Drug Sources and Information Book

Study Unit
Drug Information
Sources
Reviewed By
Michelle Jones, Pharm.D.
About the Reviewer
Michelle L. Jones, Pharm.D., received her Doctor of Pharmacy
degree from Philadelphia College of Pharmacy at the University of
the Sciences, Philadelphia, Pennsylvania. She has been an ambula-
tory staff pharmacist and pharmacy manager for many years.
Michelle also has experience in long-term care pharmacy. While at
the Philadelphia College of Pharmacy, Michelle tutored students
across a broad curriculum, including calculus, immunology, and
pharmacy calculations.
All terms mentioned in this text that are known to be trademarks or service
marks have been appropriately capitalized. Use of a term in this text should not be
regarded as affecting the validity of any trademark or service mark.
Copyright 2008 by Penn Foster, Inc.
All rights reserved. No part of the material protected by this copyright may be
reproduced or utilized in any form or by any means, electronic or mechanical,
including photocopying, recording, or by any information storage and retrieval
system, without permission in writing from the copyright owner.
Requests for permission to make copies of any part of the work should be
mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton,
Pennsylvania 18515.
Printed in the United States of America
04/20/09
This study unit describes the reference material most often
used by pharmacists and pharmacy technicians, who refer
to these sources of drug information to keep abreast of new
drugs, regulatory changes, professional news, and other
pertinent information.
Drug information sources and their delivery methods have
changed drastically in the past several years. Electronic
databases and technology such as handheld computers have
changed the way pharmacists, technicians, and other health-
care professionals access and review drug information. Most
drug information previously disseminated in book form is
now delivered electronically by means of CD-ROM or the
Internet. The sheer volume of information has increased
dramatically. Weve included many sources of information
most used by pharmacists and technicians, but this list is
far from exhaustive. Due to the rapid development in the
pharmaceutical industry and the new uses of drugs already
on the market, drug references are revised constantly. Web
addresses also change frequently. If you have difficulty
accessing a Web address, try looking for it by using an
Internet search engine such as Google, Dogpile, or Ask.
iii
P
r
e
v
i
e
w
P
r
e
v
i
e
w
When you complete this study unit, youll be
able to
Explain the main types of reference information and
their sources
Discuss various delivery methods of drug information
available to pharmacists and technicians
List various drug information sources that may be
required by law to be present in a pharmacy
Identify various journals and newsletters available to
pharmacists and technicians
Describe the most referenced sources of drug informa-
tion used in pharmacy practice
Remember to regularly check My Courses on your student homepage.
Your instructor may post additional resources that you can access to
enhance your learning experience.
TYPES OF PROFESSIONAL PHARMACY
LITERATURE AND DELIVERY METHODS 1
Professional Literature 1
Delivery Methods 4
OFFICIAL COMPENDIA REQUIRED BY LAW IN
PHARMACIES 11
Introduction 11
State Board of Pharmacy Law Book 11
United States Pharmacopeia-National Formulary
(USP-NF) 12
United States Pharmacopeia Dispensing Information
(USP DI) 13
Drug Formulary 14
COMMON DRUG INFORMATION SOURCES 16
Introduction 16
American Hospital Formulary Service
Drug Information (AHFS DI) 16
Drug Facts & Comparisons 18
Handbook on Injectable Drugs 20
King Guide to Parenteral Admixtures 20
Hansten and Horns Drug Interactions Analysis
and Management 21
Martindale: The Complete Drug Reference 21
Drug Information Handbook (DIH) 21
Geriatric Dosage Handbook (GDH) 22
Pediatric Dosage Handbook (PDH) 22
The Merck Manual 23
American Drug Index 23
Handbook of Nonprescription Drugs 24
Physicians Desk Reference (PDR) 24
Modells Drugs in Current Use and New Drugs 25
Clinical Pharmacology 25
Medical Drug Reference 25
Red Book 26
Micromedex Computerized Clinical Information
System (CCIS) 26
Lexi-Comp ONLINE 27
Package Inserts 28
Manufacturers Advertising 28
PubMed 30
AHFS Consumer Medication Information 31
v
C
o
n
t
e
n
t
s
C
o
n
t
e
n
t
s
Contents
vi
Patient Drug Facts 31
DrugDigest 31
RxList 31
Drugs.com 32
DrugInfoNet.com 32
Medicinenet.com 32
MediLexicon 33
GlobalRPh.com 33
SELF-CHECK ANSWERS 35
1
TYPES OF PROFESSIONAL
PHARMACY LITERATURE AND
DELIVERY METHODS
Professional Literature
Primary Sources
Primary resources are original sources of information. This
information is the most current data from recent research.
These sources often include raw statistics and unevaluated
information. A primary source typically includes information
written by researchers documenting their clinical trials and
scientific studies (Figure 1). For example, Medscapes journal
Pharmacotherapy publishes original research reports on drug
interaction studies, clinical trials, investigations of specific
pharmacological properties of drugs, and related topics.
In addition to print-based primary pharmaceutical literature,
MEDLINE (Medical Literature Analysis and Retrieval System
Online) is an international literature database of life sciences
and biomedical information. It covers the fields of medicine,
nursing, pharmacy, dentistry, veterinary medicine, and
healthcare. Youll learn more about how to access articles
contained in the MEDLINE database later in this study unit.
