe and successful for every patient. Achieving the best possible patient outcomes requires this all-encompassing strategy.
Citations
(2020) American Diabetes Association. Diabetes-related medical care standards—2020. S66–S76 in Diabetes Care, 43(Suppl. 1). The article https://doi.org/10.2337/dc20-S001
Madadi, P., and Koren, G. (2020). metabolism of drugs using pharmacogenetics. Clinical pharmacology by Koren (10th ed., pages. 364-385). Elsevier.
Aronow, W. S., Casey, D. E., Carey, R. M., and Whelton, P. K. (2018). 2017 ACC, AHA, AAPA, ABC, ACPM, AGS, APHA, ASH, ASPEN, NIH, NMA, and PCNA guidelines for the prevention, identification, assessment, and treatment of adult hypertension. American College of Cardiology Journal, 71(19), e13–e115. 10.1016/j.jacc.2017.11.006 https://doi.org
QUESTION
- CO 1: Identify the most commonly prescribed agents in the major drug classes. (POs 1, 2)
- CO 2: Make appropriate evidence-based therapeutic treatment decisions for individual patients utilizing drugs from the major drug classes. (POs 1, 2)
- CO 3: Apply knowledge of pharmacokinetics, pharmacodynamics and pharmacogenomics in prescribing patient treatment. (POs 1, 2)
- CO 4: Distinguish internal and external environment factors affecting drug action, reaction, efficacy, and interaction. (POs 1, 2)
- CO 5: Identify client indicators of therapeutic, ineffective, adverse responses and side effects to drug therapy. (POs 1, 2)