INFORMATION. Tertiary References

Transcription

1 PRINCIPLES OF DRUG INFORMATION Tertiary References Dr. Hisham S. Abou-Auda

2 Hierarchy of the Pharmacy and Medical Literature Primary Original journal articles, case reports, study reports Peer reviewed journals - New England Journal of Medicine - Journal of the American Medical Association - Annals of Internal Medicine - American Journal of Health-system Pharmacy Non-peer reviewed journals - supplements, "throw away" journals

3 Secondary Abstracting ti and indexing i service (points you towards primary literature). No interpretation - Medline (National Library of Medicine) - International Pharmaceutical Abstracts - InPharma, Reactions - Current Concepts - Excerpta Medicus - AIDSLine - Science Citation - CancerLit

4 TERTIARY LITERATURE - Interpretation of primary data. - Textbook, review articles, etc. Points of comparison of tertiary references - How is it organized? - How is it indexed? (i.e., by drug, disease, side effect, etc.) - Does it have references? - Is it updated? How often? When was the last update? - What is unique about this reference? - Is it easy to use? - What kind of information does it provide? - How current is the information? - What types of questions would this reference answer? - What is the cost?

5 TERTIARY LITERATURE What does it cover? US drugs? Investigational a drugs? OTC products? Prescription drugs? Foreign drugs? Cosmetics, household products? - Manufactures? Approved labeling? Compatibility? Combination products? Dosages? Physical and chemical properties? Physical description? Single entity products?

6 TERTIARY LITERATURE How do you access the information (indexing)? - Generic name? - Trade name? - Chemical name? - Investigational code? - Research code? - Molecular formula? - Pharmacological class? - Therapeutic class?

7 General linformation American Hospital Formulary Service (AHFS) Drug Information Drug monographs arranged by AHFS Classifications Number: (i.e., 08:00 Anti-infectives, 24:00 Cardiac Drugs, etc.) Within each subclass monographs are arranged alphabetically by generic names. More clinically oriented than some tertiary references

8 American Hospital Formulary Service (AHFS) Drug Information Each monograph includes: Chemistry and stability Pharmacology Mechanism of action (Spectrum and resistance if anti-infective) Pharmacokinetics Chronic toxicity, Acute toxicity Drug interactions Laboratory test interference Dosage and administration Preparations

9 Facts and Comparisons Published by Facts and Comparisons Updated monthly (loose-leaf version) Lag time to publication about 3 months. Contains information on investigational products and orphan drugs, discontinued products. Convenient to use, nice summary/comparison tables Contains OTC and Rx drugs Very comprehensive

10 USP-DI 3 volumes I - Drug information for the health care professional II - Drug information for the patient (in lay language) III - Legal Requirements

11 USP-DI (Appendices) I - Additional products and indications II - Selected list of drug effects III - Therapeutic guidelines IV - Poison Control Center Listing V - The USP Center for the Advancement of Patient Safety VI - The medicine chart (photos of most frequently prescribed drugs) VII - Combination Cross-reference listing VIII - VA Medication Classification (Introduction, Drug Listing by VA Code) IX - Excluded Monograph listing X - Indications Index

12 Volume I monographs arranged alphabetically, some under general headings (i.e. salicylates, opiates, tetracyclines, etc.) Most complete listing of appropriate monitoring and adverse effects Has patient consultation section.

13 Micromedex Referenced Quick and easy to use, access information by drug (generic or brand name), adverse effect, disease state, tablet imprint. Various databases available DrugDex drug information, adverse drug reactions, drug consults Poisindex poisoning information, toxicology Diseasedex disease states Martindales foreign drugs Identidex drug imprint codes

14 Physician Desk Reference (PDR) New edition yearly Has section of colored photos of products, good for product identification Monographs are essentially the product information prepared by the manufacturer (but not complete PI) Section on diagnostics Specific FDA indication Adverse effect information (manufacturer required to report every event)

15 Physician GenRx Includes: Key word list Brand names Interactions Descriptions Clinical pharmacology Dosage and administration Precautions Adverse reactions Overdosage Indications and usage Contraindications Drug abuse and dependenced

16 Pharmaceutics Merck Index New edition published relatively infrequently (every 6-10 years) Gives chemical names, structures, molecular formula, associated literature reference (not very current), physical data, therapeutic category, toxicity data Can be useful for drug identifications

17 Remington's Pharmaceutical Sciences New edition every 5 years Sections on: Pharmacy: Pharmaceutical calculations/theory Chemistry: Testing and analysis Radioisotopes: Pharmaceutical and medicinal agents Biological: Pharmaceutical preparations/manufacture Pharmacy practice Very helpful in extemporaneous compounding

18 USP-NF New edition every 5 years Includes official monographs for preparation and assay of pharmaceutical products Gives packaging and storage information, labeling, reference standards, assays, and other requirements. Two sections: USP limited to drug substances and dosage forms NF limited to pharmaceutical ingredients Useful for compounding

19 Martindales the extra pharmacopoeia Very good reference for European drugs (also helpful for investigational drugs) Lists other pharmacopoeias the drug is listed in Referenced Lists British proprietary medicines Contains a manufacturer directory and index by clinical uses

20 Index nominum: International drug directory Edited d by the Swiss Pharmaceutical Society No real monograph. Gives name, structure, therapeutic class, synonyms, and manufacturer

21 Goodman and Gilman's The pharmacological basis of therapeutics Pharmacology gold standard Very thorough discussion of pharmacology Grouped by therapeutic class Contains general principle sections that includes review of pharmacokinetics, therapeutics, and Toxicology

