Running head: PHARMACOLOGY FOR NURSING CARE 1

Pharmacology for Nursing Care

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PHARMACOLOGY FOR NURSING CARE 2

Pharmacology for Nursing Care

Health regulatory agencies are of great significance since they help protect as well as

regulate public health at every level. The agencies ensure that safe and quality care is provided

by promoting safety, providing the necessary information about industry changes, monitoring

practitioners and facilities as well as foreseeing legal compliance and quality services. Health

care standards and regulations are important to enhance compliance and also the provision of

safe healthcare to every individual who assesses the system. In the U.S, regulations are normally

developed and implemented at all levels of government and also by private organizations. This

paper discusses the agonies that regulate prescribing by APRNs in Louisiana. It further

differentiates the regulations in Texas and Louisiana.

The agency that Regulate Advanced Practice Registered Nurse Prescribing in Louisiana

Independent prescribing refers to the ability of advanced practice registered nurses to prescribe

without limitation. In Louisiana, prescribing by the APRN is regulated by the Louisiana State

Board of Nursing. The goal of this agency is to safeguard the health and life of the citizens of

Louisiana. It ensures that a person who takes up the roles of advanced practice registered nurses

and registered nurses are competent. The goals of the agency include promoting regulatory

effectiveness, enhancing image and visibility of the Board, assuring efficient and timely

responses to nursing issues that affect the safety of patients, and identifying as well as regulating

evolving roles of the registered nurse and advanced practice registered nurse as a professional

while protecting the public. The agency requires a nurse to complete all the forms and

applications that are necessary correctly, accurately, and carefully. The agency requires an

APRN to apply for reinstatement of Prescriptive Authority if she/he had been awarded by LSBN

with PA privileges before but has not practiced within the last 12 months or more.

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Educational Requirements for Prescribing as an APRN in Louisiana

In this state, the credentials for prescriptive authority that are issues are calendar year,

and nurses are required to renew the licenses and credentials before their date of expiration.

Subsequent renewals are usually biennials. Every year APRNs are usually expected to undertake

six contact hours of continuing education in pharmacotherapeutics in their role and population to

maintain the prescriptive authority credential after issuance. If selected randomly during the

yearly audit procedure, the APRNS are expected to provide evidence of the CEs to LSBN. The

CE certificate of completion or documentation should indicate clearly the topics of

pharmacology that the APRN has completed. Another requirement is for one to have practiced in

the current clinical practice for at least 500 hours as an APRN within the last two years. Annual

continuing education for pharmacology is required to be at the advanced practice level and

related to the APRN’S licensed advanced role and population specialty/focus (Phillips, 2016).

Difference between the Regulations in Louisiana and Texas

In the state of Texas, there are limitations in relation to prescriptive authority for

Advanced Practice Registered Nurses. A physician must delegate prescriptive Authority through

a written document prescribed by law to an APRN or physician assistant through a prescriptive

authority agreement. For an APRN to qualify to be a party to a prescriptive authority agreement

the APRNs must have been issued by the BON with a prescriptive authorization number that is

valid, an explanation on the nature of the practice, setting or location, the categories and types of

drugs that APRN can prescribe and not prescribe, and a prescriptive authority quality assurance

and improvement plan. In addition to that, an APRN is required by the prescriptive authority to

have a DEA registration for controlled substances and registration with the TX Department of

Public Safety. On the other hand, in the state of Louisiana, the APRN, before engaging in

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practices that involve writing orders or prescriptions, the nurses are expected to obtain a letter of

approval from the Louisiana State Board of Nursing that shows approval for Prescriptive

Authority privileges in conjunction with the licensed physicians (Paulozzi, Strickler, Kreiner, &

Koris, 2015). The collaborating physician is expected to engage in clinical practice within the

state of Louisiana in the same, or a practice that is comparable in specialty, the scope of expertise

to that of the APRN. Nurse practitioners have the authority to prescribe medications, which

includes controlled substances as long as it is outlined in the collaborative practice agreement

parameters. In Louisiana, the APRNs are prohibited from writing prescriptions for controlled

substances for their family members or themselves. They are also prohibited from distributing or

prescribing controlled substances in regard to the treatment of intractable or chronic pain

(Gadbois, Miller, Tyler, D., & Intrator, 2015).

