DNRS 6521 Week 10 Deprescribing Plan Example

Course	DNRS 6521 Advanced Pharmacology (DNP level)
Week	Week 10
Paper type	Deprescribing plan
Length	About 1,060 words, 6 pages
Format	APA 7 student paper
School	Walden University
Program	Doctor of Nursing Practice (DNP)
Updated	October 2026

Free sample paper for DNRS 6521 Week 10

Deprescribing Plan: One Change at a Time for an 83-Year-Old Man Whose Ten Medicines Were Each Started for a Reason

Student Name

College of Nursing, Walden University

DNRS 6521: Advanced Pharmacology (DNP level)

Instructor Name

Month Day, Year

What this page is doingThe title promises sequencing, one change at a time, which is the part of deprescribing hardest to defend. It also concedes that each medicine had a reason once, which is where the analysis starts.

Deprescribing Plan: One Change at a Time for an 83-Year-Old Man Whose Ten Medicines Were Each Started for a Reason

The Regimen as a History

Walter is a composite 83-year-old widower who lives alone and has fallen twice in 4 months. His regimen accumulated over 15 years, and each medicine had a reason when it began. Table 1 reconstructs that history; the last column, whether the reason still holds, does the analytic work.

Table 1

Walter's Regimen Reconstructed as a History

Medicine	Began	Begun for	Does the reason still hold?
Metformin 500 mg twice daily	2009	Type 2 diabetes	Yes; eGFR 52
Glipizide 10 mg twice daily	2011	Added when HbA1c rose	No; HbA1c now 6.1% with two episodes of low glucose
Insulin glargine 12 units nightly	2016	HbA1c 9.2% during an illness	Partly; current HbA1c is below his target
Aspirin 81 mg daily	2010	Primary prevention; no cardiovascular disease	No
Omeprazole 40 mg daily	2014	Stomach protection during a course of ibuprofen	No; ibuprofen stopped in 2015
Atorvastatin 40 mg daily	2012	Primary prevention	Uncertain at 83
Lisinopril 20 mg daily	2011	Hypertension and albumin in urine	Yes
Amlodipine 10 mg daily	2017	Blood pressure above goal	No; pressure now 112/64 seated, falling on standing
Tamsulosin 0.4 mg nightly	2019	Urinary symptoms from an enlarged prostate	Yes, though it adds to orthostatic drops
Zolpidem 5 mg nightly	2020	Insomnia after his wife's death	No; grief-related sleep problem, now chronic use

What this page is doingReconstructing the list as a history, with the original reason and whether it still holds, turns a medication list into an argument. The last column is where the deprescribing candidates reveal themselves.

Prioritizing the Candidates

Five medicines have lost their reason, and a sixth is uncertain. They are ranked by four stated criteria: current harm, the strength of the case that the indication has lapsed, the risk of withdrawal itself, and Walter's own priorities, which are to stop falling and to take fewer pills. The approach follows the stepwise deprescribing process of reviewing each drug's indication, weighing current harm against benefit, and planning withdrawal with monitoring (Scott et al., 2015).

Glipizide ranks first. It is causing harm now: with an HbA1c of 6.1%, a sulfonylurea exposes him to hypoglycemia, which is a plausible contributor to his falls. For older adults with complex health, diabetes guidance recommends a less stringent glycemic target and deintensifying drugs that cause hypoglycemia (American Diabetes Association Professional Practice Committee, 2024), and the Beers Criteria advise avoiding sulfonylureas in older adults where possible (American Geriatrics Society Beers Criteria Update Expert Panel, 2023).

Amlodipine ranks second. His blood pressure is low and falls further on standing, a second plausible contributor to falls, and stopping it is simple.

Zolpidem ranks third. It adds to fall and confusion risk and its original reason has passed, but after 4 years of nightly use it needs a slow taper, which makes it slower to act on than the first two.

Aspirin and omeprazole rank fourth and fifth. Neither is causing obvious harm today, but aspirin for primary prevention is not recommended for starting after age 60 because bleeding risk offsets small benefit (US Preventive Services Task Force, 2022), and a proton pump inhibitor without a continuing indication appears among the STOPP criteria (O'Mahony et al., 2023).

