NP Prescriber

Question 1

Prescription Rights

Answer 1

NP in all states have prescriptive rights
however rights vary state to state especially in regards to controlled substance prescription authority.

Collaborative agreement requirement varies
DEA Requires seperate collaborative agreement

Question 2

KY specific

Answer 2

No collaborative agreement to practice
Collaborative agreement required to prescribe.

BILL in Congress to eliminate collaborative agreement.

Question 3

Non pharmacological Treatment

Answer 3

Exercise
Nutrition
CAT- Complimentary Alternative Treatments
   Herbal Therapy
   Massage Ttherapy
   Physical Therapy

Question 4

Clinical Judgement

Resources to answer NP questions-Other NP’s, books, pharmacists
Drug reps are also good resources for info.
Practice guidelines

Answer 4

Clear indication for medication tx?
Effective Drugs?
Goal of med TX?
non efficacy of medication & change of  tx?
unnecessary duplications? 
 ie: Metformin, amaryl, & insulin + d/c PO's
Equality of OTC?
Cost?

Question 5

Responsibility

% pharamcology CEU’s required annually

Answer 5

NP final responsibility
Develop own Formulary
  Few drugs in each class
  Make notes
  Stay updated

Question 6

Process of Rational Treatment

Answer 6

Define pt problem
Develop objective for tx
Verify suitability of selected tx
initiate treatment
discuss and educate pt
monitor treatment

Question 7

Variations
Considerations
( Your individual formulary may not work in these cases )

Answer 7

Allergies
Renal and hepatic fx
age, cost, compliance

Question 8

Legal issues in Prescribing

Answer 8

FDA

DEA- Controlled Substances

Question 9

Legal issues in Prescribing (2)

DEA - Controlled substances by category

Answer 9

Class I - IV
I. Illegal drugs- not prescriptive ( cocaine)
II. Prescriptive &@ hours only by NP
III. Monthly prescriptions
IV. Monthly prescriptions
V. Monthly and refills (least controlled)

Question 10

Controlled substances

Answer 10

Controlled substance agreements
KASPER- National pt registry narcotics
Drug seeking behavior
Pressure to prescribe

Question 11

Controlled Substance Scams

Answer 11

Prescription Altering
I lost it
It was stolen
I gave it to my friend…who really needed it