Clinical Pharmacy

Alligation:

The compounding of two or more products to obtain a desired concentration; also the concentration obtained through this process.

Or

A rule relating to the solution of questions concerning the compounding or mixing of different ingredients, or ingredients of different qualities or values.

Alligation alternate method:

The mathematical calculation used to determine the amounts of two or more dilutions of differing strengths that will be mixed to prepare a product of a desired strength and quantity.

Alligation medial method:

The mathematical calculation used to find the final concentration created when two or more known quantities of known concentrations are compounded.

Antiseptic:

A substance that destroys or inhibits the growth of bacteria and other micro-organisms on living tissue.

Adverse experience:

An adverse experience is any adverse event associated with the use of a drug or biological product in humans, whether or not considered product related, including the following:

An adverse experience occurring in the course of the use of the product in professional practice;

An adverse experience occurring from overdose of the product whether accidental or intentional; An adverse experience occurring from abuse of the product;

An adverse experience occurring from expected pharmacological action withdrawal of the product; and any failure of expected pharmacological action.

Adverse drug event:

An adverse drug event or adverse drug experience is an adverse outcome that occurs during or following clinical use of a drug.

Adverse drug reaction:

An adverse drug reaction is an adverse drug event that is judged to be caused by the drug.

Adherence to Treatment (also Compliance):    

The degree to which patients adhere to medical advice and take medicine as directed. Adherence depends not only on acceptance of information about the health threat itself but also on the practitioner’s ability to persuade the patient that the treatment is worthwhile and on the patient’s perception of the practitioner’s credibility, empathy, interest and concern.

Bolus Dose:

An amount of IV medication administered rapidly to decrease the response time or to be used as a loading dose prior to an infusion.

Body mass index (BMI)

A guide to use in determining whether to initiate pharmacologic treatment for obesity; calculated by dividing the patient's weight (in kilograms) by the patient's height (in meters) squared (kg/m2) or gm/cm2or pounds/inch2.

Case control studies:

Case control studies are studies that compare cases with a disease to controls without the disease looking for differences in antecedent exposures.

Case reports:

Case reports are reports of the experience of single patients. As used in pharmacoepidemiology, a case report describes a single patient who was exposed to a drug and experiences a particular, usually adverse, outcome.

Case series:

Case series are reports of collections of patients, all of whom have a common exposure, examining what their clinical outcomes were. Alternatively case series can be reports of patients who have a common disease, examining what their antecedent exposures were. No control group is present.

Changeability:

Changeability is the ability of an instrument to measure a difference in score in patients who have improved or deteriorated.

Clinical Pharmacy

Clinical pharmacy is defined as that area of pharmacy concerned with the science and practice of rational medication use.

Or

Clinical Pharmacy includes all the services performed by pharmacists practising in hospitals, community pharmacies, nursing homes, home-based care services, clinics and any other setting where medicines are prescribed and used.

Clinical pharmacology:

Clinical pharmacology is the study of the effects of drugs in humans.

Clinical Pharmacologist:

A physician who has had specialized training in the uses, side-effects, warning and dosages of medications for human use.

Cohort studies:

Cohort studies are studies that identify defined populations and follow them forward in time examining their rates of disease. Cohort studies generally identify and compare exposed patients to unexposed patients or to patients who receive a different exposure.

Confidence intervals:

Confidence intervals are a range of values within which the true population value probably lies.

Confidentiality:

Confidentiality is the right to limit the transfer of private information.

Cost:

A cost is the consumption of a resource that could otherwise be used for another purpose.

Cost benefit:

Cost benefit analysis of medical care compares the cost of a medical intervention to its benefit. Both costs and benefits must be measured in the same monetary units (e.g., dollars).

Cost effectiveness:

Cost effectiveness analysis of medical care compares the cost of a medical intervention to its effectiveness. Costs are determined in monetary units, while effectiveness is determined independently and may be measured in terms of any clinically meaningful unit.

Cost identification:

Cost identification analysis enumerates the costs involved in medical care, ignoring the outcomes that result from that care.

Cross sectional:

Cross-sectional studies examine populations at one point in time; they have no time sense.