Atorvastatin is last and is a conversation rather than a plan: evidence for primary prevention at his age is limited, and the decision depends on what he wants.

One Change at a Time

The plan changes one medicine at a time, and this is deliberate. If glipizide and amlodipine were stopped together and his falls ended, no one could say which change mattered; if his glucose or pressure then rose, no one could say which to restart. Changing one thing per step keeps each result interpretable.

Step 1, week 0: stop glipizide. Monitoring window 2 weeks: fingerstick glucose before breakfast and dinner. Pause and review if fasting glucose is above 250 mg/dL on 2 days, or if he has symptoms of high glucose.

Step 2, week 2: stop amlodipine. Monitoring window 2 weeks: home seated and standing blood pressure twice daily and any dizziness. Pause if seated pressure is above 160/90 on repeated readings.

Step 3, week 4: taper zolpidem over 6 weeks, halving the dose and then moving to alternate nights, with sleep hygiene support. A direct-to-patient education brochure about sedative risks led 27% of older adults to stop benzodiazepines within 6 months, against 5% of controls (Tannenbaum et al., 2014); the same approach is used here, though that trial studied benzodiazepines rather than zolpidem. Pause the taper if insomnia becomes severe for more than a week.

Step 4, week 10: stop aspirin. Step 5, week 12: reduce omeprazole to 20 mg for 4 weeks and then stop, with an antacid available for rebound symptoms. Pause if heartburn is persistent.

Glargine is reviewed at each step: once glipizide is gone, his glucose will rise somewhat, and his glargine dose may need to stay as it is rather than fall.

Who Else Needs to Know

A plan made in one clinic can be undone in another. Walter's urologist prescribed the tamsulosin, and his endocrinologist, whom he sees once a year, started the glargine. Both receive a short letter at the start: the reason for the plan, the order of changes, and a request not to restart glipizide or amlodipine without discussion. His pharmacy receives the same list, so that an automatic refill of a stopped drug is flagged rather than dispensed. His daughter, who visits on weekends and fills his pill organizer, is shown which compartments change at each step, because an organizer filled from an old list is the most common way a stopped drug returns. Each of these contacts is recorded in his chart with the date, so that anyone reviewing the plan later can see who was told.

The Conversation

The plan is presented to Walter as a way to stop falling and simplify his day, not as a list of mistakes. He is told that each change is a trial, that any medicine can be restarted if it turns out to have been doing something, and that he will be asked how he feels at each step. His preferences can change the plan. If he wants to keep the statin, it stays. If he finds the zolpidem taper too hard, it slows. If he would rather stop more quickly to have fewer pills sooner, the tradeoff is explained: faster changes are harder to interpret, and the plan exists to learn which changes help him.

References

American Diabetes Association Professional Practice Committee. (2024). 13. Older adults: Standards of care in diabetes, 2024. Diabetes Care, 47(Suppl. 1), S244-S257. https://doi.org/10.2337/dc24-S013

American Geriatrics Society Beers Criteria Update Expert Panel. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society, 71(7), 2052-2081. https://doi.org/10.1111/jgs.18372

O'Mahony, D., Cherubini, A., Guiteras, A. R., Denkinger, M., Beuscart, J.-B., Onder, G., Gudmundsson, A., Cruz-Jentoft, A. J., Knol, W., Bahat, G., van der Velde, N., Petrovic, M., & Curtin, D. (2023). STOPP/START criteria for potentially inappropriate prescribing in older people: Version 3. European Geriatric Medicine, 14(4), 625-632. https://doi.org/10.1007/s41999-023-00777-y

Scott, I. A., Hilmer, S. N., Reeve, E., Potter, K., Le Couteur, D., Rigby, D., Gnjidic, D., Del Mar, C. B., Roughead, E. E., Page, A., Jansen, J., & Martin, J. H. (2015). Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Internal Medicine, 175(5), 827-834. https://doi.org/10.1001/jamainternmed.2015.0324

Tannenbaum, C., Martin, P., Tamblyn, R., Benedetti, A., & Ahmed, S. (2014). Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: The EMPOWER cluster randomized trial. JAMA Internal Medicine, 174(6), 890-898. https://doi.org/10.1001/jamainternmed.2014.949

