Drug Information Resources and

Literature Search Strategies

Sandra R. Bai, PharmD

PGY-1 Regulatory Pharmaceutical Fellow in Drug Information
Purdue 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

FORMAL

INFORMAL

Hospital pharmacies

Gym

Community pharmacies

Dinner table

Ambulatory Clinics

Places of worship

Managed Care

Off-duty

Pharmaceutical Industry

Anywhere friends/family/coworkers
can reach you

Public Health

Finding Resources
General Purdue Library
https://www.lib.purdue.edu/
Databases
Change All Subjects to Medicine and Health

Finding Resources
Pharmacy, Nursing, and Health Sciences Library
https://www.lib.purdue.edu/libraries/pnhs
Drug Information Resources

Finding Resources
E- Text (Access Pharmacy, Lipincott Health Library)
Pharmacy.purdue.edu
Current Students Resources Health Library Access
Log In
Textbook access through Access Pharmacy (e.g. DiPiro, Drug Information Textbook)

Selecting References

Selecting References

Be the change you wish to

see in the world
-Mahatma Gandhi
(allegedly)

Selecting References

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

Selecting References
Tertiary
Literature
Secondary
Literature

Primary
Literature

Appropriate References

Selecting References Factors

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?
A. ATLAS, a randomized trial
B. Drug Information: A Guide for Pharmacists, 5e
C. Google Scholar
D. PubMed

Tertiary Resources
Information that has been summarized to provide an

overview of a topic
Examples
Textbooks

Compendia
Treatment Guidelines
Internet Websites
Review Articles

Tertiary Resources
Advantages of Tertiary Resources
Comprehensive information from a variety of sources
Citations to primary and secondary sources
Fast, easy to use

Disadvantages of Tertiary Resources

Older, less current information
Not sure if authors looked at the right sources
Bias/lack of expertise

Drug Information: A Guide for Pharmacists, 5e, Table 3-1

Secondary Resources
References that index or abstract primary literature
Indexing: Providing the citation
Abstracting: Providing the citation and a brief description
(abstract)

Secondary Resources
Examples:
Medline (free access via PubMed)
EMBASE
Google Scholar
International Pharmaceutical Abstracts (IPA)
Cochrane Library
CINAHL
Advantages of Secondary Literature
Easily accessible
Directs to primary literature
Disadvantages of Secondary Literature
Index terms
Non-uniformity
Cost

Secondary Literature
Search Terminology
Medical Subject Headings (MeSH)
United States Adopted Name (USAN)
International Classification of Diseases (ICD)

Boolean Operators

Additional Search Tools

Limits
Filters

MeSH Terms

MeSH Terms

MeSH Terms

MeSH Terms

MeSH Terms

PubMed Tutorials

i>Clicker Question #2
Which of the following Boolean operators is
matched appropriately with its effect on the
literature search
A. Using AND will broaden the number of results
B. Using OR will increase the number of results
C. Using NOT will increase the number of results
D. Using OR will narrow the number of results

Primary Literature
Clinical research studies and reports (published or

unpublished)
Examples:

Controlled trials
Cohort studies
Case Series
Case Reports

Advantages of Primary Literature

Detailed information
Self-evaluation
Most recent
Disadvantages of Primary Literature
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

Categorizing Questions
Adverse Effects

Identification

Availability

Nomenclature

Compatibility/Stability

Pharmacokinetics

Compounding

General Drug Information

Dosing/Administration

Poisoning/Toxicology

Drug Interaction

Pregnancy/Lactation

Herbal

Therapeutic Use

What is the mechanism of action of

prednisone?

General Drug Information

American Hospital Formulary Service (AHFS)

Drug Information
Clinical Pharmacology
Facts and Comparisons
Drug Information Handbook (LexiComp)
Micromedex
Physicians Desk Reference (PDR)
Pharmacists Letter
National Library of Medicine (NLM)
Drug Information Portal

Package inserts (DailyMed)

What are common side effects

associated with Januvia (sitagliptin)

Category: Adverse Events

General Drug Information References
Package Inserts
Drug-Induced Diseases: Prevention, Detection, and

Management
Meylers Side Effects of Drugs

What are signs/symptoms of

hypothyroidism?

Disease information

Harrisons Principles of Internal Medicine

DiPiros Pharmacotherapy
Merck Manual
Washington 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

Pediatric Pharmacist:

Diuril 50 mg/mL oral suspension is

on manufacturer backorder. Will you
please look up an appropriate
formula for compounding?

Pharmacy intern:
Sure! Thanks to Dr. Bai, I know
exactly where to look.

Compounding

Compounding
Remingtons The Science and Practice of Pharmacy
Trissels Stability of Compounded Formulations
Allens Compounded Formulations

Merck Index
United States Pharmacopeia National Formulary (USP-NF)
International Journal of Pharmaceutical Compounding
bimonthly publication

A patient calls your pharmacy:

Ive 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
Hansten and Horns Drug

Interaction Analysis and

Management
Drug Interaction Facts
DRUG-REAX
Evaluations of Drug Interactions
Drug Therapy Monitoring System
(MediSpan)
Stockleys 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
Nelsons Textbook of Pediatrics
Pediatric Dosage Handbook
The Harriet Lane Handbook
Neofax
The Teddy Bear Book (Pediatric

Injectable Drugs)
ASHPs Pediatric Injectable
Drugs

You are a contractor at CDC working on a public health

initiative regarding falls prevention.

Where can you find a list of drugs that

may contribute to falls in elderly patients?

Geriatric Information
Merck Manual of Geriatrics

FDA Medicines and You: A

Guide for Older Adults

Geriatric Dosage Handbook
American Geriatric Society

You are developing a drug monograph while on an

international APPE rotation.

