PEBC Evaluating Exam key terms

The body's tendency to keep internal conditions such as temperature, pH, blood glucose and fluid balance within narrow ranges despite outside changes, using feedback loops involving nerves, hormones and organs.

A rapid, brief reversal of electrical charge across a neuron or muscle cell membrane that travels along the cell and triggers neurotransmitter release or muscle contraction; it is generated when depolarization reaches threshold.

A chemical released from a presynaptic nerve ending that binds receptors on a target cell to excite, inhibit or otherwise modify its activity; examples include acetylcholine, dopamine, serotonin, GABA and norepinephrine.

Any molecule, often a protein or polysaccharide on a microbe or foreign cell, that the immune system recognizes and can trigger a specific antibody or T-cell response.

A Y-shaped protein made by B cells that binds a specific antigen, neutralizing the pathogen or marking it for destruction; also called an immunoglobulin (IgG, IgM, IgA, IgE, IgD).

A small signalling protein released by immune and other cells that regulates inflammation, cell growth and communication between immune cells; examples include interleukins, interferons and tumour necrosis factor.

The volume of plasma filtered by the glomeruli per unit time, usually expressed in mL/min; estimated from serum creatinine (eGFR) to stage chronic kidney disease and adjust drug doses.

A hormone cascade in which renin leads to production of angiotensin II, which constricts blood vessels and stimulates aldosterone release, raising blood pressure and retaining sodium and water.

A selectively permeable barrier formed by tight junctions between brain capillary endothelial cells, supported by astrocytes and pericytes, that restricts entry of many drugs and large molecules into the central nervous system.

The fraction of an administered dose that reaches systemic circulation unchanged; intravenous dosing is set at 100%, while oral bioavailability depends on absorption and first-pass metabolism.

An apparent volume relating the amount of drug in the body to its plasma concentration; a very large value indicates extensive distribution into tissues rather than a large physical fluid space.

The volume of plasma completely cleared of a drug per unit time; total clearance is the sum of renal, hepatic and other elimination pathways and helps determine steady-state concentration.

The time needed for plasma drug concentration, or the amount of drug in the body, to fall by half; it depends on clearance and volume of distribution and guides dosing intervals and time to steady state.

Metabolism of an orally absorbed drug in the intestinal wall and liver before it reaches the general circulation; it can greatly lower oral bioavailability and make oral doses much larger than intravenous doses.

A pharmacologically inactive compound converted in the body, usually by enzymes, into the active drug; used to improve absorption, stability or targeting, as with enalapril converted to enalaprilat.

A ratio comparing the dose that causes toxicity with the dose that produces the desired effect; a narrow index means small dose changes can cause toxicity or loss of efficacy.

Blocking of drug-metabolizing CYP enzymes by one drug, which slows clearance of other drugs using the same enzyme and raises their concentrations and risk of toxicity; onset is usually rapid.

An inactive ingredient added to a dosage form to aid manufacture, stability, absorption or patient acceptability, such as fillers, binders, disintegrants, preservatives, flavours and colouring agents.

A regulatory finding that two products containing the same drug show comparable rate and extent of absorption, usually demonstrated in pharmacokinetic studies; it supports interchangeability of generic and brand products.

Elimination at a constant rate regardless of drug concentration because metabolic enzymes are saturated; a fixed amount is removed per unit time, so concentrations can rise sharply with dose increases.

The study of how inherited genetic variation affects drug metabolism, transport and target sensitivity, helping predict efficacy or toxicity and individualize drug choice and dose.

A patient-centred practice model in which pharmacists take responsibility for identifying and resolving drug-related problems and work with patients and other professionals to achieve defined therapeutic outcomes.

A structured process in which a pharmacist or trained staff gathers and verifies all medications a patient is actually taking, including prescription, non-prescription and natural health products, before admission or a visit.

A formal process of comparing a patient's verified medication list with new orders at care transitions, identifying discrepancies, and communicating and documenting changes to prevent errors.

Measuring serum drug concentrations for drugs with narrow therapeutic indices or unpredictable kinetics, then adjusting doses based on the concentration, efficacy, toxicity and patient-specific factors.

A noxious and unintended response to a drug occurring at doses normally used in humans for prevention, diagnosis or treatment; it may require dose reduction, discontinuation or regulatory reporting.

Any preventable event that may cause or lead to inappropriate medication use or patient harm, occurring during prescribing, transcribing, dispensing, administering or monitoring of therapy.

Coordinated strategies to use antimicrobials appropriately, choosing the right drug, dose, duration and route, to improve outcomes, reduce adverse effects and slow the development of resistance.

Replacing a prescribed drug with a different chemical entity from the same therapeutic class, usually under an agreed protocol or pharmacist authority, to address cost or supply issues.

A list of drugs approved for use and reimbursement within a hospital or drug plan, maintained by a committee that evaluates efficacy, safety and cost.

The study of drug use and drug effects in large populations, applying epidemiological methods to quantify benefits, adverse events, adherence patterns and patterns of medication utilization.

The skills needed to obtain, understand and use health information to make decisions, including reading labels, basic numeracy and navigating the health system; low literacy is linked to poorer outcomes.

A collaborative, person-centred counselling style that explores and strengthens a patient's own motivation and confidence for change, using open questions, reflection and affirmation rather than directing or advising.

A model describing behaviour change as movement through precontemplation, contemplation, preparation, action and maintenance, with relapse possible; interventions are matched to the person's current stage.

Conditions of daily life such as income, education, housing, employment, food security, culture and social support that shape health and access to care beyond biological and clinical factors.

An economic evaluation comparing the costs and health outcomes of alternative treatments, often expressed as cost per life-year or quality-adjusted life-year gained, to inform funding and formulary decisions.

Health Canada's system for collecting and assessing reports of adverse reactions to drugs, biologics and natural health products, supporting safety monitoring and regulatory action.