Drug Information Sources
2
Secondary Sources
In general, secondary resources consist of descriptions,
analyses, interpretations, and summaries of primary sources.
Secondary sources also include specialty textbooks written by
subject matter experts that are reviewed by peers. Secondary
sources are often indices and abstracts that glean and
summarize published information from technical sources. For
example, the American Pharmaceutical Review reviews busi-
ness and technology for the pharmaceutical industry
throughout North America, covering topics such as drug
delivery, information technology, research and development,
equipment and facility manufacturing, and regulatory affairs.
FIGURE 1Documented
research statistics and results
are often presented in trade
journals.
3
Secondary sources often publish peer-reviewed articles in
journals such as The AAPS Journal, which is published by
the American Association of Pharmaceutical Scientists, or
The Journal of the American Pharmacists Association (JAPhA),
which is a peer-reviewed forum that includes original research
and experiences that link science to contemporary pharmacy
practice. Many secondary sources are available online and at
university and medical center libraries.
Tertiary Sources
Tertiary resources are references that are based on both
primary and secondary sources. Tertiary sources provide
summarized, condensed information for a quick reference
guide (Figure 2). MedlinePlus is an example of a tertiary
source of information that provides consumers with prescrip-
tion and over-the-counter (OTC) information in an easy-to-use
online format.
FIGURE 2MedlinePlus is a resource provided by the National Library of Medicine and the National
Institutes of Health.
4
Delivery Methods
Journals and Newsletters
The world of pharmacy is changing constantly. New drugs are
being developed and marketed nearly every day. Community,
institutional, and mail-order/Internet pharmacies are using
computer software applications and automated technologies
that increase productivity and efficiency. Pharmacists and
pharmacy technicians can stay abreast of the latest develop-
ments in computer and automated technology as well as new
drugs and new uses for existing drugs by reading pharmacy
trade journals. Many journals related to pharmacy have free
versions available online.
Formulary is a peer-reviewed journal for P & T committee
members and those with drug management responsibilities
at hospitals, HMOs and other managed care settings, PBM
companies, and within the VA (Veterans Affairs) system.
It covers formulary trends and practical information related
to evaluating drugs for the formulary and developing policies
and procedures for effective drug use.
Hospital Pharmacy is a peer-reviewed journal dedicated to the
promotion of safe medication practice and the prevention of
medication errors to optimize patient care provided by the
health-system pharmacist. It features drug and disease state
management, recent FDA approvals, medication error and
adverse-reaction reporting, automation, medical-usage
evaluation and governmental regulation related to practice in
hospitals, organized health systems, and nursing homes.
The American Journal of Health-System Pharmacy (AJHP) is a
semimonthly publication of the American Society of Health-
System Pharmacists. The AJHP provides reports on practice,
career development, and studies on drug therapy. A sub-
scription to the print version of AJHP and additional online
features are included as part of ASHP membership.
Pharmacy Times provides pharmacists and technicians with
practical everyday information related to patient education
and counseling, new products, pharmacy law, drug inter-
actions and safety, continuing education, and pharmacy news.
5
Pharmacy Today is a monthly medication therapy manage-
ment (MTM) magazine of the American Pharmacists Association.
Regular features include new approvals of selected Rx and
OTC items, in-depth coverage of newly approved chemical
entities, and practical OTC information.
Drug Topics is a bimonthly online news magazine covering
managed care trends, professional issues, national and state
governmental activities, new prescription drugs, and OTC
products, as well as retail management and store operations.
Drug Topics also includes health-system topics in the second
issue of each month. Drug Topics also has a helpful list of
online resources for pharmacists and technicians that
includes links to state, national, and international pharmacy
associations, pharmaceutical magazines, and government
and health agencies.
U.S. Pharmacist is a monthly journal offering peer-reviewed
clinical articles concerning pharmacy practice in community,
hospital, managed-care, home-care, and long-term care
settings, as well as pharmacy industry and academia.
U.S. Pharmacist provides information relevant to pharmacy
technicians, students, other health professionals interested
in health management.
Drug News Weekly delivers information on new-drug
approvals, indications, warnings, doseforms, and Rx-to-OTC
status switches via e-mail. It also includes summaries of per-
tinent journal articles and reviews pharmacy news in the
popular press to help keep pharmacists and technicians
abreast of patient concerns and questions.
Pharmacy Choice Newsletter is delivered online and covers
industry headlines, disease-focused articles, and continuing
education opportunities.
Pharmacists Letter is a monthly newsletter that pharmacists
and other healthcare professionals can subscribe to. Its
available in print, via the Internet, and for use on PDAs. The
Pharmacists Letter began in 1985, and is characterized by
very short, concise updates and advice. This is an independent
publication, and therefore provides objective unbiased data
and advice related to drug therapy. Within each letter, topics
are usually separated by either disease state or therapeutic
class. Each topic provides concise information, usually in the
6
form of a few short paragraphs. If you need more in-depth
information, each section gives reference to a Detail-Document,
that can be accessed online or mailed to the subscriber on
demand.
