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Drug Information

Resource
Charliemaign Stanley S. Cruz, R.Ph.
Content
Drug Information Resource

Type of Resources

Tertiary

Secondary

Primary

Alternate Resources
Drug Information Resources
Medical Information and Medical Literature

are continuously increasing in quantity

the TECHNOLOGY to which it is made available


grows EXPONENTIALLY at the same time

however, the process of providing drug


information has not improved as fast.
Drug Information Resources
Choosing the Information resources to use:

Chosen information resources are:

1. easy to find

2. most familiar to the user

Disadvantages:

1. possibility of missing new resources

2. limit completeness of the information

Tertiary >> Secondary >> Primary


Types of Resources
Tertiary Resources
provide information that has been summarized and distilled
by the author/editor to provide a quick, easy summary of a
topic.

Advantages:

1. fairly complete information

2. concise overview

3. easy to use/convenient

4. familiar to most users/practitioners


Tertiary Resources
Disadvantage:

1. lag time associated with publication

availability of information may be delayed

solved by the birth of E-copies

2. May be incomplete due to

space limitation

due to incomplete literature review


Tertiary Resources

Disadvantage:

3. transcription errors

4. human bias

5. incorrect interpretation

6. authors lack of expertise


Tertiary Resources
A. General Product Information

1. AHFS Drug Information

provides DI arranged in monographs both the


FDA approved and off-label uses of medication

dosing in specific population and some


compatibility and stability are also included

In the PH, we have the Philippine Pharmacopeia


Tertiary Resources
A. General Product Information

2. Clinical Pharmacology

Gold Standard, http://clinicalpharmacology.com

electronic database for contains monographs for both


Rx and non-Rx products and some dietary supplement

designed with tools to check for drug interactions, IV


compatibility and searching for tablet imprint and codes
Tertiary Resources
A. General Product Information

3. Micromedex

contains FDA-approved indication, off-label uses, PK data,


safety information and pharmacology.

interactive tools allows assessment of drug-drug/food/


supplement interaction, incompatibilities, and PK adjustments

provides toxicology sections which allows identification based


on drug imprints and codes.

provides information of overdose management


Tertiary Resources
A. General Product Information

4. Facts and Comparisons

http://factsandcomparisons.com

contains information about RX and non-RX drugs


organised by drug class

provides excipient information of specific ingredients

provides comparative monograph to compare agents


from the same class
Tertiary Resources
A. General Product Information

5. Drug Information handbook

http://www.lexi.com

data regarding clinical use and safety is organized in


brief monographs

has a tablet identification section

appendices for treatment options and comparison of


agents in the same class
Tertiary Resources
A. General Product Information

6. Handbook of Nonprescription Drugs: An


interactive preach to Self-care

http://www.pharmacist.com

focused on body systems and disease states for


which self-care may be appropriate

covers information on efficacy of OTC products


Tertiary Resources
A. General Product Information

7. Physicians Desk Reference

http://www.pdr.net

compilation of Rx products package inserts

contact information of manufacturers, list of


poison control centers
Tertiary Resources
A. General Product Information

8. USP Dictionary

http://www.usp.org

official resource for generic & chemical names


and even intl nonproprietary name (INN) of
drug products
Tertiary Resources
A. General Product Information

9. Epocrates

http://www.epocrates.com

includes a variety of data about drugs


(monographs, interaction checker, safety data
and tablet identification) and diseases
(epidemiology, prognosis and treatment)
Tertiary Resources
B. Adverse Effect

1. Meylers Side Effect of Drugs

http:// www.elsevier.com

provides critical review of international literature in the


area of adverse events and its management

Chapters are organized by drug classification

ADE are organized by drug name and then by organ


system
Tertiary Resources
B. Adverse Effect

2. Side Effects of Drugs Manual: A Worldwide Yearly


Survey of New Data and Trend in Adverse Drug
Reactions

http:// www.elsevier.com

serves as companion to Meylers Side Effects of Drugs

a team of reviewers looks into adverse drugs reports and


publications annually, reviews them and summarizes the
data.
Tertiary Resources
C. Availability of Dosage Forms

1. American Drug Index

http://www.lww.com, by Lippincott Williams & Wilkins

organized by product & generic name

provides information on product use, dosage availability, &


manufacturer information

also has charts for sound/look-alike drugs, pregnancy


category, normal lab values and pharmaceutical calculation
Tertiary Resources
C. Availability of Dosage Forms

2. Red Book (Red Book Drug Topics)

http://www.redbook.com, by Truven health Aanlytics

data is primarily about Rx and OTC product availability


and pricing

also has data on sugar/lactose/alcohol-free


preparations

available electronically within Micromedex


Tertiary Resources
D. Compounding/Formulations

extemporaneous preparation for pedia/geriatric, & special


needs patients

1. Merck Index

http://www.merck.com, by Merck & Co., Inc.