US Preventive Services Task Force. (2022). Aspirin use to prevent cardiovascular disease: US Preventive Services Task Force recommendation statement. JAMA, 327(16), 1577-1584. https://doi.org/10.1001/jama.2022.4983

DNRS 6521 Week 10 instructions, in plain terms

The tenth week usually asks for a deprescribing plan for an older adult with polypharmacy. You review each medication's indication, assess benefit and harm now, identify candidates for stopping or reducing, and set out the order, method and monitoring for each change. DNRS 6521 prompts often name the Beers Criteria or STOPP/START as the screening tool, and many ask how the patient's goals and preferences shape the plan. Expect a structured APA 7 paper, frequently with a table of the regimen. Communication with other prescribers, pharmacists and family is commonly part of the grade. Most sections want one change at a time with clear review points rather than several stops at once. Cite guidance for tapering where withdrawal effects are possible.

How this DNRS 6521 Week 10 example is built

A four-page document that opens with the accumulated regimen reconstructed as a history rather than as a list. Each entry carries when it began, what it was begun for and whether that indication still holds, and the third column is the one doing the analytic work. A prioritization section ranks candidates for reduction using stated criteria, and the ranking is justified in prose rather than presented as a table alone. The sequencing section then permits one change at a time and says why, including what a simultaneous reduction would make impossible to interpret. Each step carries a monitoring window and a defined reason to pause. A conversation section covers how the plan is presented and what patient preference would change about it.

DNRS 6521 Week 10 rubric: what earns full marks

The heaviest credit follows the indication review, because a plan proposing reductions without establishing which indications expired has recommended without diagnosing. Graders read the sequencing justification closely, and plans reducing several entries at once are marked down even when each reduction is individually defensible. Monitoring windows stated without a reason to pause are treated as incomplete, since the pause condition is what makes a window operational. Papers omitting the conversation section lose a criterion that professional-practice rubrics list rather than imply. Withdrawal effects are expected to be addressed by category, and a plan silent on them reads as theoretical. Length pressure usually shows up as a truncated prioritization section, which is unfortunate, as the criteria stated there are what the rest of the document depends on.

Common DNRS 6521 Week 10 mistakes, and how to avoid them

Deprescribing plans lose credit most often by proposing cuts before showing which indications have expired. Review each reason first. Another mistake is stopping several drugs at once, since nobody could then say which stop caused which result. Sequence the steps and give each a review date. Students also forget tapering for drugs that cause withdrawal or rebound. Keep the patient's goals in the plan; a list of potentially inappropriate drugs is not a plan without them. Make sure the table matches the text, including doses. Do not ignore the other prescribers, since they may restart a stopped drug. Close with how the plan will be explained to the patient in plain words.

Get a DNRS 6521 Week 10 example written to your instructions

Forward the case, the deprescribing prompt and any tool or framework the classroom names, and a sequenced plan with criteria, windows and pause conditions comes back to you. The first custom one is free and lands inside 24 to 48 hours. An actual regimen belonging to somebody in your care is their record and does not become a worked example here.

More DNRS 6521 papers and DNP samples

DNRS 6521 Week 10 questions, answered

How many entries should the plan address?

Enough to require prioritization and few enough to sequence properly, which usually means a regimen where several candidates compete. The example works with an accumulated list that yields three reduction candidates. When a section issues a case of its own, that one governs, and the criteria section is written to whatever competition it actually creates.

Should the plan use a published deprescribing framework?

If the prompt names one, yes, and citing it while showing the reasoning underneath is better than either alone. Several validated approaches exist for identifying candidates. The example names its criteria explicitly so a reader can see the judgment being made, which is what a doctoral rubric assesses regardless of which framework sits behind it.

Does patient preference really belong in the plan?

Most nursing rubrics carry a criterion for it, and in deprescribing it is more than a formality, since willingness to stop is often the deciding factor. The example gives preference the power to reorder the sequence. Documenting how the plan would be presented is part of the same criterion in many classrooms.

Where can I find a free DNRS 6521 Week 10 sample paper?

Walter's full deprescribing plan is on this page, including the regimen history table, the priority order, each step and the closing conversation.

How do you prioritize deprescribing in DNRS 6521 Week 10?

Start with drugs whose original reason no longer applies and those most likely linked to the current harm, here falls, then sequence changes one at a time with review points.