The Pharmacists Letter also puts out the Pharmacy
Technicians Letter. This publication is in the same format as
the Pharmacists Letter, but provides reliable recommendations
and practical help for pharmacy technicians. Each month,
the newsletter contains the CE-in-the-Letter, which allows
the practitioner to earn continuing education credit based on
that months articles.
Subscribers of both newsletters also have access to other
articles that provide additional CE credits. Both the
Pharmacists Letter and the Pharmacy Technicians Letter
Web sites allow access to many useful tables and charts,
along with a section titled Rumor vs. Truth, which covers
many common rumors and myths surrounding drug therapy.
Subscribers to either publication may also have access to
the Ident-a-Drug Reference and the Natural Medicines
Comprehensive Database. The Natural Medicines
Comprehensive Database provides objective information
on effectiveness, uses, and potential drug interactions of
natural medicines, such as herbal supplements.
The Medical Letter is another newsletter-type resource for phar-
macists and other healthcare professionals. The Medical Letter
was founded in 1959, and is divided into two separate publica-
tions: The Medical Letter on Drugs and Therapeutics (known as
The Medical Letter) and Treatment Guidelines from the Medical
Letter (known as Treatment Guidelines).
The Medical Letter is published every other week as a four-page
newsletter. It offers unbiased critical evaluations of drugs
(especially new drugs), in terms of effectiveness, toxicity, cost,
and possible alternatives. The Medical Letter also reviews older
drugs when theres important new information available. It
differs from the Pharmacists Letter in that it provides a bit
more detail with respect to clinical studies and their outcomes,
where the Pharmacists Letter mainly offers summaries.
7
Treatment Guidelines is published once a month in a newsletter
format. This publication offers review articles of drug classes
for treatment of common disorders. Issues contain recom-
mendations on first choice and alternative therapies for a
given condition, along with considerations for effectiveness,
cost, and safety.
Books
Several major drug information (DI) references have been in
print for many years. Although many are now available in
various electronic formats, most are still printed as either
hardbound books or loose-leaf pages to be kept in a binder.
The loose-leaf editions are often updated several times each
year. Textbooks are also a good source of reference material
and often have ancillary material available online from the
publisher. In addition, medical dictionaries, drug guides, and
language translations are useful additions to your bookshelf.
Many books related to drug information, pharmacy operations,
and legal issues are available at university and medical center
libraries (Figure 3).
FIGURE 3Most states require pharmacies to have certain professional
literature available, including applicable legal references.
8
Desktop Computers
At one time, information was passed among pharmacists by
word of mouth or handwritten notes. For years, pharmacies
relied on volumes of books containing drug-related informa-
tion. Today, with so many drugs on the market and so much
material available about each drug, information is produced,
stored, and delivered by computer.
Pharmacies rely on software applications to view formularies,
drug monographs, and legal issues related to pharmacy. Staff
members can access this information on CD-ROMs or online
using desktop computers. Later in this study unit, youll
learn about many drug references that are delivered in print,
online, and by CD-ROM.
Personal Digital Assistants (PDAs)
Handheld and palm-sized computers, known as personal
digital assistants, or PDAs for short, have become a main-
stay for the medical community. Theyre small, easy-to-use
computers that can store information and access the
Internet. Using PDAs, physicians and pharmacists can access
drug databases to instantly get current drug information,
such as warnings, drug/food interactions, side effects, and
dosing (Figure 4). Most drug information available in print is
also available electronically for PDAs.
Many software applications for drug formularies and drug
information are available from sources such as Epocrates,
Skyscape, Micromedex, and Lexi-Comp.
9
FIGURE 4Many medical professionals rely on PDAs to access the most
current drug information available.
Health on the NetHONcode Accreditation
Whenever youre looking for drug information on the Internet, its important to make sure
youre getting accurate information. Many Web sites that at first appear to be giving good infor-
mation turn out to be nothing more than advertisements. One thing you can look for is the logo
from Health on the Net Foundation, or HON. HON was created for improving the quality of med-
ical and health information available to both patients and healthcare professionals. In order for
Web sites to be HONcode accredited, there are specific criteria that the Web site must meet and
maintain, including whether medical advice is being given by a medical professional. Becoming
HONcode accredited is a voluntary process, so not all Web sites will display the logo. However,
if you do see the logo, you can be sure that you are getting accurate, trustworthy information.
10
Self-Check 1
At the end of each section of Drug Information Sources, youll be asked to pause and check
your understanding of what youve just read by completing a Self-Check exercise.
Answering these questions will help you review what youve studied so far. Please
complete Self-Check 1 now.
15: Indicate whether the following statements are True or False.
______ 1. Due to time constraints, desktop computers are rarely used by community pharmacists
and technicians to access drug information such as formularies.
______ 2. Epocrates provides drug-related software for PDAs.
______ 3. Pharmacy technicians can stay abreast of the latest computer applications and auto-
mated technology by reading journals and newsletters.
______ 4. Primary sources are often analyses of secondary sources.
______ 5. Drug Topics is a helpful weekly online magazine for pharmacists and technicians.
Check your answers with those on page 35.
11
OFFICIAL COMPENDIA
REQUIRED BY LAW IN
PHARMACIES
Introduction
There are several legal reference books commonly found in
any pharmacy in the United States. Which legal references
are required in pharmacies varies from state to state.