provides chemical and pharmacological information about


chemicals, drugs, and biologicals

Ex: CAS number, chemical structure, MW and physical


data
Tertiary Resources
D. Compounding/Formulations

2. Remington: the Science and Practice of Pharmacy

contains information about all aspects of pharmacy


practice

3. A Practical Guide to Contemporary Pharmacy Practice

information about compounding techniques,


calculations, and rationale behind excipients are also
available.
Tertiary Resources
D. Compounding/Formulations

4. Trissels Stability of Compound Formulations

provides information about preparation of sterile and


non-sterile dosage forms

also provides general stability concerns/data

5. USP/NF

contains data on official substances and products


standards
Tertiary Resources
E. Dietary Supplements

1. Natural Medicine Comprehensive Database

http://www.naturaldatabase.com

provides summary of information on dietary supplements and


rates its relative safety & efficacy

2. Natural Standard

http://www.naturalstandard.com

provides extensive evidence-based information regarding safety


and efficacy
Tertiary Resources
E. Dietary Supplements

3. PDR for Herbal Medicines

4. Review Natural Product

found within facts and comparison website

provides chemistry, pharmacology, and


toxicology of a number of natural products
based on primary literature documents
Tertiary Resources
E. Dietary Supplements

5. Trease and Evans Pharmacognosy

textbook which contains classic ph-cog, crude


plant - based drug classification and
examination.

Also provides data on clinical applications,


pharmacology and phytochemistry
Tertiary Resources
F. Drug Interaction

1. Hansten & Horns DI Analysis and


Management

http://www.hanstenandhorn.com

provides summaries of mechanism &


management options for DI
Tertiary Resources
F. Drug Interaction

2. Drug Interaction Facts

incorporated in facts and comparison website

provides information on drug-drug/drug-food


interactions

discusses significant interaction and


suggestions for management
Tertiary Resources
F. Drug Interaction

3. Food-Medication Interactions

http://www.foodmedinteractions.com

focuses on the impact of food on medication efficacy

highlights a list of food

discusses significant interaction and suggestions for


management
Tertiary Resources
G. Geriatric Dosage Recommendations

1. Geriatric Dosage Handbook

http://www.lexi.com

2. The Merck Manual of Geriatric

http://merck.com

both focuses on specific discussion on factors related


to geriatric care
Tertiary Resources
H. Pediatric Dosage Recommendations

1. The harriet Lane Handbook

http://www.lexi.com

2. Pediatric Dosage Handbook

http://www.lexi.com

both focuses on specific discussion on factors related


to pediatric care
Tertiary Resources
I. Incompatibility and Stability

1. Handbook on Injectable Drugs

http://www.ashp.com

2. King Guide to Parenteral Admixtures

http://www.kingguide.com

3. Trissels 2 Clinical Pharmaceutics Database

http://trissels2.rcl.com/tsweb

provides detailed information regarding stability profile and compatibility


issues of ingredients for IV medication
Tertiary Resources
J. International Drug Equivalency

1. Index Nominum: International Drug Directory

http://www.medpharm.de

2. Martindale: The Complete Drug Reference

contains information on several drug in over 130 countries,


local and international.

Other resources would be BP, Rote Liste, Dictionary Vidal


Tertiary Resources
K. Pharmacokinetics

1. Basic Clinical Pharmacokinetics

provides basic principles of PK esp. interpretation and implications of


plasma concentration

2. Applied Biopharmaceutics and Pharmacokinetics

provides information on PK and its relation to drug development and


patient care

also addresses the impact of Pharmacogenetics on drug

metabolism included in Access Pharmacy e-subscription


Tertiary Resources
L. Pharmacology

1. Goodman & Gilmans: The Pharmacological Basis of


Therapeutics

2. Basic & Clinical Pharmacology

3. Brodys Human Pharmacology: Molecular to Clinical

4. Modern Pharmacology w/ Clinical Applications

provides thorough information on PK, PD and


Pharmacology of drugs and its impact in the clinical setting
Tertiary Resources
M. Pharmacy Law

1. Pharmacy Practice and the Law

http://www.jblearning.com

provides information regarding federal laws and regulations on


Pharmacy practice

2. Nelson Tubons Jurisprudence Book

a detailed and comprehensive source of information regarding


PH law that has impact in the practice of pharmacy
Tertiary Resources
N. Teratogenicity/Lactation

1. Drugs in Pregnancy and Lactation

often referred to as Briggs textbook

focuses on information regarding use of drugs during pregnancy or


for a lactating mother

also looks into the impact of drug usage on the developing infant

2. Catalog of Teratogenic Agents


provides information about a list of chemical, pharmaceuticals,
food additives, household products, and viruses and their
teratogenicity
Tertiary Resources
O. Therapy Evaluation/Drug of Choice

1. Applied Therapeutics: The Clinical Use of Drugs

contains text on disease states and treatment options

information is presented in a clinical case-based format

2. Goldmans Cecil Medicine

information is organized by disease states and color coded to


speed usage

info on etiology, manifestation, diagnosis, treatment and prognosis


is provided as well
Tertiary Resources
O. Therapy Evaluation/Drug of Choice

3. Harrisons Principles of Internal Medicine

comprehensive information on pathophysiology,


differential diagnosis, and disease management is
provided.

