Clinical Drug Information

Julie Whelan Fall 2007

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.

Name Game

One Drug
51146-56-6 Deltaran, Dolomin, Amersol, Menadol RD-13621, U-18573 2-(4-Isobutylphenyl)propionic acid C13H18O2 Anti-inflammatory NSAID ibuprofen

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.

Sources for Names

Brand names
Micromedex, formulary, PDR, Clinical Pharmacology, USPDI, Mosbys 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, Mosbys Foreign Names- Martindales (Mmdx), EMBASE, Index Nominum Laboratory names,Investigational #-USAN dictionary, PubMed/EMBASE, Merck Index

Tour of Major Resources

Micromedex AHFS Clinical Pharmacology Dynamed

Non-subscription Resources
LactMed http://toxnet.nlm.nih.gov/cgibin/sis/htmlgen?LACT MassMedline http://www.massmedline.com Needy Meds http://www.needymeds.com

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

PDA- Quick References

Available to you
ePocrates Pro - HMS Mobile Micromedex HMS LexiDrugs- Partners CPOnHand- HMS

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

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

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