SBFC Farmácia Clínica key terms

A practice model in which the pharmacist takes direct responsibility for a patient's medication-related needs, working with the patient and other professionals to achieve defined therapeutic goals and improve quality of life.

Structured, longitudinal follow-up of a patient's pharmacotherapy, documenting indication, effectiveness, safety and adherence at each encounter so that problems are detected and resolved in a planned way.

Any circumstance involving drug therapy that actually or potentially interferes with a desired health outcome, such as lack of indication, ineffective drug, unsafe dose, adverse reaction, or non-adherence.

Health outcomes in a patient that are undesirable and attributable to pharmacotherapy, classified by whether the medicine is unnecessary, ineffective, or unsafe given the patient's clinical situation.

A formal process of obtaining a complete and accurate medication list at transitions of care and comparing it with the new prescription to identify and resolve discrepancies, omissions, duplications or dose errors.

Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of a health professional, patient or consumer.

Any harmful or unintended response to a medicine occurring at doses normally used in humans, regardless of whether it is caused by the drug itself, by a quality defect or by inappropriate use.

A noxious and unintended response to a medicine at doses normally used for prophylaxis, diagnosis or therapy, judged to be causally related to that medicine rather than to other causes.

The science and activities relating to detection, assessment, understanding and prevention of adverse effects or any other drug-related problem, including spontaneous reporting, signal detection and regulatory risk-minimization measures.

Voluntary reporting of a suspected adverse drug reaction or quality problem by a health professional, patient or company to the national pharmacovigilance system, forming the main source of post-marketing safety signals.

A validated ten-item questionnaire that scores the probability that a suspected adverse reaction was caused by a specific drug, classifying the relationship as definite, probable, possible or doubtful.

An interaction in which one drug alters the absorption, distribution, metabolism or excretion of another, changing its plasma concentration and therefore its effect or toxicity.

An interaction in which drugs acting at the same receptor, pathway or physiological system produce additive, synergistic or antagonistic effects without necessarily changing plasma concentrations.

A drug that reduces the activity of a cytochrome P450 enzyme, slowing metabolism of substrates and raising their concentrations, with risk of toxicity when the victim drug has a narrow therapeutic index.

A drug that increases expression or activity of a cytochrome P450 enzyme, accelerating substrate metabolism and potentially causing therapeutic failure; effect develops over days and resolves slowly after withdrawal.

The apparent volume relating the amount of drug in the body to its plasma concentration; a large value indicates extensive tissue distribution and predicts limited removal by dialysis.

The volume of plasma completely cleared of drug per unit time, reflecting the combined activity of hepatic metabolism and renal excretion and determining the maintenance dose needed to reach steady state.

The time required for the plasma concentration to fall by half during first-order elimination, governing how long a drug accumulates before steady state and how quickly it washes out after withdrawal.

The condition reached when drug input equals elimination, so plasma concentrations fluctuate within a stable range; in first-order kinetics it is approached after roughly four to five half-lives of constant dosing.

A larger initial dose intended to reach therapeutic concentrations rapidly by filling the volume of distribution, after which regular maintenance dosing sustains the target concentration.

A small range between the minimum effective and minimum toxic concentrations, so that modest changes in dose, adherence, metabolism or interactions can cause treatment failure or serious toxicity.

Measurement of drug concentrations in blood with clinical interpretation, used for drugs with narrow therapeutic index to individualize dosing and confirm whether a poor response is due to underdosing or toxicity.

The study of how variation across the genome, including multiple genes and non-coding regions, influences drug response, used to develop predictive tests and guide precision prescribing.

The study of how inherited variation in single genes, especially those encoding drug-metabolizing enzymes, transporters and targets, explains differences in drug exposure and response among individuals.

Common inherited variants in the CYP2C19 gene that produce poor, intermediate, rapid or ultrarapid metabolizer phenotypes, altering activation of clopidogrel and plasma levels of proton pump inhibitors and some antidepressants.

A phenotype in which a patient carries variants causing absent or markedly reduced enzyme activity, leading to accumulation of parent drug and toxicity or, for prodrugs, to therapeutic failure.

An inactive compound that must be converted by the body, usually through hepatic enzymes, into an active metabolite, so that enzyme inhibition or genetic deficiency can abolish its efficacy.

A drug inhibiting cyclooxygenase and prostaglandin synthesis, giving analgesic, antipyretic and anti-inflammatory effects but also gastric mucosal injury, sodium retention and reduced renal perfusion.

An abrupt decline in kidney function with rising creatinine or falling urine output, frequently caused in hospitalized patients by hypovolemia, nephrotoxic drugs, contrast or combinations such as AINE plus ACE inhibitor plus diuretic.

A spectrum of myocardial ischemia from unstable angina to non-ST-elevation and ST-elevation infarction, requiring antiplatelet therapy, anticoagulation and reperfusion, with dual antiplatelet therapy after stenting.

Therapeutic prevention of thrombus formation or extension using agents such as heparins, vitamin K antagonists or direct oral anticoagulants, requiring assessment of bleeding risk and renal function.

A syndrome of typical symptoms and signs with left ventricular ejection fraction of 40 percent or less, treated with guideline-directed therapy including renin-angiotensin system inhibitors, beta-blockers, mineralocorticoid antagonists and SGLT2 inhibitors.

An oral agent blocking sodium-glucose cotransporter 2 in the proximal tubule, lowering glucose and providing cardiorenal protection in heart failure and chronic kidney disease regardless of diabetes status.

Coordinated interventions promoting appropriate antimicrobial selection, dose, route and duration, aiming to improve outcomes, reduce adverse effects and resistance, and lower costs, often led by a multidisciplinary team.

Narrowing spectrum, changing to a targeted agent or switching to oral therapy once culture results and clinical response are known, reducing resistance pressure and toxicity while maintaining efficacy.

Initial antimicrobial treatment chosen on the basis of likely pathogens, site of infection and local resistance patterns before culture results are available, later adjusted according to microbiological data.

A drug such as lithium, valproate or lamotrigine used to prevent manic and depressive relapses in bipolar disorder, requiring monitoring of concentrations, renal and thyroid function or hematologic safety.

A potentially life-threatening toxicity from serotonergic drugs, presenting with mental status change, autonomic hyperactivity and neuromuscular abnormalities such as clonus, tremor and hyperreflexia.

An acute asthma exacerbation with severe airflow obstruction unresponsive to initial bronchodilators, treated with repeated inhaled short-acting beta-2 agonists, systemic corticosteroids and oxygen, with escalation if response is poor.

Persistent airflow limitation from airway and alveolar abnormalities, managed with inhaled bronchodilators, pulmonary rehabilitation and smoking cessation, with corticosteroids reserved for selected exacerbation-prone patients.

Fever in a patient with severe neutropenia after chemotherapy, an oncologic emergency requiring prompt empirical broad-spectrum antibiotics and risk stratification for outpatient or inpatient care.

The pharmacist's legal act of selecting and documenting pharmacotherapy for minor self-limiting conditions or, in defined protocols, adjusting therapy, within the scope established by Brazilian professional regulation.

A product whose prescribing and dispensing are restricted by Brazilian health regulation because of dependence or abuse potential, requiring special prescription forms, retention and reporting to health authorities.

The ethical and legal duty to keep confidential all patient information learned in professional practice, disclosing it only with consent or when required by law or serious risk to third parties.