22 Applied Therapeutics: The clinical use of drugs (Koda-Kimble) Ki New edition every few years Case study format. Brief introduction followed by sample cases and questions Referenced Contains good summary tables

23 Pharmacotherapy: A pathophysiologic approach (DiPiro) New edition every few years Referenced Provides overview of pathophysiology of the disease state, diagnosis, clinical presentation, non-drug and drug treatment

24 Stability/Compatibility Handbook on Injectable Drugs (Trissels) Periodic new editions Referenced Gold standard reference Alphabetical by generic Table format Solutions, additive, syringe, and y-site Not complete Kings Handbook of Intravenous Admixtures Chart format Updated, loose-leaf format

25 Drug Interactions Drug Interaction and Updates (Hansten s) Updated, loose-leaf format Referenced Gives summary of effect, proposed mechanism, statement of significance, and management recommendations

26 Drug Interaction Facts Published by Facts and Comparisons Alphabetical by drug Referenced Lists: - significance (1-5) - severity (major-minor) - documentation (1=severe and well documented, 5=no more than unlikely or possible documentation) - onset (rapid or delay) not complete

27 Adverse Drug Reactions Meyler's side effects of drugs; Side effects of drug annuals (SEDA) New edition of Meyler's every 4-5 years, SEDA is Annually Many tables/lists Referenced References for widely known effects are not included Contents

28 Meyler's side effects of drugs; Side effects of drug annuals (SEDA) Includes: O Overview of inherent problems of the therapeutic class O Adverse reaction patterns O Effects on organs and systems O Risk situations O Withdrawal O Second-generation effects O Overdose O Interactions O Lab/diagnostic interference

29 Pediatrics Nelson Textbook of Pediatrics i New edition every 4-5 years Referenced (2004) Pediatric Drug Handbook Includes: O Doses Comparison tables O Precautions Interactions O ADR's Contraindications O Toxicology Antidotes O Supplied Administration Good quick reference, pocket size Has useful tables (1995)

30 Pediatrics Harriet Lane Handbook New edition every 3 years Pocket size, good quick reference Contains: Nomograms, Therapeutic pearls, Tables 4 sections O Emergency management O Diagnostic O Formulary O Therapeutic data Contains some pregnancy/lactation information

31 Drugs in Pregnancy Drugs in pregnancy and lactation (Briggs) Gold standard Includes: O Generic name O Pharmacological class O Risk factor O Fetal risk summary O Breast feeding summary O References Drugs not assigned pregnancy categories by manufacturer are assigned one by the editors

32 Infectious Disease Mandell's principles i and practice of infectious disease Infectious disease - gold standard Review of infection, diagnosis, treatment Very useful for background information Disadvantage Lag time Guide to Antimicrobial Therapy (Sanford's) New edition annually Includes: Doses, Renal dosing Spectrum of activity Empiric therapy Disadvantage

33 Pharmacokinetics Basic clinical pharmacokinetics (Winter) Mostly theory, lots of equations Disadvantage Applied pharmacokinetics: Principles of therapeutic drug monitoring Published by Applied Therapeutics More drug specific information than Winter's

34 General Medicine Harrison's Principle of internal medicine New edition every few years Internal medicine gold standard Medical viewpoint Referenced Cecil Textbook of Medicine Periodic new editions Diagnostics, labs to run, normal lab values

35 Non-Prescription Drugs Handbook of Nonprescription Drugs Product tables at end of book include product trade name, manufacturer, dosage form, generic ingredients, other Ingredients Contains numerous tables comparing products (i.e., pregnancy categories, classification, properties) p

36 Handbook of Nonprescription Drugs Includes: O Questions to ask in patient assessment and counseling O Overview or introduction to the topic or chapter O Physiology O Etiology O Pathophysiology h and Symptoms O Treatment includes non-pharmacological, pharmacological and maintenance therapy O Pharmacological Agents includes dosing, adverse drug reactions, interactions, and indications. O Product Selection Guidelines O Patient Education

37 PDR for Nonprescription Drugs Like the PDR Indexes in book: O Manufacturer Index - Address, phone, fax number and OTC products included in the book O Product Name Index - Alphabetical list by brand name O Product Category Index Alphabetical list by therapeutic category O Active Ingredient Index - Alphabetical list by generic name O Product Identification Index Guide Color pictures of the product

38 Other Information, listed alphabetically by company O Brand name, generic name O Dosage form O Description O Ingredient (Active and Other) O Indication O Warning/Cautions O Precautions O Usual dosage, Dosage and administration, Directions - tells the patient how to use the product. O How supplied

39 Non-Prescription Drugs The Review of Natural Products (Formerly: Lawrence Review of Natural Products) Published by Facts and Comparisons Updated monthly Si Scientific ifi approach to herbal blproducts Historical perspective Uses Toxicity it Patient information - newer monographs

40 Oncology Cancer. Principles and practice of oncology (DeVita) New edition every 3-4 years Gold standard Referenced Cancer Chemotherapy Handbook New edition every few years Good index Introduction on malignancy : Lag time

41 Cardiology Textbook of Cardiology Medicine New edition every 5 years Cardiology gold standard Rapid interpretation of EKGs (Dubin) Best way to learn EKGs User friendly format

42 Availability/Identification American Drug Index New edition annually Lists generic and trade names Some foreign medications listed USAN Dictionary New edition annually Medication and chemical formulas, registry numbers Lists drugs no longer under investigation