Transcript Drug Information Resources

Amy Chatfield, MLS
Norris Medical Library
[email protected]
Objectives
Identify preliminary and ultimate questions
 Classify questions to aid retrieval in
information resources
 Differentiate between primary, secondary,
and tertiary resources
 Identify five major resources to answer
questions on drugs
 Identify major resources to locate
guidelines and patient education materials
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Pharmacy and Information
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Information-heavy profession
Information resources available to pharmacy students:
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Textbooks
Reference Books
Journal articles
Databases
Web pages
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Clinical guidelines
Patient information
Government-produced
web pages
Abstracting sources
The Ultimate Question
The actual question
for which you are
seeking an answer
UQ
Scenario
This patient is
taking fosamax
and Tums. Does
that seem curious
or unusual to you?
Your preceptor
Questions!
What is fosamax used for?
 How is fosamax administered?
 Is fosamax a brand name or a generic?
 How is fosamax absorbed by the body?
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What is Tums?
 What chemicals constitute Tums?
 How does Tums work?
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Ultimate question
UQ
Are there known interactions
between alendronate and
calcium carbonate?
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Other questions: preliminary questions which permit us
to create the ultimate question.
You may need to answer multiple preliminary questions
before you can start answering the ultimate questionespecially when new to a profession
Categorizing questions
Adverse effects
Availability
Compatibility/stability
Compounding
Dosing/administration
Drug interaction
Herbal
Identification
Nomenclature
Pharmacokinetics
Pharmacology
Poisoning/toxicology
Pregnancy/lactation
Therapeutic use
Categorizing questions
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What is fosamax
used for?
How is fosamax
administered?
Is fosamax a brand
name or a generic?
How is fosamax
absorbed by the
body?
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Therapeutic Use
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Dosing/administration
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Nomenclature

Pharmacokinetics
Categorizing your questions makes it easier to find
information to answer each question
Three Types of Resources:
Primary
Secondary
Tertiary
Primary Resources

Original research
articles
 Many kinds of study
designs
 Clinical trials
 Cohort studies
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Conference
Papers/Posters
Dissertations
Patents
Advantages of primary
sources:
Current information
May be only source of info on a
new drug
Narrow in scope
Disadvantages of primary
sources:
Limited in scope
Complex, hard to interpret
Secondary Resources
Review articles
 Literature reviews
 Meta-analyses
 Guidelines
 Indexing sources
 Abstracting sources
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Secondary Resources
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Literature Reviews
Advantages:
Many primary resources
consulted to write 1 article
Disadvantages:
Need to examine sources
included closely
Potential for bias in selection
Secondary Resources

