PEBC flashcards

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

Absolute bioavailability

Fraction of an extravascular dose reaching systemic circulation, calculated as (AUC oral × dose IV) divided by (AUC IV × dose oral), expressed as a percentage.

Volume of distribution

Apparent volume relating amount of drug in the body to plasma concentration; calculated as dose divided by extrapolated initial concentration, and useful for estimating loading doses.

Clearance

Volume of plasma cleared of drug per unit time; equals dose divided by AUC, and equals volume of distribution multiplied by elimination rate constant.

Half-life

Time for plasma concentration to fall by half; approximately 0.693 times volume of distribution divided by clearance, and determines time to steady state.

Loading dose formula

Loading dose equals volume of distribution times target concentration divided by bioavailability; it rapidly achieves therapeutic concentration without waiting several half-lives.

Zero-order elimination

Elimination at a constant amount per unit time because enzymes are saturated; half-life increases with concentration, as with phenytoin and ethanol at high doses.

First-order elimination

Elimination of a constant fraction of drug per unit time; half-life is constant regardless of concentration, and most drugs follow this pattern at therapeutic doses.

Cockcroft-Gault equation

Estimates creatinine clearance as (140 minus age) times weight, times 0.85 for females, divided by 72 times serum creatinine; guides renal dose adjustment.

CYP inhibitors

Drugs that reduce cytochrome P450 metabolism and raise substrate concentrations; examples include azole antifungals, macrolides, protease inhibitors, cimetidine, and grapefruit juice.

CYP inducers

Drugs that increase cytochrome P450 enzyme activity and lower substrate concentrations; examples include rifampin, carbamazepine, phenytoin, and St. John's wort.

Narrow therapeutic index

Small margin between therapeutic and toxic concentrations; examples include digoxin, lithium, phenytoin, warfarin, and aminoglycosides, requiring concentration monitoring.

CYP2C19 poor metabolizer

Genotype associated with reduced conversion of clopidogrel to its active metabolite, lowering antiplatelet effect; alternative antiplatelet therapy may be considered.

CYP2D6 ultrarapid metabolizer

Genotype causing rapid conversion of codeine and tramadol to active opioids, increasing toxicity risk; reduced efficacy may occur with prodrugs requiring this enzyme.

HLA-B*5701 screening

Genetic test required before starting abacavir; a positive result predicts hypersensitivity reaction and contraindicates use of the drug.

Therapeutic drug monitoring

Measurement of drug concentrations in blood to individualize dosing for narrow therapeutic index drugs, using trough sampling at steady state unless otherwise specified.

Protein binding displacement

Competition for plasma protein binding raises free fraction of a highly bound drug; clinically important mainly with narrow therapeutic index drugs and rapid IV administration.

OSCE station structure

Candidates read a scenario, identify the request, gather missing information, then deliver a prioritized recommendation including monitoring and follow-up.

Red-flag referral

Symptom or sign requiring urgent medical escalation rather than self-care, such as chest pain, stroke symptoms, GI bleeding, anaphylaxis, or suicidal ideation.

Counseling sequence

Structured patient education covering medication name and purpose, dose and timing, adverse effects, administration technique, missed doses, storage, and when to seek help.

Prescription validity check

Verification of patient identifiers, drug, dose, route, frequency, quantity, date, and prescriber signature; ambiguous or incomplete orders must be clarified before dispensing.

Warfarin counseling

Education on consistent vitamin K intake, INR monitoring, bleeding signs, and interacting drugs or foods; emphasizes adherence and prompt reporting of unusual bleeding.

DOAC counseling

Direct oral anticoagulant teaching covers fixed dosing, renal function assessment, adherence without missed doses, bleeding signs, and avoiding interacting drugs such as strong inducers.

Opioid safety assessment

Evaluation of indication, dose, sedation, constipation prophylaxis, naloxone provision, and concurrent sedatives, with documentation of a treatment agreement when appropriate.

Inhaler technique teaching

Demonstration and observation of inhaler use, spacer use with metered-dose inhalers, mouth rinsing after corticosteroids, and distinguishing reliever from controller medications.

Antimicrobial stewardship

Practice of confirming indication, selecting appropriate agent and duration, checking allergies, and educating patients about resistance and adverse effects to optimize antibiotic use.

Allergy clarification

Detailed questioning about the reaction type, timing, and severity to distinguish true allergy from intolerance before selecting or recommending an alternative medication.

Medication reconciliation

Systematic comparison of a patient's current medications with new orders to identify omissions, duplications, and interactions, especially at transitions of care.

Adverse drug reaction reporting

Documentation and reporting of suspected reactions to national pharmacovigilance programs, including serious or unexpected events, to support post-marketing safety surveillance.

Naloxone provision

Take-home opioid antidote counseling for patients at risk of overdose, including recognition of overdose signs, administration technique, and calling emergency services.

Motivational interviewing

Patient-centered counseling using open questions, reflective listening, and affirmation to explore ambivalence and strengthen commitment to behavior change such as smoking cessation.

Teach-back method

Technique where the patient explains or demonstrates the plan in their own words, allowing the pharmacist to confirm understanding and correct misunderstandings.

Special population dosing

Adjustment of drug selection and dose for pregnancy, lactation, pediatrics, older adults, hepatic impairment, or renal impairment using validated formulas and references.