Drug Classifications and Prototypes

Every question here, with the answer

1. A client is prescribed metoprolol for chest discomfort associated with coronary artery disease and also has elevated blood pressure. The client asks why the same drug is listed as both an antianginal and an antihypertensive. Which response by the nurse is best?

   1. One of the classifications must be incorrect because a drug can have only one therapeutic classification.
   2. The drug can have more than one therapeutic classification because it is used for different clinical indications, while its mechanism of action remains essentially the same.
   3. The drug changes pharmacologic classification depending on which diagnosis is being treated.
   4. The two therapeutic classifications mean the nurse should expect two different sets of side effects and safety parameters.

   Answer: The drug can have more than one therapeutic classification because it is used for different clinical indications, while its mechanism of action remains essentially the same.

   Therapeutic classification is based on the drug’s clinical use, so one drug may have more than one therapeutic classification. The section explains that even with multiple therapeutic classifications, the drug essentially has the same mechanism of action, side effects, and safety parameters.

2. A nurse who is very familiar with metoprolol receives an order for atenolol, another beta-adrenergic blocker. Which action best reflects use of the prototype approach?

   1. Disregard safety parameters because prototypes are used only to identify therapeutic indications.
   2. Use knowledge of metoprolol to anticipate that atenolol will have a similar mechanism of action, side effects, and safety parameters.
   3. Assume atenolol must have the same dosage quantity, frequency, and route as metoprolol.
   4. Treat atenolol as unrelated to metoprolol because prototypes are helpful only in textbooks, not clinical practice.

   Answer: Use knowledge of metoprolol to anticipate that atenolol will have a similar mechanism of action, side effects, and safety parameters.

   The prototype approach uses one representative drug to help understand other drugs in the same class. The section specifically describes applying knowledge of metoprolol to atenolol because both are beta-adrenergic blockers.

3. A nurse is auditing controlled-substance prescribing and documentation procedures in a hospital pharmacy. Which findings are consistent with the federal controls described in the section? Select all that apply.

   1. A controlled substance prescription includes the prescriber’s unique DEA identifier.
   2. A health care provider with prescriptive authority is registered with the DEA.
   3. The pharmacy fills routine Schedule I prescriptions because Schedule I drugs have no accepted medical use.
   4. Schedule II, III, and IV prescriptions are linked to a medically sound reason.
   5. The hospital and pharmacy keep records of drugs purchased and sold.

   Answer: A controlled substance prescription includes the prescriber’s unique DEA identifier., A health care provider with prescriptive authority is registered with the DEA., Schedule II, III, and IV prescriptions are linked to a medically sound reason., The hospital and pharmacy keep records of drugs purchased and sold.

   The section states that hospitals and pharmacies must keep purchase and sale records, and prescribers must be registered with the DEA and use a unique DEA identifier on controlled substance prescriptions. It also states that Schedule II, III, and IV drugs require a medically sound reason; Schedule I prescriptions generally cannot be issued or filled.

4. A nurse is teaching new staff why a routine prescription for a Schedule I drug should not be expected to be filled by a pharmacy. Which explanation is most accurate?

   1. Schedule I drugs have general medical use but must be prescribed only with a DEA identifier.
   2. Schedule I drugs have no medical use and a very high potential for abuse and dependency, so most providers cannot prescribe them and pharmacies cannot fill those prescriptions.
   3. Schedule I drugs may be prescribed when there is a medically sound reason, similar to Schedule II, III, and IV drugs.
   4. Schedule I drugs have the lowest potential for misuse and dependency, so prescriptions are limited to special pharmacies.

   Answer: Schedule I drugs have no medical use and a very high potential for abuse and dependency, so most providers cannot prescribe them and pharmacies cannot fill those prescriptions.

   Schedule I drugs are described as having no accepted medical use and a very high potential for abuse and dependency. Because of this, most health care providers cannot issue prescriptions for them, and pharmacies cannot fill those prescriptions.