Contraindications:

Diseases, conditions, and symptoms for which a drug will not be beneficial and may do harm.

Controlled substances:

Drugs with high potential for abuse; liable to cause addiction, tolerance and dependence,  organized into five categories or schedules that specify the way the drug must be stored, dispensed, recorded, and inventoried.

Controlled-release medication:

The dosage form that is formulated to release medication over a prolong duration of time.

Descriptive studies:

Descriptive studies are studies that do not have control groups, namely case reports, case series, and analyses of secular trends. They contrast with analytic studies.

Drug utilization:

Drug utilization, as defined by the World Health Organization (WHO), is the ``marketing, distribution, prescription and use of drugs in a society with special emphasis on the resulting medical, social, and economic consequences''.

Drug utilization evaluation (DUE) programs:

Drug utilization evaluation (DUE) programs are ongoing structured systems designed to improve drug use by intervening when inappropriate drug use is detected.

Drug utilization evaluation studies:

Drug utilization evaluation studies are studies that assess the appropriateness of drug use. They are designed to detect and quantify the frequency of drug use problems.

Drug utilization review programs:

Drug utilization review programs are ongoing structured systems designed to improve drug use by intervening when inappropriate drug use is detected.

Drug utilization review studies:

Drug utilization review studies are studies that assess the appropriateness of drug use. They are designed to detect and quantify any drug use problems.

Drug clearance:

Drug clearance is the proportion of the ``apparent'' volume of distribution that is cleared of drug in a specified time. The total body clearance is the sum of clearances by different routes, e.g., renal, hepatic, pulmonary, etc.

Drug Abuse:

The use of illegal drugs or the inappropriate use of legal drugs. The repeated use of drugs to produce pleasure, to alleviate stress, or to alter.

Or

The use of a drug (either licit or illicit) in sufficient quantity and frequency to interfere with a person’s ability to make sound life decisions, perform appropriate actions, and fulfill responsibilities with the result that the person is unable to be a law abiding and self-supporting.

Drug Misuse:

Use of any drug (legal or illegal) for a medical or recreational purpose when other alternatives are available, practical or warranted, or when drug use endangers either the user or others with whom he or she may interact.

DUR/DUE:

It is a structured, organized, authorized ongoing review of prescribing practices, dispensing practices by pharmacist and patient use of medication.

Or

It is a structured, organized, ongoing, quality assurance programme to evaluate drug use practices within a hospital or community , comparing these practices with the standard and then designing and implementing interventions for the improvement of these practices if required.

Dose:

A dose is a quantity of something (chemical, physical, or biological) that may impact an organism biologically; the greater the quantity, the larger the dose.

Or

The amount of medicine to be taken at one time.

Dosage form:

A dosage form is the physical form of a dose of medication, such as a capsule or injection. The route of administration is dependent on the dosage form.

Disinfectant:

Disinfectants are antimicrobial agents that are applied to non-living objects to destroy microorganisms.

Or

A chemical agent used on inanimate objects (i.e., nonliving) (e.g., floors, walls, sinks) to destroy virtually all recognized pathogenic microorganisms, but not necessarily all microbial forms (e.g., bacterial endospores).

Exposure:

An exposure causes a health event when it truly increases the probability of that event.

Ecological studies:

Ecological studies examine trends in disease events over time or across different geographic locations and correlate them with trends in a putative exposure, such as rates of drug utilization. The unit of observation is a subgroup of a population rather than individuals.

Essential Drugs:

Drugs which satisfy the majority of the  population/ community needs, in appropriate dosage form, should be available round the year, in adequate quantity, at a cost affordable to patient and community.

Or

Essential medicines are those that satisfy the priority health care needs of the population.Essential medicines are intended to be available within the context of functioning health systems at all times in adequate amounts, in the appropriate dosage forms, with assured quality, and at a price the individual and the community can afford.

Exotoxins:

An exotoxin is a soluble protein excreted by a microorganism, including bacteria, fungi, algae, and protozoa.

Or

Poisons produced by bacteria that leave the cell and enter the area around the cell.