Actions Required to Prescribe in Louisiana

The state of Louisiana has a prescription monitoring program that was put in place to

give guidelines for effective and safe prescription (Brandeis University & United States of

America., 2018). This program comes in handy to eliminate issues like drug abuse, medical

errors, and, most importantly, to fight the opioid epidemic. All prescribers are required to register

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in this program. Through the program, they can receive regular training and education, which

would enable them to prescribe effectively. The Louisiana Board of pharmacy also has in place

regulations and procedures that healthcare providers should put in place when doing

prescriptions. The first and most important action is the verification of the patient requiring

medication. This includes doing a background medical check-up to ascertain that they genuinely

need the drug for health purposes. During the prescribing process, there is important information

that needs to be recorded, which include the prescriber’s information, prescription information,

patient information, drug information, and dispenser information.

During the Opioid crisis, a large number of teenagers would use older friends or family

members to get these drugs for them. Patient verification prevents issues of impersonation by

people just to get drugs and abuse them or sell them to addicted teens. It also eliminates cases

where patients with Opioid addiction get more opioid prescriptions. When a patient’s history

shows a past addiction, prescribing personnel can find alternative ways of medication. The

patient is also required to be medically examined to prove their compatibility with the medicine.

This prevents issues like reactions. The healthcare provider is also expected to educate the

patient on the risks and side effects of the medication. They also need to highlight issues of

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medicine counter-reaction with other substances they could be taking, such as alcohol. In cases

where the patient requiring a prescription is a minor, parental consent should be sought. This

eliminates cases where children abuse drugs behind their parents back. Such instances can

expose healthcare facilities to legal suits.

Controlled Substance Regulation

Controlled dangerous substances (CDS) in Louisiana include drugs such as cocaine,

heroin, marijuana, and also the compounds used to manufacture them. In this state, the controlled

dangerous substances are usually classified into five groups. These groups are usually known as

schedules. Schedule I is made up of the most dangerous drugs which have a high likelihood of

abuse and addiction, whereas they don’t have any medical significance. On the other hand,

schedule II, III, IV, and V drugs are less dangerous, have lower possibilities of abuse, and have

some identified medical value. The different schedules also attract different penalties for the

illegal possession of the CDS. Schedule I substances have different penalties depending on the

specific CDS involved, and the fine ranges between $5000 up to $600,000 and imprisonment of

up to 30 years. The penalty for schedule II substances also depends on the specific CDS

involved, and the fine ranges from $5000 to $600,000 and imprisonment of five or up to 30

PHARMACOLOGY FOR NURSING CARE 7

years. Schedule III substances attract a fine of up to $5000 and up to five years in prison.

Penalties for schedule IV substances attract a maximum fine of $5000 and up to 10 years in

prison. Schedule V substances usually attract a fine of up to $5000 and a maximum of 5 years in

prison. The manufacturers or distributors, if found guilty for unlawful of the CDS, also face hefty

fines and even prison time for the individuals involved.

A DEA number refers to a number that is assigned to enable a health provider to

prescribe medications legally, including controlled substances. In Louisiana, APRNs who would

like to prescribe controlled substances the requested DEA schedules need to be identified by the

CPA and Attestation of Collaborative practice. To obtain DEA regulations, I am expected to

provide a detailed description of the practice site of a family nurse practitioner, describe how the

patients I administer care to will benefit, identify the schedules of controlled substances I

anticipate to administer. In addition to that, to obtain the regulations as a family nurse

practitioner am also expected to explain the various conditions that will require the prescription

of controlled substances.

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References

Brandeis University, & United States of America. (2018). Prescription Drug Monitoring

Program: Louisiana State Profile.

Gadbois, E. A., Miller, E. A., Tyler, D., & Intrator, O. (2015). Trends in state regulation of nurse

practitioners and physician assistants, 2001 to 2010. Medical Care Research and

Review, 72(2), 200-219.

Paulozzi, L. J., Strickler, G. K., Kreiner, P. W., & Koris, C. M. (2015). Controlled substance

prescribing patterns—prescription behavior surveillance system, eight states,

2013. Morbidity and Mortality Weekly Report: Surveillance Summaries, 64(9), 1-14.

Phillips, S. J. (2016). 28th annual APRN legislative update: advancements continue for APRN

practice. The Nurse Practitioner, 41(1), 21-48.