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52 Cards in this Set
- Front
- Back
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Skills Needed Provide Info |
1. Access Available info( collect situational data0 2. Formulate an appropriate question 3. Systemic approach 4. Evaluate info critically (validity/ applicability) 5. Develop, organize and summarize response 6. Communicate clearly Anticipate other info needs |
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What is a drug information specialist
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A well trained clinicial who knows how to locate, evaluate and apply drug info obtained from appropriate resources
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Tertiary or General Reference |
These are textbooks or reference books which are compilations of information collected from studies, reviews and other texts |
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Secondary References |
These are abstracting and indexing sources of drug info. They may give only a reference to the original journal article or they may abstract or interpret the original literature for you |
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Primary References |
These include original journal artices |
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How to evaluate a Tertiary Reference |
Does this author have appropriate experience to publish in this area? Is the info likely to be timely based on the publication date? Is the info supported by appropriate citations? Does the resource contain relevant information? Does the resource appear free from bias and blatant error? |
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Drug Facts and Comparisons |
Monthly (loose-leaf), annual (bound0 and electronic formats Includes prescription, otc, investigational and orphan drugs Extensive drug monographs Be aware of general class info 3000 comprehensive charts and tables for easy comparisons of products with similar formulations |
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Physical Desk Reference (PDR) |
Annual (print) and electronic formats Compilation of FDA approved product labeling for commonly prescribed prescription drugs Does not include investigational info if off-label uses of medications Color images of select drugs Does not include all prescription drugs Specialty editions for nonprescription drugs, herbal medications, nutritional supplements and ophthalmic medicines |
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Handbook for Nonprescription Drugs: An interactive Approach to Self-care |
-Published by the APhA -Text also available as an e-book -Text is organized by body system -focus on disease states for which self-care would be appropriate -provides comparative efficacy information of OTC products |
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RED BOOK |
-Information on prescription and OTC product availability and pricing -Number of tables including sugar-free, lactose-free and alcohol-free preparations -NDC (National Drug Code) numbers -Available in Micromedex |
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Americal Hospital Formulary Service (AHFS) |
-Print and electronic format -Published by ASHP -Extensive collection of drug monographs -Comprehensive review prior to publication -Drug arraigned by AHFS nummber -General statements precede the monograph -Thorougly references, however can only be accessed via electonic version
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Martindale: The Complete Drug Reference |
-Print and electronic versions -International drug information over 43 countries and regions -Includes info on: selected herbals, diagnostic agents, radiopharmaceuticals, pharmaceutical excipients, toxins and poisons -Mutilingual pharmaceutical terms -Foreign product proprietary product names -Forenign manufactures and distributors -Active ingredients -summary of indications -extensively referenced -available in Micromedex |
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Index Nominum |
-International Drug Directory -Print and Electronic Versions -Information of drugs available of 171 countries Inforation included: Structure, Therapeutic class and proprietary names for single entity medications |
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Clinical Pharmacology |
-Electronic -OTC drugs, prescriptions, investigational, nutritional and herbal products -Updated in real-time with late-breaking medical news -Drug Monographs -Abbreviated monographs for older drugs -References for less well known or controversial topics
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Drug Information Handbook |
-Lexicomp -Print and Electronic -Useful quick reference but often information is not as detailed as other references -Drug Monographs Useful appendices: Drug interactions, toxicology info and P450 inducers and inhibitors |
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Different versions of Lexicomp |
Lexi Drugs Handbook Pediatric and Neonatal Dosage Handbook Geriatric Dosage Handbook Lexi-Tox Lab Tests and Diagnostic Procedures Lexi Patient Education Pregnancy and Lactation, In-depth Infectious Diseases Handbook |
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Epocrartes |
Family of Electronic Resources Mobile and online products Drug Monographs Drug Interaction Checker Tablet Identification Diseases (Epidemology, prognosis, and treatment)
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Micromedex |