Endotoxin:

Any toxin secreted by a microorganism and released into the surrounding environment only when it dies.

Or

Endotoxins are a poisonous substance released from bacteria when it dies, and can cause tissue destruction directly or trigger an immune response.

Epidemiology:

Epidemiology is the study of the distribution and determinants of diseases in populations.

Half Life (T1/2):

Half life is the time taken for the drug concentration to decline by half .

Half life is a function of both the volume of distribution and clearance of the drug.

Extemporaneous compounding:

The production of medication in an appropriate quantity and dose form from several pharmaceutical ingredients in response to a prescription written by a physician.

Extra dose error:

An error in which more doses are received by a patient than were prescribed by the physician.

Extravasation:

The escape of IV fluids into the surrounding tissue.

Fahrenheit temperature scale:

The temperature scale that uses 32 degrees F as the temperature at which water freezes and 212 degrees F as the temperature at which water boils.

Flow rate:

The rate, expressed in milliliters per hour or drops per minute, that medication is flowing through an IV line; also called infusion rate and rate of infusion.

Good Clinical Practice (GCP):

GCP is a standard for clinical; studies which encompasses the design, conduct, termination, audit, analysis, reporting and documentation of the studies and which ensures that the studies are scientifically and ethically sound and that the clinical properties of the diagnostic/ therapeutic/prophylactic product under investigation are properly documented.

Large-volume parenterals (LVPs):

IV infusions of more than 100 mL.

Lozenges:

Medications in a sweet-taste formulation that is absorbed in the mouth.

Loading Dose:

A loading dose refers to an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose.

Maintenance Dose:

An amount of a drug designed to enable a patient to continue to benefit from a therapeutically effective regimen of medication.

MedWatch:

A voluntary program run by the FDA for reporting serious adverse events, product problems, or medication errors; serves as a clearinghouse to provide information on safety alerts for drugs, biologics, diet supplements, and medical devices including drug recalls.

Metered-dose inhaler (MDI):

A device that delivers a specific amount of medication in a puff of compressed gas through inhalation into the lungs.

Milliequivalent (mEq):

The ratio of the weight of a molecule to its valence, used to measure the concentration of electrolytes in a volume of solution; also an amount of medication that will provide the patient with a specific amount (equivalent amount) of an electrolyte.

Millimole (mM):

A molecular weight, expressed as milligrams.

Mini-drip set:

A drop set at a rate of 60 gtt/mL.

Non-verbal communication:

Communication without words through facial expression, body contact, body position, and tone of voice.

Nosocomial infections:

Infections acquired by patients when they are in the hospital.

Orphan drug:

A medication approved by the FDA to treat rare diseases .

Or

A drug developed under the U.S. Orphan Drug Act (1983) to treat a disease that affects fewer than 200,000 people in the United States.

Osmolality:

The amount of particulate per unit volume of a liquid preparation, measured in milliosmoles (mOsm).

Patient identifiers:

Any demographic information that can identify the patient such as name, address, phone number, social security number, or medical identification number.

Patient profile:

A record kept by the pharmacy that lists a patient's identifying information, insurance information, medical history, prescription history, and prescription preferences.

Pharmaceutical care:

A philosophy of care that expanded the pharmacist's role to include appropriate medication use to achieve positive outcomes with prescribed drug therapy.

Or

Responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life.

Piggyback:

A small-volume parenteral (SVP) admixture often containing a medication that is attached to an existing IV line.

Polypharmacy:

The concurrent use of multiple medications.

Pooling:

A time-saving process used when preparing a three-in-one TPN, in which all electrolytes except phosphate are put into a small-volume parenteral bag and then transferred into each batch.

Prescription:

An order for medication for a patient that is written by a physician or a qualified licensed practitioner to be filled by a pharmacist.

Protocol:

In the natural sciences a protocol is a predefined written procedural method in the design and implementation of experiments. This should establish standards that can be adequately assessed by peer review and provide for successful replication of results by others in the field.

Or

A rule, guideline, or document which guides how an activity should be performed; The original copy of any writing, as of a deed, treaty, dispatch, or other instrument; The minutes, or rough draft, of an instrument or transaction; A preliminary document upon the basis of which negotiations are made.

