Roles and Responsibilities of the Advanced Nurse Practitioner in Prescribing
The roles and responsibilities of the advanced nurse practitioners in prescribing medications to patients are to obtain as much information from the patient by a verbal history and through a hands on physical examination in order to diagnose and then establish a course of treatment for the patient, (Arcangelo et al., 2017, p. 7). In order to do no harm and provide for the best outcome for the patient, the advanced nurse practitioner must consider many things when choosing which medication to treat the patient with.
When making the drug choice, the advanced nurse practitioner should ask themselves if the drug is required, and if so, what will be the effect on the patient? Side effects should be reviewed with the patient. The nurse practitioner should also consider if the regimen is one the patient can abide by. Other concerns would be is this the most effective medication for the patient, and if the cost is a barrier to compliance for the patient, (Arcangelo et al., 2017, p. 7). Also, does the patient agree with the course of treatment? If the patient agrees, they will more likely be compliant with the medication regimen.
Another aspect the advanced nurse practitioner should consider is if the medication is truly needed for the illness. A patient that is ill may come in and specifically request a medication. In this case, the advanced nurse practitioner should not be influenced by the patients request, but should weigh all aspects of the patient illness presentation before a decision is made. One common example of this is a patient request for an antibiotic. Antibiotics have been noted to be prescribed by advanced nurse practitioners at a higher rate than physicians. Therefore, the advanced nurse practitioner should be judicious in their decision to prescribe an antibiotic in order to prevent antibiotic resistance, (Sanchez et al., 2016).
The next important responsibility of the advanced nurse practitioner in regards to prescribing medication would be to consider the drug that is chosen for the illness. The advanced nurse practitioner should review if the patient has any allergies to the medication. Another consideration is if the medication will interact with a medication the patient is currently prescribed. For example, if a patient is receiving Methadone therapy for opioid use disorder (OUD), the prescriber should not consider Azithromycin as a treatment for infection as this can lead to increased prolongation of the QT interval and result in the possible fatal condition of Torsades de Pointes, (Sunilkumar & Lockman, 2018).
Lastly, the legal and regulatory aspects of prescribing medication should be considered by the advanced nurse practitioner. One important example of this would be an advanced nurse practitioner prescribing Suboxone to a patient with OUD in their primary care practice. The advanced nurse practitioner can legally prescribe this Schedule III medication if they have received their Drug Addiction Treatment Act (DATA) 2000 waiver and are legally able to prescribe this under their states regulatory body, (Frank et al., 2018).
References
Arcangelo, P. V., Peterson, M. A., Wilbur, V., & Reinhold, A. J. (2017). Pharmacotherapeutics
for Advanced Practice: A Practical Approach (4th Ed.). Philadelphia, PA: Wolters
Kluwer/Lippincott Williams & Wilkins American
Frank, J. W., Wakeman, S. E., & Gordon, A. J. (2018). No end to the crisis without an end to the
waiver. Substance Abuse, 39(3), 263-265, DOI: 10.1080/08897077.2018.1543382
Guillermo V. Sanchez, Adam L. Hersh, Daniel J. Shapiro, James F. Cawley, Lauri A. Hicks,
Outpatient Antibiotic Prescribing Among United States Nurse Practitioners and Physician
Assistants, Open Forum Infectious Diseases, Volume 3, Issue 3, Summer 2016, ofw168,
https://doi.org/10.1093/ofid/ofw168
Sunilkumar, M. M., & Lockman, K. (2018). Practical Pharmacology of Methadone: A Long-
acting Opioid. Indian journal of palliative care, 24(Suppl 1), S10S14.
https://doi.org/10.4103/IJPC.IJPC_180_17