Compilation of a number of excellent databases Electronic Access, Smart phone app Drug monographs toxicology Drug Identification Foreign Drugs Reproductive Risk |
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Drug Points System
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USPDI Volume I
Available in Statref Good source of General Inforamtion Drug Monographs Includes OTC Medication |
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Detailed Drug Information for the Consumer |
USPDI II Available in STATref Detailed drug information written in lay language Drug Monographs Good patient teaching source |
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Handbook of Injectable Drugs (Trissel's) |
Hardcopy and electronic; available in STATref Monographs of parenteral medications Tables include: Solution compatibility, addictive compatibility, drugs in syringe compatibility and drugs in y-site compatibility |
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King Guide to Parenteral Admixtures |
Loose-leaf, bound and electronic versions Monographs of over 500 drugs Tables provide compatibility in 12 common fluids: drug in solution and drugs in solution with other drugs Includes info on parenteral nutrition |
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Meyler's Side Effects of Drugs |
Comprehensive source of adverse drug interactions Drug monographs with detailed ADR data Comprehensive references to primary literature Reports of clinically relevant drug interactions |
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Side Effects of Drugs Annual |
A worldwide yearly survey of new data and trends in adverse drug reactions Companion text to Meyler's Supplements Meyler's between editions A team evaluates international published ADR literature and summarizing the information |
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Drug Interaction Facts |
Hardcopy and Electronic Drug-drug and drug-food interactions Each interaction review contains: significance rating, onset, severity rating, documented effects, mechanism of interaction and management options |
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Hansten and Horn's Drug interaction Analysis and Management |
Similar to Drug Interaction Facts Risk factors Mechanism of interaction Related Drugs References |
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Drugs in Pregnancy and Lactation |
In the R2 Library Compilation of 1200 common drugs Summarize current literature of fetal risk and impact on breastfeeding Includes references Also review Lact-Med in the NLM |
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The Harriet Lane Handbook |
Pediatric Reference Common diseases and conditions in the newborn to adolescent patient Concise medication dosing Monographs are brief and do not have detailed information or references Common Side Effects Separate publication for antimicrobiial therapy |
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Pediatric and Neonatal Dosage Handbook |
900 monographs for pediatric and neonatal dosing Includes 100 extemperaneous preparation recipes Comprehensive appendices: acute life support, toxicology and conversion tables |
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Natural Standard |
Print and Electronic Formats Evidence based information for herbal products as well as complementary and alternative medicines Each Product is graded A-F reflecting the quality of scientific evidence Monographs include patient handouts |
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Natural Medicine Comprehensive Database |
Monographs covering herbal and other complimentary medicines Each monograph is evidence based and fully referenced Provides guidance for use based on available evidence for safety and efficacy Online version has additional info |
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Using Tertiary References |
-Consult tertiary resources first when answering a DI question or finding a medication -Do not rely on general tertiary info resources to find specific, focused types of info -Do not rely on info found in only one tertiary resource. Always verify it with another available source |
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Secondary References |
-Used to locate clinical studies or other original research (primary lit) that are published in medical or health-related journals -Abstracting services- includes a complete citation and provides a brief overveiw of the article Indexing Services which include a complete citation |
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Cochrane Library |
-Evidence based Medicine Resource -Collection of 6 databases:Cochrane Database of Systemic Reviews, Database of Reviews of Effectiveness(DARE) and Cochrane Central Register of Controlled Trials -Extensively Reviewed -All reviews follow a systemic approach so there is consistency in the reviews
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Medline & PubMed |
Covers 5500 biomedical journals from 70 different countries Utilizes a controlled search vocabulary (MeSH) |
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Iowa Drug Information System (IDIS) |
-Indexes articles from over 200 medical and pharmaceutical journals -Articles are only indexed of they are directly relevant to drug use in humans -Controlled vocabulary for searching -Also includes FDA approval packages |
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International Pharmaceutical Abstracts (IPA) |
