NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

How do beta-blockers work? What exactly do antibiotics do to the bacteria they target? What effects does an anti-depressant have on blood flow?

These are questions about the underlying pharmacokinetic and pharmacodynamic mechanisms of pharmacotherapeutics. Understanding these essential pharmacotherapeutic concepts as an advanced practice nurse is critical to ensuring that the prescription drugs you offer for your patients are safe and effective in treating and/or managing their symptoms. Furthermore, as an advanced practice nurse, it is your obligation to guarantee that while prescribing prescription drugs, you follow the ethical and legal guidelines for prescribing drugs as an added layer of protection and safety for the patients you will treat.

This week, you will examine elements that may influence a patient’s pharmacokinetic and pharmacodynamic processes, as well as the specifics of a personalized plan of care that you create based on the influencing factors and patient history. You will also assess and analyze the ethical and legal issues and practices associated with drug prescribing, including disclosure and nondisclosure, as well as the prescription writing process to avoid medication errors. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Learning Objectives – NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Students will:

Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients
Assess patient factors and history to develop personalized plans of care
Evaluate ethical and legal implications related to prescribing drugs
Analyze ethical and legal practices of prescribing drugs
Analyze strategies to address disclosure and nondisclosure
Justify advanced practice nurse strategies to guide prescription drug decision-making
Analyze the process of writing prescriptions to avoid medication errors

Learning Resources for NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Required Readings (click to expand/reduce)

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

Chapter 1, “Prescriptive Authority” (pp. 1–3)
Chapter 2, “Rational Drug Selection and Prescription Writing” (pp. 5–9)
Chapter 3, “Promoting Positive Outcomes of Drug Therapy” (pp. 11–16)
Chapter 4, “Pharmacokinetics, Pharmacodynamics, and Drug Interactions” (pp. 17–40)
Chapter 5, “Adverse Drug Reactions and Medical Errors” (pp. 41–49)
Chapter 6, “Individual Variation in Drug Response” (pp. 51–56)

American Geriatrics Society 2019 Beers Criteria Update Expert Panel. (2019). American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 67(4), 674–694. doi:10.1111/jgs.15767

American Geriatrics Society 2019 updated AGS Beers criteria for potentially inappropriate medication use in older adults by American Geriatrics Society, in Journal of the American Geriatrics Society, Vol. 67/Issue 4. Copyright 2019 by Blackwell Publishing. Reprinted by permission of Blackwell Publishing via the Copyright Clearance Center. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

This article is an update to the Beers Criteria, which includes lists of potentially inappropriate medications to be avoided in older adults as well as newly added criteria that lists select drugs that should be avoided or have their dose adjusted based on the individual’s kidney function and select drug-drug interactions documented to be associated with harms in older adults.

Drug Enforcement Administration. (n.d.-a). Code of federal regulations. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/21cfr/cfr/1300/1300_01.htm

This website outlines the code of federal regulations for prescription drugs. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Drug Enforcement Administration. (n.d.-b). Mid-level practitioners authorization by state. Retrieved May 13, 2019 from http://www.deadiversion.usdoj.gov/drugreg/practioners/index.html

This website outlines the schedules for controlled substances, including prescriptive authority for each schedule.

Drug Enforcement Administration. (2006). Practitioner’s manual. Retrieved from http://www.legalsideofpain.com/uploads/pract_manual090506.pdf
This manual is a resource for practitioners who prescribe, dispense, and administer controlled substances. It provides information on general requirements, security issues, recordkeeping, prescription requirements, and addiction treatment programs.

Drug Enforcement Administration. (n.d.-c). Registration. Retrieved February 1, 2019, from https://www.deadiversion.usdoj.gov/drugreg/index.html

This website details key aspects of drug registration. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Fowler, M. D. M., & American Nurses Association. (2015). Guide to the Code of Ethics for Nurses with Interpretive Statements: Development, Interpretation, and Application (2nd ed.). Silver Spring, Maryland: American Nurses Association.

This resource introduces the code of ethics for nurses and highlights critical aspects for ethical guideline development, interpretation, and application in practice.

Institute for Safe Medication Practices. (2017). List of error-prone abbreviations, symbols, and dose designations. Retrieved from https://www.ismp.org/recommendations/error-prone-abbreviations-list

This website provides a list of prescription-writing abbreviations that might lead to misinterpretation, as well as suggestions for preventing resulting errors.

Ladd, E., & Hoyt, A. (2016). Shedding light on nurse practitioner prescribing. The Journal for Nurse Practitioners, 12(3), 166–173. doi:10.1016/j.nurpra.2015.09.17

This article provides NPs with information regarding state-based laws for NP prescribing.

Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist‐led educational intervention for nurse practitioner students. Journal of the American Association ofNursePractitioners, 29(5), 248–254. doi:10.1002/2327-6924.12446

The authors of this article assess the impact of a pharmacist‐led educational intervention on family nurse practitioner (FNP) students’ prescribing skills, perception of preparedness to prescribe, and perception of pharmacist as collaborator. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

To Prepare

Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
Think about a personalized plan of care based on these influencing factors and patient history in your case study.

By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

By Day 6 of Week 1

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing Submission and Grading Information

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Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

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Week 1 Discussion

NURS 6521 Week 1: Basic Pharmacotherapeutic Concepts/Ethical and Legal Aspects of Prescribing – Assignment: Ethical and Legal Implications of Prescribing Drugs

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing

Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

To Prepare

Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing
Review the scenario assigned by your Instructor for this Assignment.
Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors.

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing
Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. NURS 6521 Week 1 Basic Pharmacotherapeutic Concepts Ethical and Legal Aspects of Prescribing
Explain the process of writing prescriptions, including strategies to minimize medication errors.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The College of Nursing Writing Template with Instructions provided at the Walden Writing Center offers an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

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