Drug Information Resources
Stepwise approach to find information 1. Ter Tertia tiary ry (text (textboo books, ks, full full-te -text xt datab database ases, s, revie review w articl articles) es) ○
General information
2. Se Seco cond ndar aryy (inde (indexi xing ng or abs abstr trac acti ting ng serv servic ices es)) 3. Pr Prim imar aryy (c (cli lini nica call st stud udie ies) s) ○
Most recent and in-depth
*not all inquiries will need all the steps *type of requestor may influence the resources used
Stepwise approach to find information 1. Ter Tertia tiary ry (text (textboo books, ks, full full-te -text xt datab database ases, s, revie review w articl articles) es) ○
General information
2. Se Seco cond ndar aryy (inde (indexi xing ng or abs abstr trac acti ting ng serv servic ices es)) 3. Pr Prim imar aryy (c (cli lini nica call st stud udie ies) s) ○
Most recent and in-depth
*not all inquiries will need all the steps *type of requestor may influence the resources used
Tertiary Resources ●
provide information that has been summarized and distilled by the author or editor to provide a quick easy summary of a topic ○
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Textbooks, compendia, compendia, review articles in journals, other general information
provide a complete and concise overview of information available on a specific topic Convenient, easy to use, familiar Disadvantages: ○ ○ ○
lag time with publication; less current information May be incomplete Errors in transcription, human bias, incorrect i ncorrect interpretation, lack of expertise of authors
Tertiary Resources General Product Information 1. AHFS Drug Information ○ ○ ○ ○ ○
Infomation on FDA-approved and off-label uses of medications For determining reimbursement of unlabeled uses of medications Dosing in specific populations Compatibility and stability of injectable formulations Paper format, mobile drug reference version
Tertiary Resources General Product Information 2. Clinical Pharmacology ○ ○ ○ ○ ○ ○
Monographs of prescription and nonprescription products, dietary supplements Screen for drug interactions Create comparison tables for products Determine IV compatibility Search for tablets by description or imprint codes Electronic database (online or smartphone app)
Tertiary Resources General Product Information 3. Micromedex 2.0 ○ FDA-approved indications, off-label uses, pharmacokinetic data, safety information, pharmacology ○ Assess drug interactions, incompatibilities, pharmacokinetic adjustments ○ Toxicology - identification on imprint codes, overdose management ○ Patient medication materials Electronic resource ○
Tertiary Resources General Product Information 4. Facts & Comparisons ○ ○ ○ ○
Prescription and nonprescription drugs organized by drug class Inactive ingredients in commercial preparations Comparative monographs of drug classes Hardcopy, online, and for mobile device
Tertiary Resources General Product Information 5. Drug Information Handbook ○ ○ ○ ○ ○ ○
Brief product monographs Clinical use, safety, monitoring FDA-approved and off-label use of medications Tablet identification, medication pricing information (electronic format) Treatment options and comparing agents in the same class Hardcopy, online, for mobile device
Tertiary Resources General Product Information 6. Handbook of Nonpresription Drugs: AN Interactive Approach to Self-Care ○ ○ ○ ○ ○
Disease states - self-care may be appropriate Comparative efficacy of OTC agents CI for self-treatment, drug interactions, other safety information Treatment algorithms and patient care cases Paper and e-book
Tertiary Resources General Product Information 7. Physicians’ Desk Reference ○ ○ ○ ○ ○
Compilation of prescription product package inserts Contact information for manufacturers List of poison control centers Limited tablet identification online, for mobile devices
Tertiary Resources General Product Information 8. USP Dictionary ○
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Official resource for determining generic and chemical names of drugs; international nonproprietary name Chemical structure, mlecular weight, CAS (Chemical Abstracts Services) registry number, pronunciation guide Online and print
