Week 1 Reflection Discussion.
docx
keyboard_arrow_up
School
South University, Savannah *
*We aren’t endorsed by this school
Course
NSG6005
Subject
Health Science
Date
Feb 20, 2024
Type
docx
Pages
3
Uploaded by KidLightning12738
Week 1 Reflection Discussion
This week I gained a lot of information about basic terms in pharmacology, how I can prevent medication errors, and how to prescribe effectively. I learned about the principles of full prescriptive authority and how it is interpreted differently for APRNs and PAs. As the supervisory requirements vary for the two professions, PAs are required to have an affiliation with a physician to practice and prescribe. Even though some state laws set restrictions, APRNs are educated to practice and prescribe independently without supervision
(Burchum & Rosenthal,
2020). I learned how to choose the best drug safely and rationally for a patient and how to keep our patients safe by prudent and deliberate decision-making and clear documentation.
As APRNs, we have a great responsibility to educate our patients and families about the medications, indications, adverse effects, drug monitoring, and how to detect and treat side effects early to provide the best outcomes. The lesson also explained how to promote adherence, by addressing common causes of nonadherence proactively, which can ensure ongoing therapy without interruption. I learned the importance of scheduled medication reviews, based on patient experiences and needs, which can help promote positive outcomes.
It was a good refresher on pharmacokinetics and the principles of pharmacodynamics. The major takeaway this week was t
he term first-pass effect. It was new to my knowledge which refers to the rapid hepatic inactivation of certain oral drugs (Burchum & Rosenthal, 2020). Metoprolol undergoes extensive first-pass metabolism in the liver (Rosenthal & Burchum, 2020).
Metabolism, also called biotransformation, is the enzymatically mediated alteration of a drug structure. The primary site of metabolism of metoprolol is the liver, where it is metabolized by the cytochrome P450 enzyme system, particularly the CYP2D6 isoenzyme (Berger et al., 2018).
This explains why the intravenous administration of drugs like metoprolol is more effective than oral administration.
Another major takeaway was the lesson improved my knowledge about drug interactions that result in reduced drug effects and reversal of effects. In the cardiac ICU, we take care of asthma patients on albuterol and on propranolol for cardiac diseases. If propranolol and albuterol
are administered together, propranolol can act in the lungs to block the effects of albuterol and reduce albuterol's therapeutic effects (Rosenthal & Burchum, 2020). For chest pain, we administer morphine and elderly patients sometimes develop coma and profound respiratory depression. The use of naloxone to treat morphine overdose is an excellent example of a beneficial inhibitory interaction. Naloxone blocks morphine's actions and can completely reverse
all symptoms of toxicity (Rosenthal & Burchum, 2020). I will use the knowledge I gained from this lesson at my work and improve the outcomes of my patients.
References
Berger, B., Bachmann, F., Duthaler, U., Krähenbühl, S., & Haschke, M. (2018). Cytochrome P450 enzymes involved in metoprolol metabolism and use of metoprolol as a CYP2D6 phenotyping probe drug.
Frontiers in Pharmacology
,
9
.
https://doi.org/10.3389/fphar.2018.00774
Burchum, J., & Rosenthal, L. D. (2020).
Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants
(2nd ed.). Elsevier Health Sciences (US).
https://digitalbookshelf.southuniversity.edu/books/9780323554954
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help