NR Week 6: Open Forum Discussion

NR Week 6: Open Forum Discussion

NR Week 6: Open Forum Discussion – This is a required, but not graded open forum. Please feel free to post questions related to content or assignments

One of the most challenging aspects of prescribing medications is the possibility of dangerous interactions with those patients on multi-drug therapies. According to Woo & Robinson, 2016, Colchicine, probenecid, and sulfinpyrazone are all used cautiously in the presence of peptic ulcer disease or spastic colon. Gastrointestinal (GI) adverse reactions from these drugs are likely to make these disorders worse. When it comes to prescriptive authority, precise critical thinking in decision making is crucial.  Medications can and do alter people’s lives, and the ability to prescribe them is an awesome responsibility. NR Week 6: Open Forum Discussion Some of the antigout medication that is being utilized such as allopurinol and febuxostat has hepatoxicity side effects. Liver function test should be performed on a regular basis. During my career as a nurse I have given patients colchicine and allopurinol numerous times, but I wasn’t aware of the dangerous side effects of these drugs.  The mechanism of action is quite impressive, allopurinol and febuxostat inhibit xanthine oxidase, the enzyme responsible for the conversion of hypoxanthine and xanthine to uric acid. Allopurinol has a metabolite (alloxanthine) that is also an inhibitor of xanthine oxidase. Allopurinol acts directly on purine metabolism, reducing the production of uric acid, without disrupting the biosynthesis of vital purines. (Woo & Robinson, 2016). Part of the fear of having this responsibility lies in the fact that many times, as providers, we do not always know what medications a patient is already taking. Many of the antigout medicines excreted via the renal system, so it is essential to know what other medication the patient is taking. Indeed, patients do their best in relaying their medical history and providing up-to-date lists of their current medications; however, we know that information is often forgotten or omitted from our conversations with them. Febuxostat, a xanthine oxidase inhibitor, is contraindicated in patients treated with drugs requiring xanthine oxidase for metabolism (azathioprine, mercaptopurine, or theophylline) because of increased risk for toxicity. (Woo & Robinson, 2016). The risk causes concern when prescribing new medications, as there may be harmful drug-drug interactions that we are not able to avoid without all the pertinent information from the patient NR Week 6: Open Forum Discussion.

NR Week 6: Open Forum Discussion Reference

Woo, T. M., & Robinson, M. V. (2016). Pharmacotherapeutics for Advance Practice Nurse prescribers (4th ed.). Retrieved from http://bookshelf.vitalsource.com NR Week 6: Open Forum Discussion