Tertiary Resources General Product Information 9. Epocrates ○ ○ ○
Drugs (monographs, interaction checker, safety data, tablet ID) Diseases (epidemiology, prognosis, treatment) Online and mobile device
Tertiary Resources Adverse Effects 1. Meyler’s Side Effects of Drugs ○ ○ ○
Organized by drug classification Adverse events are organized by drug name and then by organ system within each drug Adverse events and management
Tertiary Resources Adverse Effects 2. Side Effects of Drug Annual: A Worldwide Yearly Survey of New Data and Trends in Adverse Drug Reactions ○ ○
Updated annually Serves as a companion to the Meyler’s
Tertiary Resources Availability of Dosage Forms 1. American Drug Index ○ ○ ○ ○
Indexed by product and generic name Product use, available dosage forms and sizes Manufacturer information Charts: LASA medications, pregnancy categories, normal lab values, pharmacy calculations
Tertiary Resources Availability of Dosage Forms 2. Red Book ○ ○ ○ ○
Prescription and OTC product availability and pricing Tables: sugar-free, lactose-free, or alcohol-free preparations National Drug Code numbers, routes of administration, dosage form, size, strength Paper and electronically (within Micromedex 2.0)
Tertiary Resources Compounding/Formulations 1. Extemporaneous Formulations for Pediatric, Geriatric, and Special Needs Patients (Children’s Hospital of Philadelphia) ○ ○ ○
Compilation of published formulations with stability data Most are oral formulations Legal and technical issues in compounding practices
Tertiary Resources Compounding/Formulations 2. Merck Index ○ ○ ○
Descriptions of the chemical and pharmacological information of chemicals, drugs, and biologicals CAS number, chemical structure, MW, physical data (solubility) Print and online
Tertiary Resources Compounding/Formulations 3. Remington: The Science and Practice of Pharmacy ○ ○ ○
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All aspects of pharmacy practice Social issues Basics of pharmaceutics, manufacturing, pharmacodynamics, nuclear pharmacy, medicinal chemistry Common compounding techniques and ingredients Paper and CD-ROM
Tertiary Resources Compounding/Formulations 4. A Practical Guide to Contemporary Pharmacy Practice ○ ○
Compounding techniques, pharmacy calculations, explanations of additives Text and CD-ROM
Tertiary Resources Compounding/Formulations 5. Trissel’s Stability of Compounded Formulations ○ ○ ○ ○
Preparation of sterile and nonsterile dosage forms Organized by drugs Summary of the properties of drugs, general stability, stability of compounded preparations Beyond-use dating
Tertiary Resources Compounding/Formulations 6. USP/NF ○ ○ ○
Official substance and product standards Official preparation instructions Print, online, flash drive formats
Tertiary Resources Dietary Supplements 1. Natural Medicine Comprehensive Database ○ ○ ○ ○
Rates the relative safety and efficacy By brand names or by a variety of common names Interaction checker and disease state/condition Text, online and mobile device formats
Tertiary Resources Dietary Supplements 2. Natural Standard ○ ○
Evidence-based information regarding efficacy Monographs - dosing information (doses used in clinical trials and recommended by expert opinion)
3. PDR for Herbal Medicines ○ ○
Indexed by common name Action, usage, dosage
Tertiary Resources Dietary Supplements 4. Review of Natural Products ○ ○ ○ ○
Chemistry, pharmacology, toxicology of natural products Relevant clinical trials Limited patient counseling information Loose-leaf, bound, online, mobile device formats
5. Trease and Evans’ Pharmacognosy ○
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Classic pharmacognosy, crude plant-based drug classification and examination, clinical applications, pharmacology, phytochemistry NOT a resource for patient care issues
Tertiary Resources Drug Interactions 1. Hansten and Horn’s Drug Interactions Analysis and Management ○ ○ ○ ○
Summaries of, mechanism of, and management options for reported drug interactions Severity of interaction Risk factors Loose-leaf, bound, some integrated in electronic Facts and Comparisons
Tertiary Resources Drug Interactions 2. Drug Interaction Facts ○ ○ ○ ○