Pharmacists should check their states statutes and rules
and regulations for the specific compendia they need to
have on shelf to comply with the law. A compendium is a
condensed summary or list compiling information about a
particular field of knowledge.
There are no federal laws governing what professional
literature needs to be maintained in a pharmacy. However, as
you learned previously, OSHA requires that MSDS (Material
Safety Data Sheets) be kept on hand for chemicals used and
stored in the pharmacy.
In addition, you should always remember that the federal
government requires all pharmacies to adhere to HIPAA pri-
vacy standards as found in the HIPAA Privacy Standards: A
Compliance Manual for Pharmacies.
Lets look at the legal references available to pharmacies
concerning issues related to the manufacturing, handling,
and distribution of all drugs found in the pharmacy.
State Board of Pharmacy Law Book
Every state in the United States has a board of pharmacy to
oversee pharmacy practice and create laws to ensure public
safety. Every pharmacy is required to have a copy of the state
law book, which usually contains the federal laws as well.
This reference lists all requirements for pharmacy technicians
practicing in that state.
12
United States Pharmacopeia-National
Formulary (USP-NF)
In the past, the United States Pharmacopeia (USP) and the
National Formulary (NF) were separate books. However,
they were combined in 1980 to become The United States
Pharmacopeia-National Formulary (USP-NF). Today, the
USP-NF is available in print, on CD, and online at
www.usp.org. The U.S. Federal Food, Drug, and Cosmetic
Act designates the USP-NF as the official compendia for
drugs manufactured and marketed in the United States.
The USP-NF includes monographs for drug substances and
preparations, as well as monographs for dietary supplements
and ingredients (Figure 5).
Traditionally, the USP-NF was a required reference in every
pharmacy. Today, however, some states are allowing flexibility
in the selection of titles and available references to meet the
needs of individual practices.
FIGURE 5The USP-NF is available in an easy-to-navigate online presentation.
13
United States Pharmacopeia
Dispensing Information (USP DI)
Some states allow The United States Pharmacopeia Dispensing
Information (USP DI) to be used in place of the USP-NF. The
USP DI is produced by Thomson Healthcare as three separate
bodies of work. Many states have adopted it as a required
reference in pharmacies.
The USP DI contains
DrugPoints, formerly the USP DI, Volume I, Drug
Information for the Health Care Professional
USP DI, Volume II, Advice for the Patient
USP DI, Volume III, Approved Drug Products and Legal
Requirements
DrugPoints provides comparable drug information to Drug
Information for the Health Care Professional, plus black box
warnings, images, and a new toxicology section. Primarily
used by healthcare professionals, DrugPoints includes
summary information on dosing, drug interactions, adverse
effects, pregnancy warnings, indications, cautions, therapeutic
classes, and brand information.
Advice for the Patient, the second USP DI volume, is intended
for patient education. The monographs are written in lay
language to make them easy to understand. The material in
this section is available through MicroMedex Healthcare
Series or in print.
The United States Pharmacopeia Drug Information (USP DI)
Volume III: Approved Drug Products and Legal Requirements
contains the national standard for products made in the
United States as well as state and federal laws related to the
manufacturing and dispensing of medicines. Excerpts on
quality, packaging, storage, and labeling requirements are
included from the USP-NF. The USP DI Volume III contains the
complete FDA Orange Book. Pharmacists and technicians can
review a drugs chemical properties, find out if a drug has been
discontinued, and choose a generic substitute for a brand name
drug. The USP DI Volume III is a comprehensive source for
guidelines and laws governing the safe handling and distribu-
tion of drugs and is available only in print.
A black box warning
indicates that medical
studies have deter-
mined that the drug
carries a significant
risk of serious or even
life-threatening
adverse effects.
14
Drug Formulary
As you learned previously, a drug formulary is a source of drug
information for ambulatory, institutional, and managed-care
organizations. It includes policies and procedures concerning
drugs, a list of drug products, and special information. Some
drug formularies are more comprehensive and include infor-
mation on dosing, precautions, special drug substitutions,
dosage forms in stock, and side effects.
Formularies today are stored and viewed electronically via
desktop computers and handheld devices using formulary
software applications.
15
Self-Check 2
______ 1. The USP-NF contains information on U.S. standards for drugs.
______ 2. A drug formulary is a list of drugs that have been deemed unacceptable for use by an
authoritative group.
______ 3. The second volume of the USP DI contains drug information as a patient reference.
______ 4. DrugPoints was formerly Volume III of the USP DI.
16
COMMON DRUG INFORMATION
SOURCES
Introduction
A quick look on the Internet using a search engine will reveal
hundreds of sources of drug information. Here weve included
those sources most useful to the pharmacist and technician,
as well as a sample of sources meant to aid the consumer.
American Hospital Formulary Service
Drug Information (AHFS DI)
American Hospital Formulary Service Drug Information
(AHFS DI), produced by the American Society of Health
System Pharmacists, is an authoritative source of drug infor-
mation. It was first published in 1959 as the Big Red Book
and is still known by that name. Its monographs are grouped
by therapeutic category using the AHFS classification system.