What are brand names of pirfenidone

and N-acetylcysteine in Spanish?

International References
Martindales The Complete Drug

Reference
Index Nominum International Drug
Directory
USP Dictionary of United States
Adopted Names (USAN) and
International Drug Names
Diccionario de Especialidades
Farmacuticas (Spanish print)
Drugs.com International Drug
Names
Country Specific
Australia
Canada
United Kingdom
Asia

New Zealand
South Africa

Im running propofol on my patient

who is also receiving a vancomycin
infusion. Are the two compatible?

Compatibility / Stability
Trissels Handbook on

Injectable Drugs
Trissels 2 Clinical

Pharmaceutics Database
Trissels Stability of

Compounded
Formulations
King Guide to Parenteral

Admixtures

I have terrible migraines. Is there

something I can take over-the-counter to
treat them?

Over-The-Counter
Handbook of

Nonprescription Drugs
Nonprescription Product

Therapeutics
Physicians Desk

Reference

What 3 drugs are considered appropriate

to use for treatment of hypertension in a
pregnant patient?

Pregnancy and Lactation

Briggs Drugs in Pregnancy and Lactation
Hales Medications and Mothers Milk
Breastfeeding: A Guide for the Medical

Profession
Catalog of Teratogenic Agents
American Academy of Pediatrics
DRUGDEX
NLM LactMed
CDC: Medications and Pregnancy

Pricing
Red Book

provided online through Micromedex RED BOOK Online

LexiComp (Medi-Span)

A father finds a packet of pills in his sons

laundry basket. He calls the local poison
center for help identifying them.
Shape: Round
Color: Blue
Imprint: DP
Imprint: 10

Drug Identification
IDENTIDEX (via

Micromedex)
Lexi-Drug ID
Facts and Comparisons
Ident-A-Drug
Clinical Pharmacology
Drugs.com Pill Identifier
NLM PillBox

A college student enters your pharmacy:

Is it safe to take Echinacea for my cold?

Is it going to help me feel healthy in time
for my final?

Dietary Supplements and Natural Products

Natural Medicines
Natural Medicines Comprehensive
Database
Natural Standard
Review of Natural Products
PDR for Herbal Medicines
USP

Manufacturer Information
Facts and Comparisons
American Drug Index
DRUGDEX (via Micromedex)
Red Book
PDR

Manufacturers website

Veterinary
Compendium of Veterinary

Veterinary Drug Handbook

Products
Textbook of Veterinary Internal
Medicine: Diseases of the Dog
and Cat

Food and Drug

Administration - Center for
Veterinary Medicine

As a pharmacy resident, you are asked to

monitor serum levels for all patients on
aminoglycosides.

Pharmacokinetics and Pharmaceutics

DRUGDEX & Lexi-Comp
Package Insert
Goodman & Gilmans: The Pharmacological Basis of Therapeutics
Applied Pharmacokinetics
Basic Clinical Pharmacokinetics
Clinical Pharmacokinetics
Applied Biopharmaceutics and Pharmacokinetics
Handbook of Pharmaceutical Excipients

Pharmacology
Goodman & Gilmans: The Pharmacological Basis of

Therapeutics
Koda-Kimbles Applied Therapeutics: The Clinical Use of
Drugs
DiPiros Pharmacotherapy
Basic and Clinical Pharmacology

You are a pharmacist in the poison center. A frantic

grandmother calls in:

Im watching my granddaughter and I left the room for

2 seconds. When I came back, a bottle of gummy
vitamins was open. I only see 2 on the floor, but there
were 50 in the bottle. I think she ate them. Do I need to
take her to the hospital?

Toxicology and Poisoning

POISINDEX (via Micromedex)
Safety Data Sheets (SDS)
The Basic Science of Poisons
Medical Toxicology
Goldfranks Manual of

Toxicological Emergencies
Lexi-Tox
NLM TOXNET
National Poison Control Center
Indiana Poison Center
1 (800) 222-1222

A 60 year old patient wants to know if he

can receive his flu AND shingles
vaccinations today.

Vaccinations and Immunizations

ImmunoFacts
CDC Vaccines & Immunizations
CDC Travelers Health

Miscellaneous Resources
FDA Orange Book therapeutic equivalence
FDA Purple Book biologics and interchangeable biologic

products
FDA National Drug Code Directory

Writing Resources
Drug Information Handbook
Guide to CVs, Resumes and

Interviewing
American Medical Association

Manual of Style
Online Writing Lab

Pharmacy Law
Guide to Federal Pharmacy Law
Pharmacy Practice and the Law
National Board of Pharmacy
State Contact Information
State and Federal Laws
Indiana
Federal

Review Resources
Comprehensive Pharmacy Review
ASHPs PharmPrep
Appleton & Lange Review of

Pharmacy
APhA Complete Review for
Pharmacy
RxPrep
Memorang

Mobile Health Apps

FDA Guidance
By 2015, ~500 million smartphone users with a health care

application
By 2018, ~1.7 billion smartphone/tablet users will download a
health application
Users: HCPs, patients, consumers

FDA. Mobile Medical Applications. Avalaible at:

http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ConnectedHealth/MobileMedicalApplications/ucm255978.htm. Accessed August 18, 2015.

Mobile Health Applications

Micromedex
LexiComp
UpToDate
STAT! Ref
Epocrates (Rx)
Medscape (from WebMD)
Rx Shortages

Sigler Drug Cards (Lite)

OTC Guide, Dosecast,

iTriage
CDC Vaccine Schedule
Shots
STAT Asthma NHLBI
Guidelines
Google Translate
Medibabble Translator
NLM Mobile

DO NOT reference a mobile health application.

Mobile Health Applications

DO NOT reference a mobile health application.

Questions?