Drug Information Resources Lecture No:2 Smitha C Francis

Drug Information resources Tertiary sources Secondary sources Primary sources Internet Alternative information resources Consumer health information

Tertiary sources Textbooks, data bases, review articles in journals Benefits:- - Easy and convenient access to a broad spectrum of topics. - Background information on drugs and diseases. - Answer many drug related problems, excellent first line resources. Limitations:- - Lag time associated with publication. - Incomplete information, human bias. - lack of expertise by authors- misinterpretation of primary and secondary literature.

Databases - convenient, easy to use, referenced - similar to text books - updated more frequently e.g. Micromedex, Clinical Pharmacology on Hand, Lexi-comp on Hand

General considerations while using tertiary sources Author, publisher Year of publication or last revision date Edition of the text Bibliography Scope – how accessible is the information Alternative resources

Tertiary resources

Secondary resources References that either index or abstract the primary literature with the goal of directing the user to the primary literature. Benefits:- Quick and selective screening of primary resources for specific information, data , citation and articles. May provide sufficient information to serve as references for answering DI requests. Medline/pubmed, International pharmaceutical abstracts , Iowa drug Information system. Vast majority of these resources are utilized primarily in an electronic format although still some may have a print form.

Limitations:- Review of finite number of journals- hinder the thoroughness of a literature search. lag time- publication and citation in an index. Describe only articles and clinical studies from journals, addition of new information through letters which are not included in the services- Medline/Pubmed, Iowa DI services Used to locate journal articles. Abstracts - no enough information to critically evaluate the study.

Secondary resources

Primary literature Journals Consists of clinical research studies and reports, both published and unpublished.( Controlled trials, case series, case reports) Not all articles published in a journal are primary literature.(review articles, articles of opinion, correspondence, special reports) Journals enable pharmacists to:- - Keep abreast of professional news, new developments in pathophysiology, diagnostic agents, and therapeutic regimens. - distinguish useful from useless or even harmful therapy. - enhance communication with other health care professionals and consumers. - Share opinions with other healthcare professionals through letters to the editor.

Advantages: - Access to detailed information about a topic. Ability to personally assess the utility and validity of study results. More recent information than tertiary or secondary literature. Disadvantages:- Does not guarantee that an article is accurate, misleading conclusions based on only one trial without the context of other researches Need to have good skills in medical literature evaluation, time needed to evaluate the large volume of literature.

Primary resources

Tertiary Secondary Primary Nature Examples Advantages Limitations Textbooks, general references, review articles Intermediary between texts & primary resources–indexing and abstracting services Original research –clinical trials & case reports Examples Therapeutic Guidelines, Micromedex International Pharmaceutical Abstracts, Medline/ Pubmed JAMA, NEJM Advantages Easy and convenient access to broad range of information Quick and easy selective screening of primary literature for specific information Most current information Helps to answer specific questions Reputable sources are peer-reviewed Limitations Information may not be recent Information omissions Information misinterpretation Source/intent of information Usually describe content from journals . Mainly used to locate relevant journals A lot of information to go through and absorb No guarantee of accuracy

Internet Another method to identify relevant resource. Benefits:- Ability to search therapies that have been recently published or discussed in the media. Most popular web browsers- Mozilla Firefox, Microsoft internet explorer, Search engines- Google, altavista, Yahoo- index as much of the internet as possible. Limitations:- Information may not be peer reviewed or edited before release. A website should be evaluated by its source of information. Literature evaluation skills should be used to determine whether information is clear, relevant and referenced.

www.lexisnexis.com Inorder to assess the quality of online information, several standards and programs exist. (www.hon.ch) Alternative information sources: www.cnn.com www.healthnewsdaily.com www.prnewswire.com www.reutershealth.com

Consumer health information website Maintained by Content www.medlineplus.gov National library of medicine Medications, disease states and conditions www.fda.gov Food and drug administration New drugs and dietary supplements and recalls of drug or food.

Drug information resources - Texts and References Adverse drug reactions- AHFS DI, DrugDex, Martindale’s : The Extra Pharmacopoeia, Side effects of Drugs. Alternative Medicines- Review of natural products, professional’s Handbook of Complementary and Alternative Medicine Doses- Drugs Facts and Comparisons, Physician’s Drug Reference. Pediatric- Pediatric Drug Handbook Drug Identification- Drugs Facts and Comparisons, Identidex, Lexicomp, Merck Index, European Drug Index. Drug Interactions- AHFS DI, USP DI Indications- Pharmacotherapy, Drug Information Handbook Teratogenecity- Drugs in Pregnancy and Lactation, ReproRisk, AHFS DI.

Conclusion All pharmacists must be effective DI providers regardless of their practice. An effective provider perceives, assesses and evaluates DI needs and retrieves, evaluates, communicates and applies data from the resources as an integral component of patient care. There is still the need for practitioner to have support from DICs to meet special information needs, to serve as a resource on effective medication use, and to assist pharmacy practitioners as well as others in solving medication therapy situations.

References Drug Information – A guide for Pharmacists. A textbook of clinical pharmacy, essential concepts and skills.