D-D and D-F interactions Significance of interaction Suggestions for management Bound, loose-leaf, CD-ROM, integrated in electronic Facts and Comparisons
Tertiary Resources Drug Interactions 3. Food- medication Interactions ○ ○ ○
Food impacts on medications Foods to be avoided with specific medications Print, online, mobile device formats
Tertiary Resources Geriatric Dosage Recommendations 1. Geriatric Dosage Handbook ○ ○ ○
Dosing recommendations for geriatric patients Specific concerns of geriatric populations Online and for mobile devices
2. The Merck Manual of Geriatrics ○ ○ ○
Management of diseases and conditions common in geriatric patients Appropriate dosing of medications Print and online
Tertiary Resources Identification of Product 1. IDENT-A-DRUG ○ ○ ○
Organized by imprint codes and provides ID of drugs based on codes Description of medications, NDC, Canadian DIN Electronic and text
2. Drugs.com ○ ○
Easy-to-use imprint search Available to patients and NO charge
Tertiary Resources Incompatibility and Stability 1. Handbook on Injectable Drugs ○ ○ ○ ○ ○
Commonly called Trissel’s Compatibility and stability of parenteral medications In the form of charts and tables Routes of administration and commercially available strengths Pocket-sized handbook and online
Tertiary Resources Incompatibility and Stability 2. King Guide to Parenteral Admixtures ○ IV drug monographs ○ Focuses on compatibility ○ Limited on stability ○ Loose-leaf, bound, online, mobile device formats
Tertiary Resources Incompatibility and Stability 3. Trissel’s 2 Clinical Pharmaceutics Database ○ Compiles data from other Trissel publications ○ Parenteral admixtures, compounded formulations, physical compatibility, chemotherapy formulations ○ Intranet, CD-ROM, internet
Tertiary Resources International Drug Equivalency 1. Index Nominum: International Drug Directory ○ Drugs available in over 130 countries ○ Structure, therapeutic class, proprietary names ○ Contact information for pharmaceutical manufacturers worldwide ○ CD-ROM
Tertiary Resources International Drug Equivalency 2. Martindale: The Complete Drug Reference ○ Domestic and international drugs ○ Proprietary names and manufacturer contact information for a variety of countries ○ Common herbal products, diagnostic agents, radioactive pharmaceuticals, some veterinary products Hardcopy, CD-ROM, online ○
Tertiary Resources Pediatric Dosage Recommendations 1. The Harriet Lane Handbook ○ ○ ○ ○ ○ ○ ○
Assembled by medical residents Common diseases and conditions of newborn to adolescent patients Medication dosing Common side effects and dosage forms available Palliative care and toxicology Antimicrobial therapy (separate publication) Paper and mobile device
Tertiary Resources Pediatric Dosage Recommendations 2. Pediatric Dosage Handbook ○ ○ ○
Dosage recommendations for pediatrics Extemporaneous preparations Online, CD-ROM, mobile devices
Tertiary Resources Pharmacokinetics 1. Basic Clinical Pharmacokinetics ○ ○ ○
Basic principles of pharmacokinetics Interpretation and implications of plasma concentrations Monographs and discussions on drugs assessed by blood concentration levels
2. Applied Biopharmaceutics and Pharmacokinetics ○ ○ ○
Role of pharmacokinetics to drug development and patient care Impact of pharmacogenetics on drug metabolism Text and included in electronic Access Pharmacy
Tertiary Resources Pharmacology 1. Goodman and Gilman’s: The Pharmacological Basis of Therapeutics ○ ○ ○
Pharmacokinetics and pharmacodynamics Provide correlation between principles of pharmacology and contemporary clinical practice Text and in electronic Access Pharmacy
2. Basic and Clinical Pharmacology ○ ○ ○
Organized by therapeutic class of agents Pharmacology principles Text and in electronic Access Pharmacy
Tertiary Resources Pharmacology 3. Brody’s Human Pharmacology: Molecular to Clinical Designed with student focus ○ Therapeutic impact of pharmacology ○ Organized by organ system ○ Text, mobile device, internet updates ○
Tertiary Resources Pharmacology 4. Modern Pharmacology with Clinical Applications ○ ○ ○ ○
Clinical application of drugs Emphasis on SAR Some dietary supplements text