They contain information on use, drug interactions, toxicity,
cautions, dosing, stability, pharmacology, and pharmaco-
kinetics, which is the study of the rate of movement of a drug
in a body system. Theres also a section on investigational
drugs that are not FDA-approved for use in the United States.
The AHSP also produces the AHFS Handbook, a concise guide
for pharmacists and pharmacy technicians.
AHSP is partnered with several formulary hosting services
that provide hospital pharmacists and technicians access to
the hospitals formulary as well as AHFS DI drug references
via a handheld device or desktop computer. Skyscapes
SmARTlink technology is one of several providers of electronic
access to AHFS DI. Refer to Figures 68 to view typical drug
information as you would while working in a pharmacy.
Figure 6 shows the Skyscape trial versions table of contents
for AHFS DI material.
17
Figure 7 shows part of the information displayed under
Uses for the drug Lovastatin. Figure 8 shows Lovastatin
Preparations.
FIGURE 6Heres the
table of contents for a
section of AHFS DI
displayed via Skyscape.
18
Drug Facts & Comparisons
Drug Facts & Comparisons is available in two print versions:
one is bound and doesnt provide updates until the next edi-
tion; the other is a loose-leaf edition with monthly updates.
The book is organized by drug class, and it compares drugs
within the groups using text, charts, and tables. This source is
available in most pharmacies and is often consulted for brand
and generic name, dose, and use information. Facts and
comparisons are also provided for such items as IV solutions,
investigational chemotherapeutic drugs, and combination
cancer chemotherapy regimens. Most of the information is
the same as that found in package inserts, but its rearranged
in an easier-to-read format.
FIGURE 7Heres a
portion of the Uses for
Lovastatin in the AHFS DI
displayed via Skyscape.
19
Drug Facts and Comparisons is available online and on CD.
It contains a list of manufacturers, plus comprehensive infor-
mation on both Rx and OTC items grouped by therapeutic
category for ease of comparison. Drug Facts and Comparisons
also produces A2zDrugs (a drug guide with the latest FDA
approvals, indications, dosages, side effects, and patient care
considerations) and iFacts (information on drug interactions).
Also included with Drug Facts and Comparisons is MedFacts
Patient Information, Review of Natural Products, Herbal
Interaction Facts, and Off-Label Drug Facts. You can see from
these various available sections that much information can be
gained from Drug Facts and Comparisons. The Web site also
includes a section on drug identification. Often, patients will
call the pharmacy asking to identify an unknown pill based on
shape, color, and markings. This program helps to identify pills
based on the information entered.
FIGURE 8Heres a
portion of the Lovastatin
Preparation section in
the AHFS DI displayed via
Skyscape.
20
Handbook on Injectable Drugs
The Handbook on Injectable Drugs, produced by ASHP, provides
information on injectable medications in a collection of mono-
graphs. Each monograph contains information on
concentration, dosage, administration rates, stability, and
compatibility in various solutions or when combined with
other drugs.
This reference is available on CD and for download to a PDA.
Its commonly found in hospital pharmacies, as well as other
settings where injectable drugs are prepared (such as home
IV services or community pharmacies). You may also hear
this reference referred to as Trissels, after the author
Lawrence A. Trissel.
King Guide to Parenteral Admixtures
The King Guide to Parenteral Admixtures is available in hard
cover, loose-leaf editions updated quarterly and via the
Internet and CD, which can be used on an individual com-
puter or on a hospital-wide network (Figure 9). The King
FIGURE 9The King Guide to Parenteral Admixtures is available online.
21
Guide features more than 450 injectable drug monographs,
with information on the routes, dosages, temperatures, and
containers used to determine compatibility and stability.
Hansten and Horns Drug Interactions
Analysis and Management
Hansten and Horns Drug Interactions Analysis and
Management explains the possible drug interactions and
choices to consider for patients receiving a combination of
drugs. Each monograph contains a summary, risk factors,
related drugs, management options, and references. It pro-
vides information to reduce the risk to a patient by switching
medicines or watching the patient carefully. This work is
published in loose-leaf format thats updated quarterly and
also in a bound edition. Hansten and Horns Top 100 Drug
Interactions contains nearly 3400 interactions in 137 mono-
graphs and continues to list potentially important herb-drug
interactions.
Martindale: The Complete Drug
Reference
Travelers around the world bring unfamiliar medications and
remedies with them. Pharmacists in tourist and high-travel
areas often use Martindale: The Complete Drug Reference
published by the Pharmaceutical Press in London. This
comprehensive reference provides encyclopedic information
on 6300 drug monographs, 150,000 products, 14,700 manu-
facturers, 660 disease reviews, and 40,700 references. It
provides the best worldwide drug coverage including prepara-
tions used in 37 nations around the world. Providing extensive
information on drugs in clinical use worldwide, it provides
therapeutic data, synonyms, and manufacturer brand names.
The electronic version of Martindale: The Complete Drug
Reference is available in English and Spanish by Thomson
Micromedex.
22
Drug Information Handbook (DIH)
The Drug Information Handbook (DIH) by Lexi-Comp, Inc., is
published in cooperation with the American Pharmacists
Association (APhA). It contains over 1400 monographs,
including 30 new drugs and U.S. black box warnings.
