The roles and responsibilities of the APRN when prescribing medication

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

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Advanced Practice Registered Nurses (APRNs) play a crucial role in the healthcare system, and one of their key responsibilities is prescribing medication. However, this responsibility comes with specific steps, considerations, and ethical obligations.

APRN Roles and Responsibilities:

  • Diagnosis and Assessment: APRNs conduct thorough patient assessments to diagnose conditions and identify appropriate medication needs.
  • Formulary Selection: They select medications from approved formularies based on patient history, current medications, allergies, and potential interactions.
  • Dosage and Administration: APRNs determine the appropriate dosage, frequency, and route of administration for each medication.

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  • Monitoring and Evaluation: They closely monitor patients for medication effectiveness and side effects, adjusting the regimen if necessary.

Determining Drug Therapy:

APRNs use a systematic approach to determine the best medication for a patient:

  • Patient History: Reviewing medical history, allergies, and current medications to identify potential interactions or contraindications.
  • Physical Examination: Performing a physical exam to assess the patient’s overall health and identify any physiological factors that might influence medication selection.
  • Diagnostic Tests: Utilizing lab tests, imaging studies, or other diagnostics to confirm the diagnosis and guide medication selection.
  • Evidence-Based Guidelines: Consulting clinical practice guidelines and research evidence to identify the most effective and safe medication for the specific condition.
  • Shared Decision-Making: Involving the patient in the decision-making process, considering their preferences, concerns, and lifestyle factors.

Patient Education and Teaching:

APRNs have a responsibility to educate patients about their prescribed medications. This includes:

  • Medication Name and Purpose: Explaining the medication’s name, what it does, and how it will help manage the condition.
  • Dosage and Administration: Providing clear instructions on dosage, frequency, and how to take the medication (with or without food, etc.).
  • Potential Side Effects: Informing the patient about possible side effects and what to do if they experience them.
  • Medication Interactions: Discussing potential interactions with other medications or supplements the patient is taking.
  • Storage and Disposal: Providing instructions on safe storage and proper disposal of unused medication.

Schedule Drugs and Prescribing Restrictions:

The United States Drug Enforcement Administration (DEA) classifies controlled substances into five schedules based on their potential for abuse and dependence. Each schedule has specific regulations for prescribing:

  • Schedule II: High potential for abuse, with accepted medical use (e.g., oxycodone, Adderall). Requires a written prescription and refills are limited.
  • Schedule III: Moderate potential for abuse, with accepted medical use (e.g., Suboxone, codeine cough syrup). Written prescription required, but refills are allowed with limitations.
  • Schedule IV: Low potential for abuse, with accepted medical use (e.g., Xanax, Ativan). Written prescription required, and refills may be allowed with some restrictions.
  • Schedule V: Low potential for abuse, with accepted medical use (e.g., cough syrups with small amounts of codeine). May be available over-the-counter or with a written prescription depending on the specific medication.

Conclusion:

APRNs play a vital role in medication prescribing, ensuring safe and effective treatment for patients. They follow a comprehensive approach to medication selection, educate patients thoroughly, and adhere to regulations related to controlled substances. This multifaceted responsibility requires knowledge, clinical judgment, and a commitment to patient safety and well-being.

 

 

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