Tertiary Resources Pharmacy Law 1. Pharmacy Practice and the Law Federal laws and regulations impacting pharmacy practice ○ Federal and state regulation of product development, ○ dispensing, and development
Tertiary Resources Teratogenicity/Lactation 1. Drugs in Pregnancy and Lactation ○ ○ ○ ○
Often referred to as Brigg’s Use of medications in pregnant and lactating women Fetal exposure in utero or exposure through breastmilk Animal literature is provided in cases human literature is lacking
2. Catalog of Teratogenic Agents ○
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Teratogenicity of pharmaceuticals, chemicals, environmental pollutants, food additives, household products, viruses International and domestic information
Tertiary Resources Therapy Evaluation/Drug of Choice 1. Applied Therapeutics: The Clinical Use of Drugs ○ ○ ○ ○
Disease states and treatment options Cases with follow-up discussion Clinical case-based presentation Pocket-sized handbook, CD-ROM, mobile device
2. Goldman’s Cecil Medicine ○ ○
Organized by disease state and color-coded Etiology, manifestations, diagnosis, treatment, prognosis Print, CD-ROM, mobile device, internet
Tertiary Resources Therapy Evaluation/Drug of Choice 3. Harrison’s Principle of Internal Medicine ○ ○ ○
Comprehensive introduction to clinical medicine Pathophysiology, differntial diagnosis, and disease management text , electronic, included in Access Pharmacy
4. The Merck Manual of Diagnosis and Therapy ○
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Summary of disease state information - pathology, symptoms, diagnosis, and treatment Online and mobile device
Tertiary Resources Therapy Evaluation/Drug of Choice 5. Medscape ○ ○ ○ ○
Extensive information about disease states and conditions News and updates on treatment Monographs of prescription and OTC medications Electronic
6. Pharmacotherapy: A Pathophysiological Approach ○ ○
Management of disease states Epidemiology, etiology, presentation of disease, treatment, and treatment outcomes
Tertiary Resources Therapy Evaluation/Drug of Choice 7. Pharmacotherapy Principles and Practice ○
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Management of disease states - diseases most likely to be seen by pharmacists, nurses, and physician assistants Has features to help student learning Epidemiology, etiology, presentation of disease, treatment, and treatment outcomes Text and electronic
Tertiary Resources Therapy Evaluation/Drug of Choice 8. Textbook of Therapeutics ○ ○ ○
Treatment of disease states and development of therapeutic plan Pathophysiology and clinical presentation CD-ROM, PDA, print
Tertiary Resources Toxicology 1. Casarett & Doull’s Toxicology: The Basic Science of Poisons ○ ○ ○
Serve as a textbook Extensive information on organ- and nonorgan-directed toxicity Text and electronic in Access Pharmacy
2. Goldfrank’s Toxicological Emergencies ○ ○ ○
Case study approach to toxicology Basic toxicology data Management of toxicological emergencies - common drugs, botanicals, pesticides, occupational and environmental hazards
Tertiary Resources Veterinary Medicine 1. 2. 3. 4. 5.
Plumb’s Veterinary Drug Handbook Textbook of Veterinary Internal Medicine Compendium of Veterinary Products FDA/CVA Homepage American Veterinary Medical Association, Scientific Reference Material on Veterinary Compounding 6. Animal Poison Control Center
Tertiary Resources Veterinary Medicine 7. 8. 9. 10. 11. 12.
Veterinary Pharmacology and Therapeutics Small Animal Clinical Pharmacology and Therapeutics The Merck Veterinary Manual Pet Place Pets with Diabetes American Veterinary Medical Association
Secondary Literature ● ● ● ●
References that either index or abstract primary literature Directing the user to relevant primary literature Help practitioner keep abreast of recently published information Help find more recent or detailed information on treatment or disease
Secondary Literature A. Indexing ○ ○
Bibliographic citation information Title, author, citation of the article
B. Abstracting ○
Also includes brief description (abstract)
Secondary Literature Search Strategies A. Identify key terms B. Us Usee of of Boo Boole lean an op oper erat ator ors: s: AND AND,, OR, OR, NO NOT T
Secondary Literature Search Strategies C. Use of limit fields a.