Each monograph includes nearly 33 fields of information,
with detailed content on dosage, drug interactions, and
adverse reactions. The appendix includes hundreds of charts
and reviews of therapy recommendations and treament guide-
lines. Lexi-Comp also publishes the Drug Information Handbook
with International Trade Names Index that includes Canadian
and international entries.
The Lexi-Comp line of databases is also available to sub-
scribers online (which well discuss later), on CD, and for
handheld PDAs. Many practitioners use the Lexi-Comp
software on their PDAs because its easy to navigate.
In addition to the geriatric and pediatric handbooks described
next, Lexi-Comp also produces handbooks on topics including
Oncology
Anesthesiology and critical care
Psychiatry
Allied health
Geriatric Dosage Handbook (GDH)
The Geriatric Dosage Handbook (GDH) by Lexi-Comp, contains
information for medications used for elderly patients. The
monographs give geriatric dosing information and monitoring.
It also cover side effects and provides specific considerations
when using drug therapy in older adults, which have been
compiled from current literature and clinical experience.
Pediatric Dosage Handbook (PDH)
The Pediatric Dosage Handbook (PDH) also by Lexi-Comp,
contains medications used in pediatric patients. Dosing infor-
mation is provided for ages from neonate to adult. The drug
23
monographs are cross-indexed and arranged alphabetically
by brand and generic names. Tables, charts, graphs, and
recommendations are found at the back of the book. The
PDH is also updated annually.
The Merck Manual
The Merck Manual gives brief descriptions of disease conditions
and treatments and includes topics such as critical care
medicine, biological warfare and terrorism, SARS, and small-
pox. The primary users of this reference are physicians.
However, its also a very useful source for pharmacists who
want to better understand diseases and treatment. The Merck
Manuals are a series of healthcare books with content avail-
able online as part of the Merck Manuals Online Medical
Library, which is updated periodically with new information,
and contains photographs, and audio and video material not
present in the print versions. In addition, the Merck Index,
which contains more than 10,000 monographs, 32 supple-
mental tables, and a companion CD, is available online by
subscription.
American Drug Index
The American Drug Index is an exhaustive alphabetical list
of generic, brand, and chemical names. Brand name listings
include the manufacturer, dosage form, package size, and
use. It includes common abbreviations used in medical
orders or prescriptions, conversion equivalents for dose cal-
culations, normal laboratory values, a glossary, a list of oral
dosage forms that shouldnt be crushed, and a list of pharma-
ceutical companies with NDC numbers and addresses. As you
learned previously, NDC numbers are unique 11-character
codes that numerically identify all prescription medicines. The
first five digits identify the manufacturer, the next four digits
identify the product (dosage form and strength), and the last
24
two digits identify the package type or size (for example, 10 or
30 tablets). Updated annually, the latest American Drug Index
includes appendices on cancer chemotherapy regimens, as
well as new and discounted drugs.
Handbook of Nonprescription Drugs
The Handbook of Nonprescription Drugs: An Interactive Approach
to Self-Care, organized by body systems, provides information
on nonprescription drug pharmacotherapy, nutritional supple-
ments, medical foods, nondrug and preventive measures, and
complementary and alternative therapies. The handbook also
contains FDA pregnancy and lactation risk categories for
selected nonprescription products and herbs. The index lists
generic and trade names of nonprescription products and
dietary supplements. With purchase of the printed version,
buyers can download a fully seachable electronic version.
Physicians Desk Reference (PDR)
The Physicians Desk Reference (PDR) contains only informa-
tion that has been approved by the FDA, as found in the
product package inserts. This book is widely accepted in
healthcare fields, though it promotes only those products
selected for inclusion by the manufacturer. For this reason, its
important to note that the PDR isnt an exhaustive resource,
though many practitioners are under the misconception that it
is. Running more than 3,000 pages, it contains brand and
generic names, manufacturers, and product categories of
more than 4,000 drugs. In addition, it provides usage infor-
mation, warnings, and drug interactions. Thomson, the
publisher of the PDR line of products also offers a Concise
Guide for Pharmacists. There are several additional PDR prod-
ucts
covering topics such as
Herbal medicines
Terrorism response
Dietary supplements
Pediatrics
25
Mental health
Opthalmic medicines
Drug interactions, side effects, and indications
Modells Drugs in Current Use and New
Drugs
Published for more than 50 years, Modells Drugs in Current
Use and New Drugs is an annually updated drug reference
that provides brief information on the years new drugs and
on medications in current use. The compact format makes it
an alternative to the large drug reference volumes. It includes
a glossary listing the common side effects of the drugs.
Modells gives special attention to new drugs with expanded
patient care implications for nurses and other allied health
professionals.
Clinical Pharmacology
Clinical Pharmacology, produced by Gold Standard, provides
current, peer-reviewed information on all U.S. prescription
drugs, as well as off-label uses and dosage, herbal supple-
ments, nutritional and over-the-counter products, and new
and investigational drugs. It includes monographs, overviews
of many therapeutic drug classes, customizable tables to
compare drugs by indications, contraindications, interactions,
and adverse reactions. It also provides patient medication
safety education with OBRA-compliant drug information
handouts in English or Spanish. Written specifically for the
electronic environment, Clinical Pharmacology is available
online for desktop computers and PDAs. It can also be set up
to use via an intranet and is available on CD.