Pharmacoeconomics:

Pharmacoeconomics refers to the scientific discipline that compares the value of one pharmaceutical drug or drug therapy to another.

Or

The branch of economics that applies cost-benefit, cost-effectiveness, cost-minimization, and cost-utility analyses to compare the economics of different pharmaceutical products or to compare drug therapy to other treatments. Sometimes referred to as outcomes research.

Pharmacogenomics:

Pharmacogenomics is the branch of pharmacology which deals with the influence of genetic variation on drug response in patients by correlating gene expression or single-nucleotide polymorphisms with a drug's efficacy or toxicity.

Or

A scientific approach that examines the inherited variations in genes that dictate drug response and explores the ways these variations can be used to predict whether a patient will have a good response to a drug, a bad response or no response at all.

Pyrogens:

Any substance which induces fever. It can be internal (also called endogenous) e.g. immune complexes in autoimmune diseases, or external (exogenous).

Pharmacodynamics:

Pharmacodynamics is the study of the relationship between drug level and drug effect. It involves the study of the response of the target tissues in the body to a given concentration of drug.

Pharmacoepidemiology:

Pharmacoepidemiology is the study of the use of and the effects of drugs in large numbers of people.

Pharmacogenetics:

Pharmacogenetics is the study of genetic determinants of responses to drugs.

Pharmacokinetic compartment:

A pharmacokinetic compartment is a theoretical space into which drug molecules are said to distribute, and is represented by a given linear component of the log concentration versus time curve. It is not an actual anatomic or physiologic space, but is sometimes thought of as a tissue or group of tissues that have similar blood flow and drug affinity.

Pharmacokinetics:

Pharmacokinetics is the study of the relationship between the dose of a drug administered and the serum or blood level achieved. It includes the study of the processes of drug absorption, distribution metabolism, and excretion.

Or

Pharmacokinetics examines the effects of the body on a drug, specifically examining issues such as how quickly a drug is absorbed into the blood and how different dosages affect the absorption, how the drug is distributed into organs or tissues the body, how the body metabolizes the drug and excreted.

Pharmacology:

Pharmacology is the study of the effects of drugs in a living system.

Or

Branch of medicine dealing with the actions of drugs in the body both therapeutic and toxic effects and development and testing of new drugs and new uses of existing ones.

Pharmacotherapeutics:

Pharmacotherapeutics is the application of the principles of clinical pharmacology to rational prescribing, the conduct of clinical trials, and the assessment of outcomes during real-life clinical practice.

Postmarketing surveillance:

Postmarketing surveillance is the study of drug use and drug effects after release into the market. This term is sometimes used synonymously with``pharmacoepidemiology,'' but the latter can be relevant to premarketing studies, as well. Conversely, the term ``postmarketing surveillance'' is sometimes felt to apply to only those studies conducted after drug marketing which systematically screen for adverse drug effects.

Potency:

Potency refers to the amount of drug that is required to elicit a given response.

Prevalence rate of a disease:

The prevalence rate of a disease is a measurement of how common the disease is. Specifically, it is the number of existing cases of the disease in a defined population at a given point in time or over a defined time period, divided by the number of people in that population.

Prospective drug utilization review:

Prospective drug utilization review is designed to detect drug therapy problems before an individual patient receives the drug.

Quantitative drug utilization studies:

Quantitative drug utilization studies are descriptive studies of frequency of drug use.

Rational Use of Drugs:

The rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and   at the lowest cost to them and their community.

Reliability:

Reliability is the degree to which the results obtained by a measurement procedure can be replicated. The measurement of reliability does not require a gold standard, since it assesses only the concordance between two or more measures.

Reproducibility:

Reproducibility is the ability of an instrument to obtain more or less the same scores upon repeated measurements of patients who have not changed.

Retrospective drug utilization review:

Retrospective drug utilization review compares past drug use against predetermined criteria to identify aberrant prescribing patterns or patient-specific deviations from explicit criteria.

Scientific inference:

Scientific inference is the process of generalizing from a statement about a population that is an association to a causal statement about scientific theory.

