SBFC Farmácia Clínica flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Pharmaceutical care

Responsible provision of drug therapy to achieve definite outcomes that improve quality of life, requiring assessment of need, identification of drug therapy problems, and structured follow-up of the care plan.

Drug therapy problem

Any undesirable event experienced by a patient that involves or is suspected to involve drug therapy, and that requires professional judgment to resolve through a specific pharmacist intervention.

SOAP note

Structured clinical documentation with Subjective, Objective, Assessment, and Plan sections, where the Assessment states the drug therapy problem and the Plan lists interventions and monitoring parameters.

Medication reconciliation

Formal process comparing a patient's pre-admission medication list with current orders at admission, transfer, and discharge to identify and resolve unintended discrepancies with the prescriber.

HFrEF quadruple therapy

Combination of an ARNI or ACE inhibitor/ARB, an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor, each titrated toward target dose.

High-intensity statin

Atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg daily, expected to lower LDL cholesterol by at least 50 percent and used after acute coronary syndrome.

SGLT2 inhibitor caveat

These agents reduce heart failure hospitalization and slow kidney disease progression, but can cause euglycemic diabetic ketoacidosis, genital mycotic infections, and volume depletion.

Time-dependent killing

Antimicrobial activity that depends on the fraction of the dosing interval during which free drug concentration exceeds the MIC, characteristic of beta-lactams.

Vancomycin AUC target

For serious MRSA infections, the recommended exposure is AUC24/MIC of 400 to 600, estimated by Bayesian methods or two concentration levels rather than trough alone.

Antimicrobial de-escalation

Narrowing empiric broad-spectrum therapy to a targeted agent, or stopping antibiotics, once culture and susceptibility results identify the pathogen and its susceptibilities.

Serotonin syndrome

Toxicity from serotonergic drugs marked by altered mental status, autonomic hyperactivity, and neuromuscular signs such as clonus and hyperreflexia, managed by stopping the agents.

Lithium therapeutic range

Serum lithium concentrations of roughly 0.6 to 1.2 mEq/L; levels rise with dehydration, NSAIDs, thiazides, and ACE inhibitors, so monitoring and interaction review are essential.

Narrow therapeutic index

Property of drugs whose effective and toxic concentrations are close, requiring therapeutic drug monitoring; examples include digoxin, lithium, phenytoin, warfarin, and tacrolimus.

Saturable kinetics

Michaelis-Menten behavior in which metabolic enzymes become saturated, so a small dose increase produces a disproportionately large rise in steady-state concentration, as with phenytoin.

Loading dose formula

Loading dose equals target concentration multiplied by volume of distribution, divided by bioavailability; it rapidly fills the distribution volume without waiting several half-lives.

Half-life relation

Half-life equals 0.693 times volume of distribution divided by clearance; approximately four to five half-lives are needed to reach steady state.

CYP2C19 and clopidogrel

Loss-of-function CYP2C19 alleles reduce conversion of clopidogrel to its active metabolite, lowering antiplatelet effect; prasugrel or ticagrelor are alternatives after acute coronary syndrome.

HLA-B*57:01

HLA allele whose presence predicts abacavir hypersensitivity reaction; screening before starting abacavir allows selection of an alternative antiretroviral and prevents a potentially fatal reaction.

G6PD deficiency

Inherited enzyme deficiency causing oxidative hemolysis when exposed to primaquine, dapsone, nitrofurantoin, or rasburicase, so these agents are avoided or used with caution.

TPMT and NUDT15

Genes encoding thiopurine-metabolizing enzymes; deficiency raises risk of severe myelosuppression with azathioprine or mercaptopurine, so genotyping guides dose reduction.

Adverse drug reaction

A noxious and unintended response to a medicine occurring at doses normally used in humans, assessed for causality with tools such as the WHO-UMC scale.

Serious adverse reaction

An adverse reaction causing death, life-threatening illness, hospitalization or prolongation, persistent disability, or congenital anomaly, requiring expedited regulatory reporting.

CYP3A4 induction

Increased enzyme expression by rifampicin, carbamazepine, phenytoin, or St John's wort, lowering concentrations of substrates such as tacrolimus, cyclosporine, and oral contraceptives.

High-alert medications

Drugs carrying heightened risk of significant harm when used in error, including insulin, anticoagulants, concentrated electrolytes, chemotherapy, and opioids, requiring independent double-checks.

Chelation interaction

Binding of tetracyclines or fluoroquinolones to calcium, magnesium, iron, or aluminum reduces absorption; doses are separated by at least two hours.

Asthma reliever strategy

Current guidance favors low-dose inhaled corticosteroid-formoterol as both reliever and controller in mild asthma instead of a short-acting beta-agonist alone.

Proton pump inhibitor timing

Proton pump inhibitors are most effective taken 30 to 60 minutes before a meal, because they irreversibly inhibit activated proton pumps stimulated by food.

Hyperkalemia emergency sequence

Calcium gluconate stabilizes the myocardium, insulin with glucose and beta-agonists shift potassium into cells, and diuretics or binders remove potassium from the body.

Tumor lysis syndrome

Oncologic emergency from rapid tumor cell breakdown causing hyperkalemia, hyperphosphatemia, hyperuricemia, and hypocalcemia; prevented with hydration and allopurinol or rasburicase.

Calcineurin inhibitor monitoring

Tacrolimus and cyclosporine have narrow therapeutic indices and require trough monitoring; CYP3A4 inhibitors raise and inducers lower their concentrations, altering rejection or toxicity risk.

Heparin-induced thrombocytopenia

Immune-mediated platelet activation causing thrombosis rather than bleeding; heparin must be stopped and a non-heparin anticoagulant such as argatroban started.

Generic substitution in Brazil

Interchangeable generics must have bioequivalence approval from the regulatory authority; substituting a prescribed brand requires prescriber authorization unless regulation permits it.