26
Medical Drug Reference
The Medical Drug Reference by Mosby includes pertinent drug
information for the most commonly dispensed drugsmore
than 850 generic and 2800 trade drugsincluding nonFDA-
approved uses. Comparative drug tables aid in the selection
of the best medicinal therapy for patients. A therapeutic index
helps to quickly locate all potential therapies for a specific
condition. Software is included to provide access to the entire
reference on a PDA.
Red Book
Redbook: Pharmacys Fundamental Reference (referred to as
the Drug Topics Red Book) is produced by Medical Economics,
a division of Thomson Healthcare. The Red Book provides
nationally recognized average wholesale prices (AWPs), direct
prices, and federal upper limit prices for prescription drugs,
as well as suggested retail prices for OTC products. In addi-
tion, the Red Book lists NDC numbers for all FDA-approved
drugs and complete package information including dosage
form, route of administration, strength, and size.
Pharmacists and technicians can refer to the Red Book for
summaries of drug/food, drug/alcohol, and drug/tobacco
interactions, as well as sugar-free, alcohol-free, lactose- and
galactose-free, and sulfite-containing product listings.
The Red Book contains comprehensive manufacturer, pharma-
ceutical wholesaler, and third-party administrator directories.
Its vitamin comparison table shows the amounts of vitamins and
minerals in more than 50 popular multivitamin products.
The Red Book also contains a guide to leading alternative
medicines and a controlled substance inventory sheet.
The Red Book is available in a single annual print version, a
print version with monthly or quarterly updates, as well as
on CD. A subscription to the Redbook Update keeps you
abreast of pricing changes on top-volume prescription and
OTC products.
27
Micromedex Computerized Clinical
Information System (CCIS)
In addition to the products mentioned previously, Micromedex
has several electronic systems for the pharmacy, including
DRUGDEX, which covers FDA-approved and investiga-
tional prescription and nonprescription drugs, as well
as non-U.S. preparations. It includes dosage, cautions,
interactions, clinical applications, adverse effects, com-
parative efficacy, and orphan drug status.
Index Nominum, Micromedexs international guide to
drugs from 133 countries
Thomson Clinical Xpert, formerly mobileMICROMEDEX,
a PDA DI software
DRUG-REAX, an aid to identifying drug interactions and
minimizing adverse events
IV INDEX, which includes more than 50,000 compatibility
results and 600 drugs and solutions for IV infusions
Formulary Advisor, used to help manage a hospitals for-
mulary and provide access to formulary information
throughout a facility. Formulary Advisor is accessible via
desktop PCs and handheld computers.
IDENTIDEX, which helps with identifying unknown tablets
and capsules based on description.
Lexi-Comp ONLINE
In addition to the many print-based items weve discussed,
Lexi-Comp provides Lexi-Comp ONLINE, which provides real-
time drug information (including AHFS DI in hospital settings)
via a network system in both hospital and retail settings.
Lexi-Comp ONLINE includes
Lexi-Interact, which is a complete drug and herbal inter-
action analysis program
28
Lexi-Drug ID, which allows for the identification of
unknown tablets or capsules
Web Search, which is a tool that allows Lexi-Comp
online users to search other medically based web sites
Patient Care Module, which allows the user to access
and print patient-focused information leaflets on condi-
tions, procedures, and medications
I.V. Compatibility, which allows access to the King Guide
to Parenteral Admixtures homepage
Lexi-CALC, which is a comprehensive medical calculations
application
Package Inserts
The United States Package Insert, usually referred to as simply
the package insert, or PI, is a summary of a product and
contains the information needed to safely prescribe the med-
ication. The information found in the PI has been reviewed by
the FDA. A copy of the PI comes with every package of the
product. It provides general information on dosing, use, side
effects, precautions, pharmacology, mechanism of action (how
it works), contraindications, and warnings.
One drawback of the PI is that although products can be pre-
scribed for other uses, the PI reflects only uses and doses
approved by the FDA. However, information to support these
uses is often available in other sources. Many pharmacists
would like to see a real-time electronic package insert (ePI)
or prescribing information (PI) that would reflect the most
current information available from the manufacturer.
Manufacturers Advertising
The pharmaceutical industry advertises to increase awareness
of its products. Advertising can take many forms, from a
national television commercial to print ads in weekly consumer
magazines, daily newspapers, and professional journals.
29
In addition, drug companies often devote entire Web sites
to marketing the individual drugs they produce. All claims
made in advertisements must be supported with data. Many
U.S. drug companies also have sister Web sites for drugs
they produce that are sold outside the United States.
Drug sites are often designed with a dual format: one for the
health professional and one for the patient or caregiver.
Pharmacists and technicians can get detailed prescribing
information (PI) as provided in the package insert. Lets look
again at Lescol XL, the cholesterol-lowering drug whose pack-
age insert is shown in Figure 10. Norvartis, the manufacturer of
Lescol XL, has developed a Web site that provides information
for both the patient and the healthcare professional (Figure 10).
FIGURE 10Pharmacists and technicians can access prescribing information on the Lescol XL Web site.