Langua Lan guage, ge, ye year ar of pub public licati ation, on, typ typee of art articl iclee or jour journal nalss
D. Address Address all all possib possible le search search phra phrases ses (spell (spellings ings or disease disease state statess that that changes changes over time) E. Use of filters a. b.
Content Conte nt fil filter terss - spe specif cific ic to to drug drug or dis diseas easee stat statee Validity Valid ity filters filters - a way way to narrow narrow the the search search to only only the the highest highest quality quality studies studies (RCT, (RCT, doubl double-bli e-blind) nd)
Secondary Literature 1. BIOSIS PREVIEWS ○ ○ ○
Comprehensive database of biological information Abstracts from conferences relating to basic science Activity of compounds on a cellular level
2. CANCERLIT ○ ○
Indexes literature from variety of sources specific to cancer literature Oncology therapy and quality of life issues
Secondary Literature 3. CINAHL ○ ○ ○
Fields of nursing and allied health Patient care from the perspective of allied health professionals Updated monthly
4. COCHRANE LIBRARY ○ ○ ○
INDEXES about medical treatments, conditions, and alternative therapies ABSTRACTS of international systematic reviews BIBLIOGRAPHY of systematic reviews in worldwide literature
Secondary Literature 5. CURRENT CONTENTS CONNECT ○ ○ ○
Overview of recently published literature Clinical medicine, life science Recent drug research and developments
6. EMBASE ○ ○ ○
Covers biomedical literature worldwide Less lag time Dietary supplements or medications available in other countries
Secondary Literature 7. GOOGLE SCHOLAR ○ ○
Scholarly materials available online May not be able to access full-text versions
8. INTERNATIONAL PHARMACEUTICAL ABSTRACTS ○ ○
Drug-related information - drug use and development Pharmacy information - pharmacy administration and clinical services
Secondary Literature 9. IOWA DRUG INFORMATION SYSTEM ○ ○ ○
Full-text articles from biomedical publications in PDF or microfiche Indexing is by drug- and disease-specific terms Standard medications
10. JOURNAL WATCH ○ ○
Recent information, summarized by physicians from medical literature New clinical trials involving specific medications
Secondary Literature 11. LEXISNEXIS ○
Medical, legal, and business news
12. MEDLINE ○
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Basic and clinical sciences as well as nursing, dentistry, veterinary medicine, and many other health care disciplines 5000 journals in 40 languages
Secondary Literature 13. PHARMACOECONOMICS & OUTCOMES NEWS WEEKLY ○ ○ ○ ○
Biweekly publication Recent publications regarding economic use of health care resources Prescribing trends, recent health care news, and regulatory updates Economic impact of disease states and medical interventions
14. REACTIONS WEEKLY ○ ○ ○
Adverse events, drug interactions, drug dependence, and toxicology data Case reports of adverse reactions or drug safety Very short lag time
Primary Literature ● ● ●
Clinical research studies and reports Published and unpublished Controlled trials, cohort studies, case series, case reports
Primary Literature ●
Advantages: ○ ○ ○
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Detailed information Personally assess the validity and applicability of study results More recent than tertiary and secondary
Disadvantages: ○ ○ ○
Misleading conclusions - one trial without context of other research Need to have good skills in medical literature evaluation Time needed to evaluate the large volume of literature available
Alternative Resources ●
INTERNET SEARCHES ○
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Especially helpful to serve as a starting point for questions about uncommon diseases, new terms, drugs in development, or marketed OTC and dietary supplements Helpful in identifying information or specific product claims by the manufacturer Useful for topics that have been recently in the news
Alternative Resources ●
INTERNET SEARCHES ○
Carefully evaluate the quality of information Site maintained by educational institutions, not-for-profit medical organizations, or a division ■ of the US government VS. company selling or promoting specific product ■ Information appropriately detailed and referenced ■ Possibility to contact author
Alternative Resources ●
ALTERNATIVE INFORMATION SOURCES i.
ii. iii. iv.
News network websites, i.e. CNN, ABC, CBS A recent news story reporting the removal of a medication from the market ■ ■ May not provide all information but may at least serve as a point to search additional information Expert in the field or persons performing research in the area Organization affiliated with disease state Product manufacturer