4. The Merck Manual of Diagnosis and Therapy

provides quick summary of disease state information


Tertiary Resources
O. Therapy Evaluation/Drug of Choice

5. Medscape

provides up-to-date info on disease states and management

contains monographs on Rx and OTC medications

6. Pharmacotherapy: A Pathophysiological Approach

7. Pharmacotherapy Principles and Practice

8. Textbook of Therapeutics
Tertiary Resources
P. Toxicology

1. Casarett and Doulls Toxicology: The Basic Science of


Poisons

textbook on extensive organ and non-organ directed toxicity

2. Goldfranks Toxicological Emergencies

provides a case study approach on the maangement of


toxicological emergencies

provides info on common drugs, botanicals, pesticides, and


occupational hazards management
Tertiary Resources
Q. Veterinary Medicine

is growing specialty practice in the US.

Uses the concept of One Medicine.

1. Plumbs Veterinary Handbook

most useful resource on human and veterinary drug information

2. Textbook on Veterinary Internal Medicine

3. Compedium of Veterinary Products (naccvp.com)

4. FDA/CVM Homepage

5. AVMA Reference Material on Veterinary Compounding


Tertiary Resources
Q. Veterinary Medicine

6. Animal Poison Control Center

focus on animal toxicology and safety

7. Veterinary Pharmacology and Therapeutics

8. Small Animal Clinical Pharmacology and Therapeutics

9. The Merck Veterinary Manual

10.Pet Place/ Pets with Diabetes

petplace.com

petsdiabetes.com
Secondary Resources
refers o references that index or abstract the
primary literature

aims to direct user into finding primary literature

multiple database search must be utilized in order


to perform comprehensive search for literature
Secondary Resources
INDEXING

provides bibliographic information

title, author, and citation of the primary literature

ABSTRACTING

includes a short description or abstract of the


primary literature
Secondary Resources
Search Strategies

1. Identify search terms/keywords

key terms are used to narrow down returns

may be different among different search


database

2. Use BOOLEAN OPERATOR


Secondary Resources
Search Strategies

Boolean Operators

AND OR NOT
Secondary Resources
Search Strategies

3. Set Limit Fields

allows returns to restricted

ex: human study, review, case reports, type of journal, date of publication

Content Filter

specific on the drug/disease state being researched

returns with the most appropriate content

Validity Filter

method of narrowing down returns to only of the highest quality


Secondary Resources
A. BIOSIS REVIEWS

comprehensive database of biological sciences,


covering from biological to biomedical
information

useful when searching for basic science


information on compound activity on a cellular
level
Secondary Resources

B. CANCERLIT

maintained by the National Cancer Institute (US)

most useful when searching for information on


oncology therapies and QOL issues
Secondary Resources

C. CINAHL

EBSCOhost

primarily useful when searching for literature in


the filed of nursing and allied health

provides information on patient care


Secondary Resources
D. COCHRANE LIBRARY

3 parts:

Index of Cochrane reviews on medical


treatments, conditions and alternative treatments

Abstracts of Intl systematic reviews

Bibliography of systematic reviews in worldwide


literature
Secondary Resources
E. CURRENT CONTENTS CONNECT

Thompson Reuters Medical

offers very recent published literature as it


relates to scientific information

contains carrying subsets inclining clinical


medicine and life sciences
Secondary Resources
F. MEDLINE

covers basic and clinical sciences, nursing and


vetmed

G. EMBASE

comprehensive abstracting service for biomedical


literature worldwide

has more international coverage than MEDLINE


Secondary Resources
H. GOOGLE SCHOLAR

a search engine designed to target scholarly


materials online

I. JOURNAL WATCH

abstracting service including recent information


summarized by physicians from a pool of
medical literature
Secondary Resources
J. IOWA DRUG INFORMATION SYSTEM

Division of Drug Information, University of Iowa

indexing service for a variety of biomedical literature

K. INTERNATIONAL PHARMACEUTICAL ABSTRACTS (IPA)

Thompson Reuters Medical

covers drug related information on usage and development,


pharmacy administration and clinical services
Secondary Resources
L. LEXISNEXIS

LexisNexis Academics and Library Solutions

indexing and abstracting service for medical, legal and


business news

M. REACTIONS WEEKLY

Aids International

summarizes information on ADE, DI, Drug dependence


and toxicology
Secondary Resources

N. PHARMACOECONOMICS & OUTCOMES


NEWS WEEKLY

covers recent publications on the economic use


of health care resources

also provides prescribing trends, recent health


care news and regulatory updates
Primary Resources

consists of clinical research and reports bot


published and unpublished

review article and editorial are NOT primary


literature
Primary Resources
Advantage:

1. access to detailed information

2. chance to personally assess the validity and applicability of


information

Disadvantage:

1. misleading conclusions

2. require high-level skill in medical literature evaluation

3. require time for evaluation


Alternative Resources
A. Internet searches

use of search engines to complete search data prior to using


standard resource material

B. News wires

C. Consumer Health Information

mostly government sites with free access information

Informatics Pharmacist must always be open in helping consumer the


contents of such resources