30
NOTES
PubMed
Earlier, we discussed primary sources of information. One
such primary source that includes pharmacy information is
MEDLINE. Compiled by the U.S. National Library of Medicine
(NLM), MEDLINE is available on the Internet and searchable
via PubMed. Its offered by the NLM at the National Institutes
of Health as part of the Entrez information retrieval system.
It gives access to more than 5,000 journals published in the
United States and more than 80 other countries primarily
from 1950 to the present. NLM provides and maintains this
Web site for public use and regularly processes data files
uploaded from the FDAs system. Additional information
about medicines is available on NLMs MedlinePlus Web site.
You can also try PubMed Reader/MEDLINE Reader, which
is a free Web-based research program thats used to display
PubMed/MEDLINE search results on an individual basis.
AHFS Consumer Medication
Information
AHFS Consumer Medication Information is a software pack-
age for patient drug information education produced by the
ASHP. It helps pharmacists give accurate information and
advice to patients by allowing pharmacists to customize
more than 800 monographs in English and Spanish in
easy-to-understand language. The software is available in
single-user and network versions.
Patient Drug Facts
Patient Drug Facts is a professionals guide to face-to-face
patient counseling. It covers the most commonly prescribed
drugs listed by generic and brand name, organized by thera-
peutic category. It includes easy-to-understand discussions
on drug usage, precautions, side effects, and food and drug
interactions. Its purpose is to aid the pharmacist or health-
care professional in communicating important drug
information to patients.
31
32
DrugDigest
DrugDigest is a drug information site for consumers. It reviews
drugs, vitamins, herbs, and supplements. It also provides
drug images and instructions on using medications correctly.
DrugDigest is offered by Express Scripts, a pharmacy benefit
manager for employers, managed-care plans, unions, and
government entities.
RxList
RxList.com is owned and operated by WebMD and is part of
the WebMD network. RxList is an online medical resource
that offers detailed and current pharmaceutical information
on brand and generic drugs. RxList information on medica-
tions can be found using the Drugs AZ list (an alphabetical
listing of both brand and generic drug names) or by entering
the generic or brand drug name in the sites search box.
RxList also lists the top 200 dispensed drugs, new drugs, and
recent drug updates, as well as relevant articles written by
pharmacists and physicians. It also has a pill identifier sec-
tion and a section on diseases and conditions provided by
eMedicineHealth.
Drugs.com
Drugs.com is the a popular Web site for both consumers and
professionals. It provides information on more than 24,000
prescription drugs and over-the-counter medicines. Users
can search for drugs and medications, as well as diseases or
conditions and the drugs used to treat them. Drug.com also
presents pharmaceutical news, FDA updates, and new drug
applications and approvals. Other features include a drug
interactions checker, medical encylopedia, medical dictionary,
and community forums.
33
DrugInfoNet.com
DrugInfonet.com is a consumer resource that provides links to
both official package inserts and patient package inserts. The
official inserts provide information on pharmaceuticals for
health professionals and consumers, available by brand and
generic names, manufacturer, and therapeutic class. The
patient package inserts provide easy-to-understand informa-
tion from the manufacturers. DrugInfoNet.com also provides
consumers with information on various disease states.
Medicinenet.com
Medicinenet.com provides consumers with medical informa-
tion under headings such as Diseases & Conditions,
Symptoms & Signs, Procedures & Tests, and Health & Living.
It also contains a searchable medications database of more
than 2500 drugs. This online reference site provides more
than 16,000 entries in its MedTerm dictionary.
MediLexicon
MediLexicon is a vast online database of pharmaceutical and
medical abbreviations thats updated daily to include acronyms
and abbreviations related to medicine, pharmacy, healthcare,
biotechnology, and agrochemicals. MediLexicon also includes
a searchable database of pharmaceutical companies, medical
associations, and hospitals. It also includes a vast medical
dictionary, insurance codes, and a drug search feature that
utilizes the Drugs.com database.
GlobalRPh.com
GlobalRPh.com is a Web site that has a great array of infor-
mation. This site features abbreviations, drug calculators,
drug tables, and a medical dictionary among other things.
This site also offers video presentations on many health
topics. GlobalRPh.com is a free site that currently doesnt
require a login or subscription to use.
34
Self-Check 3
______ 1. The PDR provides complete drug information for all products available in the United
States.
______ 2. The Handbook on Injectable Drugs is used to find information on drug stability and
administration rates for products given intravenously.
______ 3. The Merck Manual gives information concerning diseases and treatments.
______ 4. MEDLINE is a database produced by the National Library of Medicine.
______ 5. DRUGDEX is a module developed by Micromedex thats used to look up information to
treat poisonings.
______ 6. Pharmaceutical companies generally dont need to advertise their products.
35
A
n
s
w
e
r
s
A
n
s
w
e
r
s
Self-Check 1
1. False
2. True
3. True
4. False
5. False
Self-Check 2
1. True
2. False
3. True
4. False
Self-Check 3
1. False
2. True
3. True
4. True
5. False
6. False

Drug Sources and Information Book

Hochgeladen von

Dokumentinformationen

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Drug Sources and Information Book

Hochgeladen von

Copyright:

Verfügbare Formate

Study Unit

Das könnte Ihnen auch gefallen