UF Health: Drug Information

Accessing UF Health Science Center Library Resources

• Access the UF Health Science Center Libraries through library.health.ufl.edu; bookmark this page for easy access.
• Offsite access requires either a Virtual Private Network (VPN) for longer searches or the UF Proxy Server for quick searches.
• Drug information includes facts or advice on drugs with medicinal, performance-enhancing, or intoxicating effects, specific to patients or groups.
• Drug information can be patient-specific, academic, or population-based.

Sources of Drug Information: Tertiary Sources

• Tertiary sources summarize primary literature and are the starting point for standard of care drug information.
• Use tertiary sources for general product information, adverse effects, compounding, formulations, drug interactions, toxicology, and dosing.
• Online databases like Micromedex, Clinical Pharmacology, and Lexicomp are recommended over print sources due to the currency of information.
• Micromedex is accessible via the library website under "Databases".
• Micromedex offers drug interaction information, IV compatibility, drug identification, comparison, and toxicology data.
• Information in Micromedex includes drug class, dosing, safety, mechanism of action, pharmacokinetics, and patient education.
• Off-label dosing information in Micromedex is supported by evidence from primary literature sources.

Sources of Drug Information: Secondary Sources

• Secondary sources index primary literature and guide users to relevant primary resources.
• Searching multiple databases is important; each database offers unique content.
• Successful database searching requires understanding the database's controlled vocabulary, subject headings, scope, and content.
• PubMed and Embase are biomedical literature databases; Embase contains more international journals and specialized drug searching tools.
• PubMed uses MeSH (Medical Subject Headings) and pharmacological actions as controlled vocabulary. Embase uses Emtree terms.
• International Pharmaceutical Abstracts and Web of Science contain conference abstracts and proceedings, useful for new topics.
• Cochrane Library is recommended for controlled trials and is considered the gold standard for systematic reviews.

Sources of Drug Information: Primary Sources

• Primary sources include published and unpublished clinical research studies and reports.
• Primary source publications include controlled trials, cohort studies, case series, and case reports.
• Controlled clinical trials in primary literature provide documentation for therapy use and serve as a foundation for clinical practice.
• Primary sources provide the most recent research and detailed study information, allowing assessment of validity and applicability.
• Avoid making practice changes based on a single controlled trial; evaluate multiple trials.
• Searching through secondary sources is the main way to locate primary sources.

Systematically Approaching Drug Information Questions

• Step 1: Identify who is asking the question (patient, healthcare provider) to tailor the response's perspective and language, considering health literacy.
• Step 2: Define the true question by asking follow-up questions to understand the information need and its intended use.
• Step 3: Obtain complete background information, including patient details and the purpose of the question.
• Step 4: Categorize the question by type (patient-specific, dosage, drug interaction) to tailor the search strategy.
• Step 5: Perform a systematic search of tertiary, secondary, and primary sources.
• Step 6: Analyze the information for relevance and validity.
• Step 7: Disseminate the information by providing a tailored response (oral or written), including supporting documentation.
• Step 8: Document the request, resources used, and information found.
• Step 9: Follow up to assess the information's utility and impact on medication use or patient outcomes.

Performing an Effective Literature Search

• Step 1: Focus the research question to be specific.
• Step 2: Develop search concepts using the PICO format (Patient/Problem/Population, Intervention, Comparison, Outcome). Not all PICO components may be needed.
• Step 3: Select databases based on the information needed.
• Recommended core databases are PubMed, Embase, and Web of Science.
• If clinical trials are not of interest, avoid Cochrane.
• Step 4: Find search terms using a combination of controlled vocabulary and relevant synonyms; do not rely solely on keywords or controlled vocabulary.
• Step 5: Develop a search strategy using Boolean operators ("and," "or," "not"), phrase searching with quotes, truncation, controlled vocabulary, and field codes.
• Step 6: Search the databases using MeSH terms, keywords, parenthesis for phrase searching, and field codes in PubMed.
• Step 7: Evaluate the results through a circle of revising the search, adding/removing concepts, and applying filters.
• A search that is too narrow requires broadening the categories. A search that is too broad requires adding additional concepts and referring to PICO.
• Insufficient results may require "or-ing" intervention and comparison concepts.
• Step 8: Save results using a citation manager and save search strategies in a Word document.

Evaluating and Analyzing Search Results

• Do not judge an article solely by its title; read the abstract to ascertain relevance.
• Look for structured abstracts that include context, purpose, study design, process, results, and conclusion.
• A good methods section provides a clear description of the research, details about subjects, interventions, control group, blinding, data collection, and analysis.
• Assess the quality by checking for a clear research description, justification for the design, description of study limits, clear measurement of outcomes, and stated statistical methods.
• More detail in the methods section indicates better quality and reproducibility.