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.

Roles and Responsibilities of the APRN When Prescribing Medication

1. Assessment and Diagnosis

Conduct a thorough patient assessment, including medical history, current medications, allergies, and lab results.
Diagnose the patient’s condition accurately to ensure the prescribed medication aligns with the patient’s needs.

2. Medication Selection and Prescribing

Determine the most appropriate medication, dosage, and route of administration.
Consider patient-specific factors such as age, weight, comorbidities, pregnancy, and renal or liver function.
Prescribe medications legally within the APRN’s scope of practice, adhering to state regulations.

3. Monitoring and Follow-up

Monitor patient responses to the medication, including efficacy and adverse effects.
Adjust therapy as needed based on clinical response, lab results, and patient feedback.

4. Documentation

Document all prescribing decisions, rationale, patient education, and follow-up plans in the medical record.

1. Evidence-Based Guidelines

Use clinical practice guidelines (e.g., CDC, AHA, ADA) to choose first-line therapy for specific conditions.

2. Patient-Specific Factors

3. Clinical Judgment and Pharmacology Knowledge

Consider mechanism of action, pharmacokinetics (absorption, distribution, metabolism, excretion), and pharmacodynamics.
Weigh risks vs. benefits, especially in complex cases or with polypharmacy.

4. Shared Decision-Making

Engage patients in choosing therapy options, explaining expected benefits, side effects, and alternatives.

1. Medication Purpose and Benefits

Explain why the medication is prescribed and how it addresses the patient’s condition.

2. Administration Instructions

3. Side Effects and Warning Signs

4. Adherence and Lifestyle Integration

Encourage adherence to therapy and discuss lifestyle modifications if relevant (diet, exercise, alcohol or tobacco use).

5. Monitoring and Follow-up

Controlled substances are classified by the DEA into five schedules based on medical use, abuse potential, and safety:

Schedule	Examples	Abuse Potential	Prescribing Restrictions
I	Heroin, LSD	Highest, no accepted medical use	Cannot be prescribed
II	Morphine, Oxycodone, Adderall	High	Written prescriptions only; no refills; strict documentation; may require special forms
III	Ketamine, Codeine combinations	Moderate	May be refilled up to 5 times in 6 months; written or electronic prescriptions
IV	Diazepam, Lorazepam	Low	May be refilled up to 5 times in 6 months; written, electronic, or oral prescription
V	Cough syrups with small amounts of codeine	Lowest	May be dispensed without prescription in some states; usually OTC with limitations

Additional APRN Considerations:

APRNs must comply with state-specific laws for controlled substances.
Often require DEA registration to prescribe controlled drugs.
Must maintain accurate records and adhere to monitoring and refill restrictions.

In short, APRNs have a responsibility to:

Prescribe safely and legally based on patient assessment and evidence-based guidelines.
Educate patients thoroughly to ensure adherence and safety.
Follow strict regulations for controlled substances, documenting appropriately.