Drug Information Resources

Stepwise approach to find information

1. Tertiary (textbooks, full-text databases, review articles)
General information
2. Secondary (indexing or abstracting services)
3. Primary (clinical studies)
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
Textbooks, 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 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
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. Meylers 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 Meylers
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
(Childrens 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
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. Trissels 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

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 Horns 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 Trissels
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. Trissels 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 Gilmans: 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. Brodys 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 Briggs
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

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. Goldmans 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. Harrisons 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

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
Text and electronic
Tertiary Resources
Therapy Evaluation/Drug of Choice
7. Pharmacotherapy Principles and Practice
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 & Doulls 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. Goldfranks 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. Plumbs Veterinary Drug Handbook
2. Textbook of Veterinary Internal Medicine
3. Compendium of Veterinary Products
4. FDA/CVA Homepage
5. American Veterinary Medical Association, Scientific Reference
Material on Veterinary Compounding
6. Animal Poison Control Center
Tertiary Resources
Veterinary Medicine
7. Veterinary Pharmacology and Therapeutics
8. Small Animal Clinical Pharmacology and Therapeutics
9. The Merck Veterinary Manual
10. Pet Place
11. Pets with Diabetes
12. 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. Use of Boolean operators: AND, OR, NOT
Secondary Literature
Search Strategies
C. Use of limit fields
a. Language, year of publication, type of article or journals
D. Address all possible search phrases (spellings or disease states that changes over
time)
E. Use of filters
a. Content filters - specific to drug or disease state
b. Validity filters - a way to narrow the search to only the highest quality studies (RCT, double-blind)
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
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:
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
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. 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
ii. Expert in the field or persons performing research in the area
iii. Organization affiliated with disease state
iv. Product manufacturer
Understanding where to access information is
only the first step in the provision of quality
drug information.