-Focuses on pharmacy and pharmacy practice articles -IPA indexes 750 journals as well as stte and local pharmacy publications -Topics covered: biopharmaceutics, pharmacoinetics, new drug delivery systems, pharmacist liability, legal, political, ethical issues, pharmacology, drug stability, and drug evaluations |
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Journal Watch |
Newsletter most helpful for monitoring new clinical trials Abstracting service for recent information covers topics geared toward general practice physicans |
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Google Scholar |
Search scholarly literature at no charge utilizes internet search engine style Loses specificity and revelance of results due to a lack of a controlled vocabularly Limitations include: lack of info about journals covered, ranks article relevance by various methods including citation counts therefore new articles may not appear relevant because they do not have citation counts vs. older articles |
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Key Points About Secondary References |
Allow for efficient location of relevant primary literature Must use proper terminology (controlled vocabulary) for each secondary resource A thorough search for relevant primary literature should include multiple secondary sources due to variation in journal coverage among resources |
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Preclinical Trials |
-Assessment of Primary safety and biologic activity -Involves animal and in vitro studies -average duration 3.5 years |
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Phase I Clinical Trials |
-Determination of primary safety and tolerance including safe dosage range -involves 20 to 100 normal healthy adulty volunteers -Average duration 1 year |
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Phase II Clinical Trial |
-First evaluation of drug efficacy, dose response and side effects in patients in which the drug is intended -Administered to 100 to 500 fairly homogeneous patients. -Average duration 2-5 years |
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Phase III Clinical Trial |
-Verification of drug effectiveness and safety, especially in long term use -Establishment of optimum dosage -Administered to 1000-3000 volunteers, relatively heterogeneous patients. -avg duration 2 -4 years |
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Phase IV Clinical Trials |
-Also known as Postmarketing Surveillance -Intended to obtain more info about the benefits and risks associated with the drug's use in the general population -Performed either prior to or after the release of the drug to the market -Duration: Indefinite |
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Peer Review |
-Editors of most journals use a systematic process to determine which articles are finally published -Most articles are selected from voluntarily submitted articles by authors -The journals reputation is based on the process and the criteria which it uses to select articles for publication -Peer review system: "assessment by experts of the material submitted for publication in scientific and technical periodicals" -Peer review is needed to handle the large number of articles submitted for publication annually |
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Peer Review System |
1. A journal editor sending manuscripts to one to three "experts" for review and comment on the research methodology and the clinical significance of the findings 2. Peer reviewers are anonymous to the articles authors and vice versa 3. Peer reviewers, accept, revise or reject a manuscript for publication 4. Journal editor examines the reviews and decides on publication of the article 5. Reputable journals usually reject approximately 60% of the articles submitted
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Typical Structure of Articles Describing Clinical Drug Trials |
Title: Brief description of the research conducted Abstract: Overview of the research conducted I ntroduction: Background information for the trial including results of prior research
Methods: Description of drug research design, inclusion/exclusion criteria, number needed, dosing info, measures of efficacy and safety
Results and Data Analysis: Analysis of research findings, including discussion of dropouts, discontinuation of drug therapy.
Discussion and Conclusions: Interpretations of results, comparison to current standard drug treatment, discussion of future implications of research
References: Evidence that prior research has been considered in designing and interpreting the trials
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Study Design Deficiencies |
Overall Design Biases: selection, intervention, measurement and withdrawal |
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Deficiences in Presentation |
Data Omitted Poorly Written Self promotion boring ignores other important work |
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Deficiences of Interpretation |
Data to preliminary
Conclusions Unsupported by data: statistically significant but clinically irrelevant, not generalizable
Biased intepretation
Ignores Economic Consequences
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Questions of Importance of Research |
Results unoriginal, predictable or trivial issue outdated, no longer relevant Results of narrow interest, highly specialized Risk factors of marginal importance few or no clinical implications |
