Slide 1: Clinical Drug Information
Julie Whelan Fall 2007
Slide 2: Objectives
• • • • • • • • • • Drug Names --Discuss the importance of drug nomenclature. Looks What resources will help in selecting the best drug for this particular patient? Where can I find detailed dosing information including pediatric, geriatric, renal and hepatic failure? Calculators and nomograms. Interactions--Describe sources for drug/drug interaction information? Drug/lab, drug food, drug ethanol, drug disease interactions? Where can you find adverse drug reaction ADR) and toxicity information? Safety in pregnancy & lactation? Where to find warnings and how to report an ADR. Describe PDA programs useful for quick ready reference.
Slide 3: Name Game
Slide 4: One Drug
• • • • • • • • 51146-56-6 Deltaran, Dolomin, Amersol, Menadol RD-13621, U-18573 2-(4-Isobutylphenyl)propionic acid C13H18O2 Anti-inflammatory NSAID ibuprofen
Slide 5: PubChem
• Three Databases PubChem Substance, (Compound and BioAssay)
• search by common name, systematic name, molecular weight and more. • Be as specific as possible. • Compounds not in PubMed database, have matches. • Duplicates exist so look for a record with some detail and especially with the literature link on the right-hand side. • This means there are PubMed citations link to do this substance. • Identify the common name. Search for it in PubMed using the links menu off of literature.
Slide 6: Sources for Names
• Brand names
– Micromedex, formulary, PDR, Clinical Pharmacology, USPDI, Mosby’s Drug Consult
• Generic names- all of above + F&C, ADI, MI • Registry #- Merck Index, ChemID, CAS • Molecular Forumula- Merck Index, ChemID, SciFinder • NDC#- Orange Book, Mosby’s • Foreign Names- Martindales (Mmdx), EMBASE, Index Nominum • Laboratory names,Investigational #-USAN dictionary, PubMed/EMBASE, Merck Index
Slide 7: Tour of Major Resources
• • • • Micromedex AHFS Clinical Pharmacology Dynamed
Slide 8: Non-subscription Resources
• LactMed • http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?L • MassMedline http://www.massmedline.com • Needy Meds http://www.needymeds.com
Slide 9: More Resources
• Med Watch http:// www.fda.gov/medwatch/safety.htm • RSS feed possible • Weekly Morbidity and Mortality Reports http://www.webmm.ahrq.gov/ • Sermo.com http://www.sermo.com
Slide 10: PDA- Quick References
• Available to you
– ePocrates Pro - HMS – Mobile Micromedex HMS – LexiDrugs- Partners – CPOnHand- HMS
Slide 11: How do they perform?
• Knollmann, BC et.al. Personal digital assistant-based drug reference software as tools to improve rational prescribing: benchmark criteria and performance
– Clin Pharmacol Ther 2005; 78:7-18.
• Galt KA et.al. Personal digital assistantbased drug information sources: potential to improve medication safety
– J Med Libr Assoc 93(2) April 2005. 229-236
Slide 12: Results
• Both compared 11 products
– Galt eliminated all but 3 for detailed analysis
• Assigned points for meeting quality benchmarks • Benchmarks included:
– Currency, EB dosing, dosage forms, side effects, ADRs, interactions, H/DS, comprehensiveness, accuracy, mechanism – Special features-calculators, cost, ID, pharmacokinetics, IV compatibility
• Used specific DI queries to develop ratings
Slide 13: The Winners Are!
• For Safety
– Lexi-Drugs – Mobile MDX – ePocrates RxPro
• For Rational Prescribing
– – – – – – – – Lexi Drugs CP onHand PDRDrugs A2ZDrugs Pepid PDC ePocrates RxPro DRDrugs Mobile MDX
