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Drug Information Resources and Literature Search Strategies
Sandra R. Bai, PharmD
PGY-1 Regulatory Pharmaceutical Fellow in Drug Information PGY-1 Purdue University|Janssen University|Janssen Scientific Affairs, LLC|FDA August 31, 2016
Objectives 1. Identify and find available drug information resources 2. Differentiate between primary, secondary, and tertiary
literature 3. Select and utilize appropriate drug information
references based on DI request
Drug Information Settings FORMA L
INFORMAL
Hospital pharmacies
Gym
Community ph p harmacies
Dinner ta table
Ambulatory Clinics Clinics
Places of worship worship
Managed Care
Off-duty
Pharmaceutical Industry
Anywhere fr friends/family/coworkers can reach you
Public Health
Fin indi ding ng Reso sour urce ces s • Gene eneral ral Purdue Purdu e Library Libr ary • https://www.lib.purdue.edu/
Databases
Change “All Subjects” to “Medicine and Health”
Fin indi ding ng Re Reso sour urces ces • Pharmacy Pharmacy,, Nursing, and Health Sciences Library https://www.lib.purdue.edu/li .lib.purdue.edu/libraries/pnhs braries/pnhs • https://www Drug
Information Resources
Fin indi ding ng Re Reso sour urces ces • E- Text (Access Pharmacy Pharmacy,, Lipincott Lipincott Health Library) • Pharmacy.purdue.edu • Current Students Resources Health Library Access • Log In
Inf ormation Textbook) Textbook) • Textbook access through Access Pharmacy (e.g. DiPiro, Drug Information
Sel ect i ng Refer ences
Sel ect i ng Refer ences
“Be the change you wish to see in the world” -Mahatma Gandhi (allegedly)
Sel ect i ng Refer ences
Hi, this is Dr. Bai and I would like to know the starting dose of Megace® for a patient currently experiencing hot flashes
Facts and Comparisons: 20 mg daily
Sel ect i ng Refer ences Tertiary Literature Secondary Literature
Primary Literature
Appropriate References
Sel ect ctii ng Refere ferenc nce es Fact ctor ors s • Type of Request • Patient specific • Broad or detailed • Recent News
• Identity of the Requestor • Pharmacist • Physician • Nurse • Patient
i>Clicker Question #1 Which is an example of tertiary literature? ATLAS, TLAS, a randomized trial A. A Infor mation: A Guide for Pharmacists, 5e 5e B. Drug Information: C. Google Scholar D. PubMed
Ter ti ar y Resou ourr ces • Information that has been summarized to provide an
overview of a topic • Examples • Textbooks • Compendia
Treatment ment Guidelines • Treat • Internet Websites • Review Articles
Ter ti ar y Resou ourr ces • A Ad d v an antt ag ages es o f Ter ertt i ar ary y Res Reso o u r c es • Comprehensive information from a variety of sources • Citations to primary and secondary sources • Fast, easy to use
Disadvantages s of Tert rtiary iary Re Resou sourc rces es • Disadvantage Older,, less current information • Older • Not sure if authors looked at the “right” sources • Bias/lack of expertise
Seco cond nda ary Reso sour urces ces • References that index or abstract primary literature • Indexing: Providing the citation
Ab b s t r ac actt i n g : Providing the citation and a brief description • A
(abstract)
Seco cond nda ary Reso sour urces ces • Examples: • Medline (free access via PubMed) • EMBASE • Google Scholar • International Pharmaceutical Abstracts (IPA) • Cochrane Library • CINAHL
Ad d v an antt ag ages es o f Sec Seco o n d ar ary y L i t er erat atu ure • A • Easily accessible • Directs to primary literature • Disadvantages Disadvantages of Se Secon condary dary Lit Litera eratur ture e • Index terms • Non-uniformity • Cost
Seco cond nda ary Lit L ite eratur rature e • Search Termin erminology ology • Medical Subject Headings (MeSH) • United States Adopted Name (USAN) • International Classification of Diseases (ICD)
i>Clicker Question #2 Which of the following Boolean operators is matched mat ched appropr appropriate iately ly wit with h its effect effect on on the literature search A. Usin Using g AND will will broaden broaden the number number of results results
