Chapter 7: Drug Information Resouces

Learning Outcomes Classify drug information request Obtain appropriate background information for drug request Distinguish between pharmacist & technician questions Given a specific pharmacy-related question, identify best resource to use to find answer Describe how to find answers to drug information questions at workplace

Key Terms Drug information request Material safety data sheets Medline Package insert Primary references Secondary references Tertiary references

Drug Information Request Question regarding medication Technician question or pharmacist question? any doubt  defer question to pharmacist consumers may not understand who should answer Identify person initiating request obtain contact information (phone, pager, fax, etc.)

Who is asking? How does ondansetron (Zofran) work? response different for patient compared to physician Purpose of request needs of requestor clinical judgment? general knowledge or for specific patient? patient info may be needed Urgency of request basics now & more detail later?

Classifying Request General Drug Information Availability and Cost Storage and Stability Calculations Preparation Pharmacy Law Miscellaneous

Clinical Judgment Is it a patient-specific question? Who is requesting information? patient may be indirectly asking for pharmacist’s input If there is any doubt about nature of question defer question to pharmacist

Examples: Identification & Availability What is paracetamol & what is its U.S. equivalent? technician can obtain technical information about availability therapeutic alternatives must be answered by pharmacist

Examples Allergies Which narcotic is safe to use in a patient with a codeine allergy? pharmacist must obtain more patient specific information description of allergy condition being treated clinical judgment required

Choosing Right References 1 st consult tertiary references 2 nd consult secondary references 3 rd consult primary references

References Tertiary references = general references documented information condensed and compact textbooks AHFS DI Drug Facts & Comparisons Micromedex® Clinical Information System Good: easy to use, convenient, readily accessible, concise & compact Bad: may not be up to date, errors, level of detail not deep enough due to space restrictions.

References Secondary references=indexing systems Medline list of journal articles on the topic for new or very up-to-date information or no information can be located in tertiary references Primary references are original research articles published in scientific journals American Journal of Health-System Pharmacists (AJHP) pharmaceutical manufacturer information specialized drug & poison information centers

Common References General Drug Information textbooks, PDAs, CD-ROMs, online versions Facts and Comparisons Facts & Comparisons® Drug Information Handbook Pediatric Dosage Handbook information Drug Information Handbook for Oncology Geriatric Dosage Handbook Drug Information Handbook for Psychiatry Patient drug information database (Lexi-PALs)

Other Common References American Hospital Formulary Service Drug Information (AHFS DI) Clinical Pharmacology Micromedex® DRUGDEX® POISONDEX® Material Safety Data Sheets CareNotes®

Other Common References United States Pharmacopeia Drug Information (USPDI) The Physicians’ Desk Reference (PDR) Red Book Trissel’s Handbook on Injectable Drugs Trissel’s Stability of Compounded Formulations Natural Medicines Comprehensive Database Material Safety Data Sheets Manufacturers can provide information

Other Resources Drug Information Centers Poison Control Centers Internet Pharmaceutical manufacturers FDA-approved content Government sites Pharmacy and medical organizations Commercial or personal sites can contain erroneous and/or misleading

Search Using Medlineplus The National Library of Medicine (NLM) largest medical library in world

Use Following Steps: 1. Go to 2. Click on “Health Topics.” 3. Diseases & condition a. first letter of topic b. broad group (body location or system c. disorders & conditions d. diagnosis & therapy e. demographics, f. health and wellness 4. Click on “Drugs & Supplements” tab to search for consumer drug information

Sample Search Pubmed 1. Go to 2. Click on “PubMed” on list of databases & resources 3. In search window, type “pharmacy technicians and certification” 4. Hit “enter” key or click “Go” 5. Results contain all articles with pharmacy technicians & certification as subjects 6. More details  click on blue hypertext author(s) names 7. To save multiple citations click checkboxes

Responding DI Request (DI=Drug Information) Search for information Organize & evaluate information Response verbal and/or written reply restates question outlines response recommendations should be supported by references Ask requestor if information useful Ask if you can be of further assistance