Keeping up with the fast-changing medication landscape is important for nurses at all levels of care.
For advanced practice nurses, staying abreast of pharmacology is required, and nurse practitioners and clinical nurse specialists need to take an advanced practice nurse pharmacology course every two years to renew their licenses and national certification.
The rationale for requiring nurses to update their knowledge of medicines and be aware of trends in new drugs and biological agents is important, said one of our advanced practice nurse pharmacology course authors, Paul Arnstein, RN, PhD, FAAN, a clinical nurse specialist at Massachusetts General Hospital.
That importance is stressed by the lay media and direct-to-consumer advertising always touting new therapeutic options.
Nurse practitioners increasingly are being granted full prescriptive authority, which is accompanied by the responsibility to be knowledgeable about black box warnings and potential drug-drug interactions, he said.
We asked Arnstein about the need for pharmacology knowledge for today’s healthcare professionals.
The advanced practice nurse pharmacology course allows nurses to fulfill the American Nurses Credentialing Center 25-contact hour pharmacotherapeutics requirement for certification. Why is it so important for advanced practice nurses today?
Paul Arnstein, RN, PhD, FAAN
Drugs are always changing, and there are always new drugs coming to market. There are new black box warnings of existing drugs. There are new generics and therapeutic alternatives.
Older, unfamiliar drugs may make a comeback. Common medicines may be found to be unsafe or less effective than originally thought, or some may be repurposed for off-label uses.
Ketamine, for example, was used for a long time as an anesthetic. When using it in opioid-tolerant patients, it was found to be an effective analgesic at lower the dose of opioid needed to be effective.
Subsequently, it has been shown to be effective in low doses for intractable chronic pain, while another line of research demonstrates its utility for difficult-to-treat depression.
So, the rapid expansion of drug-related research is providing new insights into the potential effects and side effects of medications.
Do healthcare trends make it more important for nurses to have a strong grasp of commonly prescribed medications and therapeutic alternatives?
Cost is always a factor. Prior authorization is another. What often happens is patients who are prescribed medications in the hospital sometimes can’t get those medicines when they’re back in the community because of regulatory reasons or prior authorization.
One of the other things we’re seeing that we didn’t see as much five years ago is how drug shortages are impacting what we can prescribe to patients. [That’s] forcing us to think more broadly about therapeutic alternatives.
In hospitals, there was an intravenous (IV) opioid shortage last year. Right now, there are immunoglobulin shortages and looming heparin shortages. That really creates a conundrum for prescribers trying to meet patients’ needs with different types or combinations of drugs.
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