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73 Cards in this Set
- Front
- Back
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hey
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this is a test
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Obtaining Demographics of requestor
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who is asking? how complex?
When do they need to know? Contact info? |
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Obtaining background info helps......
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Determine what the real question is
Patient vs Non-patient Narrow down broad questions |
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what kind of background info would you want from a patient?
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name
age gender weight/height allergies medical history lab values etc |
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determining and categorizing the actual request will help....
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determine the real question
Identify most appropriate resource |
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DI Processing Steps
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Demographics
Background Info Categorize Request Search Strategy Evaluation Analysis Formulate + Communicate Follow Up |
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Evaluation analysis and synthesis
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Limitations?
Relevance? Current info? Reputable Source? |
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Formulate + Communicate
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Manner appropriate to asker
Where info was found Facts first then judgement Anticipate questions |
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Follow up + Documentation
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QA for DI
Helps validate info for similar questions in the future |
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Overviews textbooks reviews databases
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Tertiary literature
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Original research + clinical studies
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Primary
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Disadvantages of Tertiary Resources
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Info may not be current
Less detailed Info could be biased |
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3 General Classifications of Tertiary Resources
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Disease State Oriented
Drug Therapy Oriented Specialty References |
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Used to locate
primary literature published on a specific topic and to locate review articles published in journals. Should not be cited as a reference |
Secondary Resources
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True or False
Journals themselves are NOT primary lit, but means by which primary lit is published. |
True
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Brief summaries of presentations made at a national meeting. May or may not eventually be published in full.Journals themselves are NOT primary lit, but means by which primary lit is published.
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Meeting Abstract
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Series of papers on a specific topic, or publication of the proceedings of a symposium (scientific meeting).
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Journal Supplement
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Why may journal supplements be biased?
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Often sponsored by drug industry to only give favorable information
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May include brief communications about a new drug or treatment of a disease, designed to stimulate interest and discussion, often letters critique previously published work in the same journal, may not be peer-reviewed, not all journals publish letters and not all letters primary literature.
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Letter to Editor
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Locator tools
indexing and abstracting services |
Secondary literature
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what are some disadvantages on secondary literature?
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abstracts only
skills needed cost |
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what are some disadvantages of primary literature
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difficult to obtain
skills to evaluate |
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a tertiary resource containing Pathophys, Epidemiology, Signs/Symptoms, Diagnosis, Treatment
would be __________ oriented |
Disease State
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a tertiary reference containing P.col, Therapeutic use, Side effects/ADR/toxicity, Drug interactions, Dose, Dosage forms,
Product identification, manufacturer, Federal control schedule, NDC would be ____________ oriented |
Drug therapy
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a tertiary reference containing Info on Specific patient populations (geriatrics), Specific practice area
(infectious diseases), Specific aspect of drug therapy (ADR, Parenteral drug use) would be a _______ ______ |
Specialty reference
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drug therapy oriented references
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Drug Facts and comparisons
AHFS Physicians Desk Reference Package Insert Drug Info Handbook Martindale USP DI Handbook of Nonprescription Drugs |
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Advantages of Facts and comparisons
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Off-Label
Charts Investigational drug info Canadian Drugs Manufacturers contact |
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Disadvantages of Facts and comparisons
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not referenced
no herbal info |
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what is seen on stress EKG when there is exercise induced ischemia
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subendocardial ischemia --> ST segment depression
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Factors When Evaluating Medical and Pharmacy Journals
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Impact Factor
Peer Review? Industry Support |
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High Impact Medical Journals
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NEJM
Annals JAMA British Medical Journal Am. Journal of health systems Am. Journal of Medicine Pharmacotherapy |
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Two major categories of Primary Literature
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Descriptive
Evaluative (exploratory) |
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Two subcategories of Evaluative Primary Literature
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Observational Studies
Experimental Studies |
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Experimental Studies
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Actually performing a study
(Clinical Trials) |
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Observational Studies
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Collect and observe data from retrospective or prospective study without intervening
(Cohort and Case-control) |
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Disadvantages of AHFS
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limited OTC and Combo
hard to read only referenced online |
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advantages of PDR
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compilation of package inserts and monographs
free to physicians |
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Disadvantages of PDR
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updated anually
no off label |
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Advantages of Package insert
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Black box
indications interactions storage .... |
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disadvantages of Package insert
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dosing info inadequate
no off label side effects out of date |
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Advantages of Drug Info Handbook
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easy to use
portable tables comparisons |
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disadvantages of drug info handbook
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not comprehensive
no referenced |
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Advantages of Martindale
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Comprehensive
referenced Foreign and Domestic |
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Disadvantages of Martindale
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Expensive
small print Outdated quick |
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USP DI vol I
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Monographs
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Sources including herbal information
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Harrisons
Poisindex (Micromedex) ALTMEDDEX (Micromedex) Martindale Clinical Pharmacology CRL Clineguide Natural Medicines Natural Standard |
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Information on foreign products
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Martindale
Index Nominum (Facts and Comparisons) - US + Canada only |
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USP DI vol II
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patient counseling
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USP DI vol III
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therapeutic interchange
includes orange book |
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Advantages of Handbook on Nonprescription Drugs
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counseling
disease states |
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Disadvantage of Handbook of Nonprescription
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cost
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4 Specialty tertiary Resources
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Lexi-comp (pediatric,Geriatric Dosing)
Bennetts HarrietLane Briggs |
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Geriatric dosage handbook specializes in...
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drug use in elderly
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Harriet lane provides info on...
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pediatrics (drug info weight based)
assessment and diagnostic |
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Bennetts guide
(drug prescribing in renal failure) |
dosing
renal replacement therapies |
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Adverse Drug Reaction Reference (ADRs)
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Side Effects of Drugs
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Drug interaction references
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Drug interactions and facts
Evaluation of drug interactions Hanston and Horn |
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Therapeutic textbooks
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Koda-Kimble
Herfindal Dipiro |
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Pregnancy and lactation references
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Briggs (drugs in pregnancy and lactation)
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Parenteral compatability references
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Trissle (handbook on injectable drugs)
kings guide to parenteral |
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Drug ID references
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American drug index
Red Book Merck Index Index Nominum |
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Drug Purchasing Book for rx and OTC
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Red Book
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Dictionary format listing of drug products available in the US
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American Drug Index
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Which is more detailed
Martindale vs Index Nominum |
Martindale
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Useful for compounding products contains chemical and physical properties of drugs
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Merck Index
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Where to find if it is okay to infuse multiple drugs at the same time (Y-site Compatibility)
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Handbook on Injectable Drugs
(Trissels) King Guide IV index |
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Pregnancy category Ratings
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A + B = no risk
C = no info or evidence D = benefit may outweigh risk X = Risk evidence / no utility |
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Journal with the most original research
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Pharmacotherapy
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AJHP is focused on
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Institutional pharmacy practice
very little clinical research |
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Primary focus is on international health
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The Lancet
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disease state oriented tertiary resources
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Harrisons
Cecil Merck manual |
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Which is more detailed?
AHFS vs. Drug Facts + Comparison |
AHFS
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Where does info from PDR come from
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Clinical trials prior to marketing
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