Using g OR will will increase increase the number number of resul results ts B. Usin C. Using NOT will increase the number of results D. Usin Using g OR will will narrow narrow the numbe numberr of results results
Pri rima mary ry Li Lite tera ratu ture re • Clinical research studies and reports (published or
unpublished) • Examples: • • • •
Controlled trials Cohort studies Case Series Case Reports
• A Ad d v an antt ag ages es o f Pr Prii m ar ary y L i t er erat atu ure • Detailed information • Self-evaluation • Most recent • Disa Disadvantages dvantages of Primary Lit era eratur ture e • Potential misleading conclusions • Literature evaluation skills • Time intensive
i>Clicker Question 3 Which of the following examples of primary literature are considered the “gold standard”? A. Randomized Controlled Trials B. Cohort Studies C. Case Series D. Case Reports
Cate tego gori riz zin ing g Quest Questio ions ns Adver Ad vers s e Ef Efff ec ectt s
Ident Id ent i f i c at atii o n
Avai l ab abii l i t y
Nom No m enc l at atu ure
Co m p at i b i l i t y /St ab i l i t y
Ph ar m ac o k i n et i c s
Co m p o u n d i n g
Gen er al Dr u g In f o r m at i o n
Do s i n g /A d m i n i s t r at i o n
Po i s o n i n g /To x i c o l o g y
Dr u g In t er ac t i o n
Pr eg n an c y /L ac t at i o n
Her b al
Th er ap eu t i c Us e
Wha hatt is i s the t he mechanism mechanism of o f action of prednisone?
Gene neral ral Dru Drug g Inf nfor ormatio mation n • American Hospital Formulary Service (AHFS) • •
• • • • •
Drug Information Clinical Pharmacology Facts and Comparisons Drug Information Handbook (LexiComp) Micromedex Physicians’ Desk Reference (PDR) (PDR ) Pharmacist’s Letter National Library of Medicine (NLM) • Drug Information Portal
Pack ckage age ins erts (D (DailyMe ailyMed) d) • Pa
What are are commo com mon n sid s ide e effects asso ssociate ciated d wit with h Ja Janu nuvia® via® (sit sita agli glipti ptin) n)
Catego tegory ry:: Advers Ad verse e Event vents s • General Drug Information References • Package Inserts • Drug-Induced Diseases: Prevention, Detection, and
Management • Meyler’s Side Effects of Drugs
Wha hatt are signs/ sign s/sym sympto ptoms ms of hypothyroidism?
Dis ise ease in info form rma ati tion on • Harrison’s Harrison’s Principles of Internal Medicine • DiPiro’ s Ph Phar arma maco coth ther erap apy y DiPiro’s • Merck Manual • Washing Washington ton Manual of Medical Therapeutics • Applied Therapeutics • Goldman-Cecil Medicine • Textbook of Therapeutics: Drug and Disease • • • • •
Management UpToDate DynaMed CDC: Diseases & Conditions The Medical Letter 5 Minute Consult
Pediatri Pe diatri c Pharmacis Pharmacist: t:
Diuril 50 mg/mL oral suspension is on manufacturer backorder. Will you please look up an appropriate formula for compounding?
Pharmacy intern: intern : Sur ure! e! Thanks Thanks to Dr Dr.. Bai, Bai, I know exa xactl ctly y where w here to look. l ook.
Compounding
Compounding • Remington’s The Science and Practice of Pharmacy • Trissel’s Stability of Compounded Formulations • Allen’s Compounded Formulations • Merck Index • United States Pharmacopeia National Formulary (USP-NF) • International Journal of Pharmaceutical Compounding • bimonthly publication
A patient calls your phar arm mac acy y:
“I’ve been taking simvastatin for my cholesterol for 5 years. My doctor just prescribed amlodipine for me. Will this interact with my simvastatin?”
Drug Interactions • Micromedex • Lexicomp • Ha Hans nste ten n an and d Hor Horn n s Drug ’
• • • • • •
Interaction Analysis Analysis and Management Drug Interaction Facts DRUG-REAX Evaluations of Drug Interactions Drug Therapy Monitoring System (MediSpan) Stockley s Drug Interactions Food-Medicine Interactions ’
What is an appropriate dose of Singulair® (montelukast) for a 7 year old patient with exercise-induced bronchospasm (EIB)?
Pediatric Information • Nelson’s Textbook Textbook of Pediatrics Pediat rics • Pediatric Dosage Handbook • The Harriet Lane Handbook • Neofax • The Teddy Bear Book (Pediatric
Injectable Drugs) • ASHP’ ASHP’s s Pediatric Injectable Injectable Drugs