Meta-Analyses
Advantages:
Many primary resources
consulted to write 1 article
All relevant studies must be
included
Disadvantages:
Can only be created when a
critical mass of primary
studies are available
Secondary Resources
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Guidelines
Advantages:
Many primary resources
consulted to write 1
guideline
Functionally oriented for clinical
work (bullet points, not
narrative)
Disadvantages:
Can only be created when a
critical mass of primary
studies are available
Secondary Resources
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Indexing sources
 PubMed@USC
 International
Pharmaceutical Abstracts
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Abstracting sources
 FDA’s MedWatch
Advantages:
Indexing sources create
computerized records with
additional information to make
primary sources easier to find
Abstracting services provide upto-date information
Disadvantages:
Need to pay for access (for
most)
Don’t include full-text of the
primary source
Tertiary Resources
Textbooks
 Handbooks
 Drug Compendia
 Reference books
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Hint: Pro pharmacists
consult two or more
tertiary resources to
check their answer!
Advantages of tertiary sources:
Comprehensive information
from a variety of sources
Citations to primary and
secondary sources
Fast, easy to use
Disadvantages of tertiary
sources:
Older, less current
information
Not sure if authors looked at
the “right” sources
Which ones do I use?
Consult in backwards order!
Tertiary
Secondary
Primary
Tertiary resources when:
The answer to a question is basic factual knowledge in the field
The question was studied extensively and a conclusion was made
Many experts have addressed the question and agree on answer
Secondary and primary resources when:
A question is new and has never been studied
There is no consensus among experts; various opinions abound
There is conflicting evidence and the question needs further study
Resource Categories v Question Categories
Many tertiary resources include these categories as chapter
titles or section titles
Secondary sources use these categories when they index
primary sources
Lexi-Comp
Question categories
Adverse effects
Availability
Compatibility/stability
Compounding
Dosing/administration
Drug interaction
Herbal
Identification
Nomenclature
Pharmacokinetics
Pharmacology
Poisoning/toxicology
Pregnancy/lactation
Therapeutic use
Table of Contents
Resource Categories v Question Categories
Many tertiary resources include these categories as chapter
titles or section titles
Secondary sources use these categories when they index
primary sources
Question categories
Adverse effects
Availability
Compatibility/stability
Compounding
Dosing/administration
Drug interaction
Herbal
Identification
Nomenclature
Pharmacokinetics
Pharmacology
Poisoning/toxicology
Pregnancy/lactation
Therapeutic use
Micromedex
PubMed@USC
Tertiary Resources
Epocrates
 Drug Facts & Comparisons
 Lexi-Comp
 Micromedex
 Clinical Pharmacology
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Things to think about when you use tertiary resources:
Availability of the resource
“Extra features” vary
How is it created, who creates it, and how frequently is it
updated?
Student Portal
Links to all resources on pharmacy
student year 1 portal page
 http://norris.usc.libguides.com/pharmyr1
 Drug Information tab
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Drug Facts and Comparisons
Pocket Version
Online is ABRIDGED version of print
 Print copy available in Norris
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How is it created?
-Team of Pharm Ds and MDs
-Monitor primary literature and clinical guidelines
-Updated annually/once a year
-Most frequently used drugs in American hospitals are
included in the online version
Let’s search for Ambien
Drug Facts and Comparisons
Browse by category
 Includes most popular drugs used in US
 Functional, aimed at the practicing clinician
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ePocrates Online Premium
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Two versions available:
 ePocrates Online Premium- via computer
 ePocrates: FREE version to download onto your PDA
 Free version provides less detailed information
How is it created?
- Team of Pharm Ds and MDs
- Monitor primary literature, clinical guidelines,
manufacturer labels, and FDA drug safety alerts
- Updated weekly (more frequently if safety problems
are identified)
Let’s search for Proventil
ePocrates Online Premium
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Browse feature
Includes drugs and herbals
Patient education material, English and
Spanish
Pictures
Downloadable version for PDA
Lexi-Comp
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Includes several sources of drug monographs
How is it created?
-Lexi-Drugs: Two in-house teams: one monitors FDA
drug safety alerts and manufacturer labels, the second
monitors primary literature and guidelines
-All material vetted by editorial team comprised of
Pharm Ds, MDs, PhDs, and DDSs
-Updated weekly (more frequently if safety problems are
identified)
Let’s search for Zoloft
Lexi-Comp
Audio Pronunciation
 Patient education materials
 Pearls and related info section cites guidelines
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Micromedex
FREE version to download to your PDA or mobile device
 Includes PoisonDEX and Clinical Points modules with
additional information
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How is it created?
-“Team of experts” who review primary literature
- Update schedule - ??
Let’s search for Aricept
Micromedex
Patient education materials
 Photos
 Foreign brand names
 Free download onto PDA
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Clinical Pharmacology
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ONLY for School of Pharmacy
How is it created?
- Team of editors, Pharm Ds, and MDs
- Monitor primary literature, clinical guidelines,
textbooks, other tertiary sources, trade magazines from
the pharmacy industry, major abstracting sources.
- Every monograph reviewed annually (at a minimum)
- Includes dates of update in each section
Let’s search for Zyrtec
Clinical Pharmacology
Global trade names
 Chemical structure drawings
 Interactions- sort by severity
 How Supplied– photos, plus full formulation details (active
and inactive ingredients)
 Patient Education- English and Spanish
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Additional features!
Reports- drug interactions, adverse reactions, more
Find/List- by criteria; CAM, investigational monographs;
access MedGuides
Includes monographs on vaccines
Guidelines
Gather primary and secondary literature
Analyze, assess literature
Outline “best practices” for any aspect of
clinical work (diagnosis, prevention,
screening, treatment, etc.)
 Write as steps or bullet points
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Made for all health care professionals
 May need to broaden search: beyond
simply a drug name
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Guidelines
Guidelines are produced by groups of
health care professionals
 Professional organizations, nonprofit
organizations, government groups:
coordinate the writing of guidelines
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Guidelines
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Guidelines can be referenced in drug monographs
Centers for Disease Control and Prevention (CDC)
American Pharmacists’ Association
Pharmacists’ Letter
National Guidelines Clearinghouse: Guideline.gov (part of
AHRQ)
EpSS- Electronic Preventive Services Selector (AHRQcreated)
Takeaways
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The Big Picture:
 USC subscribes to a variety of information
resources to help you answer questions
about drugs and pharmacy practices
 Basics today:
○ Identify preliminary and ultimate questions
○ Classify questions to make retrieval easier
○ Using tertiary resources to answer questions
Takeaways
All the tertiary resources we used today
are linked on your Blackboard site and
on the Year 1 Pharmacy student portal
 You will have assignments that require
you to use and cite information
resources
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 Wikipedia
 Free websites found through Google
Questions? Contact us!

Contact Norris Library reference service
 [email protected]
 323- 442-1111 (M-F, 9-5)

Contact Amy Chatfield, pharmacy liaison
librarian
 [email protected]
 323-442-1128