Sensibility:

Sensibility is a judgment about the validity of an instrument, based on an intuitive assessment of the extent to which an instrument meets a number of criteria including applicability, clarity and simplicity, likelihood of bias, comprehensiveness, and whether redundant items have been included.

Sharps:

Used needles; a potential source of infection.

Small-volume parenterals (SVPs):

An IV infusion of 100 mL or less commonly used to administer drugs.

Superinfection:

A new infection complicating the course of therapy of an existing infection.

Standard treatment guidelines:

Agreed-upon treatment practices for a diagnosed-illness; may include more than details of drug treatment.

Sterilization:

Sterilization (or sterilisation, see spelling differences) refers to any process that effectively kills or eliminates transmissible agents (such as fungi, bacteria, viruses, spore forms, etc.) from a surface, equipment, article of food or medication, or biological culture medium.

Studies of adverse effects:

Studies of adverse effects examine case reports of adverse drug reactions, attempting to judge subjectively whether the adverse events were indeed caused by the antecedent drug exposure. Studies of adverse events explore any medical events experienced by patients and use epidemiologic methods to investigate whether any given event occurs more often in those who receive a drug than in those who do not receive the drug.

Study of drug effectiveness:

A study of drug effectiveness is a study of whether, in the usual clinical setting, a drug in fact achieves the effect intended when prescribing it.

Study of drug efficacy:

A study of drug efficacy is a study of whether, under ideal conditions, a drug has the ability to bring about the effect intended when prescribing it.

 Or

A study of drug efficiency is a study of whether a drug can bring about its desired effect at an acceptable cost.

Therapeutic ratio:

The therapeutic ratio is the ratio of the drug concentration that produces toxicity to the concentration that produces the desired therapeutic effect.

Therapeutic index:

The difference between the minimum plasma level for the drug to be clinically effective and the plasma level at which the drug becomes toxic.

Or

The ratio of median lethal dose of a drug to its median effective dose: expressed as therapeutic index = median lethal dose/median effective dose.

Therapeutic Drug Monitoring:

Therapeutic drug monitoring is a branch of clinical chemistry that specializes in the measurement of medication levels in blood.

Or

Regular measurement of serum levels of drugs requiring close 'titration' of doses in order to ensure that there are sufficient levels in the blood to be therapeutically effective, while avoiding potentially toxic excess.

Type A adverse reactions:

Type A adverse reactions are those that are the result of an exaggerated but otherwise predictable pharmacological effect of the drug. They tend to be common, dose-related, and less serious than Type B.

Total nutrient admixture (TNA):

An amino acid-dextrose-lipid formulation used for parenteral nutrition; often called three-in-one.

Total parenteral nutrition (TPN):

Specially formulated parenteral solution that provides for the nutritional needs intravenously (IV) when a patient cannot or will not eat; also known as hyperalimentation solutions; also the process of feeding that solution to a patient through the veins.

Toxicology:

The study of the toxic effects of drugs or other substances in the body.

Unit:

The amount of activity associated with a medication that has biological impact on a patient.

Unit dose:

An amount of a drug prepackaged for a single administration to a particular patient at a particular time.

Unit dose profile:

The documentation that provides the information necessary to prepare the unit doses and includes patient name and location, medication and strength, frequency or schedule of administration, and quantity for each order.

Unit of use:

A fixed number of dose units in a drug stock container, usually consisting of a month's supply, or 30 tablets or capsules.

Validity:

It is the degree to which an assessment measures what it purports to measure.

Wrong dose error:

An error in which the dose is either above or below the correct dose by more than 5%.
Wrong dose form error:

An error in which the dose form or formulation is not the accepted interpretation of the physician order.

Wrong time error:

A medication error in which any drug is given 30 minutes or more before or after it was prescribed, up to the time of the next dose, not including as needed orders.

Young's Rule:

A formula used to determine an appropriate pediatric dose by using the child's age in years and the normal adult dose;

Young's Rule = [age in years/(age in years + 12 years)] * adult dose = pediatric dose

Y-site:

An injection port found on most IV administration sets.